Sit­ting in his car at the traf­fic lights in leafy sub­ur­ban Can­ber­ra in 2019, Greg Mor­ley had an epiphany.

“I’d always want­ed to go back [to remote health care] when I no longer had as many fam­i­ly respon­si­bil­i­ties, and had always thought I would, but I had moved into a senior posi­tion in the hos­pi­tal sys­tem and there was always a rea­son to stay,” Greg says.

“But at the lights I thought, if I don’t do this now, I’m nev­er going to do it. And as I took off, I just made the deci­sion. I’m going back.”

This time, he had expe­ri­ence behind him. But would the life lessons from 30 years ago still apply in the 2020s?

To answer that ques­tion, we have to wind back the clock to 1986.

Cul­ture shock

Greg had been work­ing in a busy inner Syd­ney Emer­gency Depart­ment but, look­ing for a change, he’d just moved to Adelaide.

Despite his inten­tion to rest and relax, his friends soon pre­vailed upon him to join an agency, so he could pick up a few ED shifts a week.

The agency asked him whether he’d mind work­ing in the coun­try and/​or in an Abo­rig­i­nal com­mu­ni­ty. To both ques­tions, Greg answered: ​“Why not?” This response sealed his remote nurs­ing future. He left the agency with an overnight bus tick­et for the fol­low­ing Fri­day night – but lit­tle to no infor­ma­tion about where he was going.

​“I thought, gee, I bet­ter find out about mon­ey,” Greg recalls. ​“I went to Com­mon­wealth Bank – hav­ing been told they have branch­es every­where. I asked and they told me ​‘Oh, we have branch­es every­where, mate.’ But when they opened their branch book, they said – ​‘oh, not there’. I began to won­der, where am I head­ed exact­ly?”

This was the first step in Greg’s grad­ual awak­en­ing to the new life he had court­ed. Armed with a cheque account, he made the bus trip, was ​“giv­en the keys” to the clin­ic, and immersed in an unfa­mil­iar cul­ture and clin­i­cal set­ting.

​“I was stag­gered,” Greg recalls, ​“No one told me about this. My whole per­cep­tion of Abo­rig­i­nal peo­ple was based on what I’d heard in NSW, dys­func­tion­al inte­gra­tion into white soci­ety – but here was a whole town that didn’t care about white fel­las and didn’t speak Eng­lish. Euro­pean Aus­tralians were in many ways irrel­e­vant beyond the social pathol­o­gy they’d caused and inno­cent­ly, and some­times not so inno­cent­ly, perpetuated.”

He says that his whole approach was chal­lenged. In Syd­ney, health issues had typ­i­cal­ly rep­re­sent­ed indi­vid­ual pathol­o­gy, but here Greg encoun­tered sys­temic health issues result­ing from dis­ad­van­tage at a social lev­el. And it was no longer the case that you put peo­ple in the sys­tem and away they went. Greg was sud­den­ly more involved across the tra­jec­to­ry of care.

After two months, he head­ed back to Ade­laide exhaust­ed. But the next call from the agency was not far away. When it came, Greg again answered – ​“Why not?”

Reverse cul­ture shock

Greg was to spend the next sev­en years in Cen­tral Aus­tralia before mov­ing to Can­ber­ra because of his partner’s job. His return to the burbs brought with it many com­forts – such as the pres­ence of green lawn – along with many challenges.

“Many of the drugs used had changed, the process­es had changed, and the cul­tures are very dif­fer­ent. It was a tough cou­ple of months to be a hos­pi­tal RN again.”

“Dur­ing my time away, I had grown con­sid­er­ably. The peo­ple I had pre­vi­ous­ly known in Syd­ney had not had those same expe­ri­ences. That in itself cre­ates distance.

“The harsh real­i­ties of colo­nial Aus­tralia are a no-go in mid­dle class Euro­pean Aus­tralian soci­ety. Even with peo­ple with the same polit­i­cal views, you can’t real­ly com­mu­ni­cate the real­i­ties of life in remote colo­nial Australia.”

Cul­tur­al dif­fer­ences can be a read­just­ment issue also. Back then, when work­ing in Abo­rig­i­nal com­mu­ni­ties, Greg had found that in response to ques­tions, peo­ple either told the truth or didn’t speak (when their answer would be wor­ry­ing or offen­sive). Back in the sub­urbs, the abil­i­ty to lie com­pe­tent­ly was an entrenched cul­tur­al val­ue, as was play­ing along with the lies you were told.

“But these feel­ings don’t last long, just a cou­ple of months as you rein­te­grate,” Greg says. ​“Then you car­ry on.”

Return­ing to remote Australia

So, was Greg’s return to remote health care any eas­i­er than his first for­ay back in the 1980s?

“It’s dif­fer­ent this time,” Greg con­firms. ​“I’m old­er and wis­er now. I know what to expect.”

“It was grat­i­fy­ing to come back in 2020 and find that a lot of CRANA’s aspi­ra­tions had been realised. The 24-hour Bush Sup­port Line, the man­u­als and their legit­imi­sa­tion in leg­is­la­tion, Gayle’s Law.

“These were all things that had not been there dur­ing my time as a prac­tis­ing remote area nurse, but which were now insti­tu­tion­alised – to a large extent because of the efforts of CRANA.”

Greg has kept up his involve­ment with CRANAplus since his return and now sits on the Nurs­ing and Mid­wifery Round­table, which allows him to direct­ly report to CRANAplus on the expe­ri­ences of the workforce.

He says that clin­i­cal infra­struc­ture and sup­port have improved, TV and mobile phones have led to cul­tur­al change, but that dis­ad­van­tage and a sense of polit­i­cal despon­den­cy have endured.

He speaks high­ly of his expe­ri­ences with Remote Area Health Corps with whom he became accred­it­ed and gained his recent place­ments. He also high­ly rec­om­mends the Tran­si­tion to Remote Area Nurs­ing Pro­gram through the Cen­tre of Remote Health.

All the same, accord­ing to Greg, for many remote area nurs­es some issues remain unresolved.

For exam­ple, return­ing home to Can­ber­ra recent­ly after a long stint work­ing remote, Greg mused, “[When work­ing in a remote set­ting], doing dra­mat­ic, respon­si­ble things just becomes part and par­cel of your every­day life.

“You are lead­ing this hyper-vig­i­lant, respon­si­ble life, and then you get on a plane and eight hours lat­er you’re in leafy sub­ur­ban Can­ber­ra and you don’t have any respon­si­bil­i­ties, noth­ing dra­mat­ic happens.”

On the whole though, reflect­ing on a remote area nurs­ing career that has seen him work in Yala­ta, Pukat­ja, Alice Springs, Galiwin’ku, Arey­on­ga, Yuen­du­mu and now Hermannsburg/​Ntaria, Greg says: ​“It’s just a won­der­ful life.”

“You get to work with large­ly pleas­ant peo­ple in a fas­ci­nat­ing set­ting that has cross-cul­tur­al advan­tages and brings you into touch with broad­er world­views. Why don’t more peo­ple do this?”