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Returning to remote area nursing after time away

8 Apr 2024

Greg Morley launched his remote nursing career in the 1980s, before returning to the city and building a life there for more than 25 years. But his love of remote area nursing never left him and in 2019, he decided to venture back. This time, he was able to apply the learnings from his initial foray into remote Australia and his equally jarring return to suburbia.

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?”

Is your career in a peri­od of tran­si­tion? You may also be inter­est­ed in these arti­cles on retir­ing from remote area nurs­ing, reverse cul­ture shock, and tran­si­tion­ing to remote health lat­er in life.