“One-on-one nurs­ing in these remote clin­ics can bring this qual­i­ty to the fore, a cru­cial skill to help patients ​‘own their own health’,” she says.

“When it hap­pens, the results are bril­liant,” says Helen, a Reg­is­tered Nurse and Mid­wife who has worked exten­sive­ly in remote areas, par­tic­u­lar­ly in the Tor­res Strait.

“But it requires the right atti­tude: one of respect for the patient; and team­work with both the local health work­ers and the doc­tor on the end of the phone.”

This one-on-one care is where Helen believes remote small clin­ics have a chance to give more per­son­alised care than clin­ics and hos­pi­tals in the big towns and cities, where patients may see a whole stream of dif­fer­ent health professionals.

“You want the best for each of your patients, you want them to fol­low through with your advice, care for their own health, and you are con­nect­ed and com­mit­ted to the outcomes.”

Helen is keen to pass on knowl­edge from her work­ing life ​“to talk about what has worked for me to allow oth­ers the oppor­tu­ni­ty to approach remote nurs­ing in the same way”.

Ear­ly in her nurs­ing career, Helen under­took oph­thalmic train­ing in Lon­don, spent two years in Jamaica as an oph­thalmic nurse, and lat­er vol­un­teered as one of two oph­thalmic nurs­es doing pre and post surgery work aboard Mer­cy Ships in Benin, West Africa.

Helen has worked in out­back hos­pi­tals in Queens­land and in remote pri­ma­ry health­care clin­ics through­out the country.

Her intro­duc­tion to Tor­res Strait Island nurs­ing began in 2008 when she was invit­ed to work there by the Queens­land Hos­pi­tal hub for rur­al and iso­lat­ed nurs­ing relief.

Since 2013 until her retire­ment, Helen was an agency nurse, replac­ing staff on leave or fill­ing in until a vacant posi­tion was filled, work­ing on every inhab­it­ed Tor­res Island many times over.

“To be tru­ly com­pe­tent, atti­tude is the No.1 thing,” Helen says. ​“One prob­lem is if a nurse arrives and takes every­thing away from the local health work­ers, not liais­ing with the staff that is there. Anoth­er is com­ing just for the money.“

If you are in a clin­ic as the sole nurse or in a two-nurse clin­ic, you always have a doc­tor on the end of the phone and local Islander or Abo­rig­i­nal health work­ers on hand.

“It’s impor­tant you liaise with the doc­tor: they rely on us to do the best job we can and we rely on them. And you have to work as part of the team with the local health work­ers, help­ing facil­i­tate their skills devel­op­ment, show­ing them per­haps how to do some­thing, and lis­ten­ing to them. They taught me so much in return with their local exper­tise. They know the lan­guage, the cul­ture and their own com­mu­ni­ty and they are cru­cial in help­ing pre­vent health issues arising.

Helen gives a detailed exam­ple of the approach she uses, empha­sis­ing that she is just ​‘one small cog in the wheel’. Here’s her story:

A patient came to me at the clin­ic, com­plain­ing of sores that would not heal. I gave him a fin­ger prick. He was dia­bet­ic Type 2, was not tak­ing his med­i­cine and his blood sug­ar lev­els were sky high.

I sat along­side him, tak­ing notes, at that stage not turn­ing my back to type into the com­put­er.

I opened the Pri­ma­ry Clin­i­cal Care Man­u­al, which is updat­ed every two years, and showed him the page relat­ing to his sit­u­a­tion, so he knew

I wasn’t just talk­ing off the top of my head, I was using a rep­utable source. I first used this man­u­al for my spe­cial­ist train­ing back in 2005 when I trained as a Rur­al and Iso­lat­ed Prac­tice Endorsed Reg­is­tered Nurse.

I then told him I was going to type up my notes and asked him to check with me that I had put every­thing down that we had spo­ken about. This not only helped him main­tain input and con­trol of his sit­u­a­tion, it was good for me too, to make sure I was cov­er­ing every detail.

I phoned the doc­tor at Thurs­day Island Hos­pi­tal, giv­ing him all the details and he was then able to access the patient’s his­to­ry and my notes from this vis­it. He told me to tell the patient that if he didn’t get those lev­els down he was short­en­ing his life expectan­cy.

That’s what I did and the patient and I spoke about what he would have to do.

He came back the next day and said – I’ll do it. He had tak­en every­thing on board about look­ing after his own health, eat­ing healthy food and exer­cise.

Then we had a three-way phone call with the doc­tor. Once again, the patient was involved. It wasn’t just a white nurse telling him what to do.

I can say, every time, the con­se­quences were bril­liant. In this case, I was away from the island for a few days and when I returned, there he was, walk­ing up and down the airstrip.

I lat­er met him car­ry­ing shop­ping bags filled with tinned fruit and veg­eta­bles – it’s not easy to get fresh on the islands.

I told him he was a great role mod­el and, in the days that fol­lowed, a num­ber of men came to see me, talk­ing about their issues. It was like rip­ples in a pond. They saw he had a lot more ener­gy, and they want­ed that too.

“Of course I miss nurs­ing, says Helen who retired last year. ​“But I recog­nised the time to call it quits at 74 years of age. I always enjoyed what I did and I guess my ener­gy came from the enjoyment.

“It was a ter­rif­ic job. Not always easy, I can say. There were many instances where I had to sta­bilise patients who were extreme­ly ill wait­ing for medi­vac, for exam­ple. It is always one step at a time. But it is so fulfilling.”