Q&A with Nurse Practitioner Tom Rampal

26 Aug 2024

Katherine-based NP Tom Rampal talks balancing personal and professional lives, becoming a nurse practitioner, and the ins and outs of chronic disease management.

Your career has spanned both urban and remote loca­tions. Did you start off in the city and move remote? What drew you to work in Australia’s remote areas?

I lived and worked in Mel­bourne for many years, in a busy met­ro­pol­i­tan hos­pi­tal before tran­si­tion­ing into remote health. I’ve been lucky enough to trav­el and work in some amaz­ing loca­tions wide­spread across North­ern Aus­tralia and internationally. 

I think the work drew me in ini­tial­ly because it’s unique, chal­leng­ing and inter­est­ing. I also have loved get­ting out and see­ing some stun­ning and remote parts of Australia.

How have you bal­anced your per­son­al and pro­fes­sion­al lives while gain­ing your NP endorse­ment and in your years as a locum? From what I under­stand you com­plet­ed your NP qual­i­fi­ca­tions while on Groote Eylandt – any advice to peo­ple who are pur­su­ing addi­tion­al qual­i­fi­ca­tions while working?

Becom­ing a Nurse Prac­ti­tion­er requires plan­ning and com­mit­ment but the pay­off is worth it, with many excit­ing career oppor­tu­ni­ties. I moved to Groote Eylandt for a few years to com­plete my Nurse Prac­ti­tion­er stud­ies and meet the cri­te­ria for endorse­ment as a Nurse Practitioner.

Bal­anc­ing per­son­al life on Groote Eylandt was easy – I invest­ed in a 4wd and a small boat so time out­side of work (and study) includ­ed camp­ing, boat­ing and fish­ing. Groote Eylandt is the crème de la crème of liv­ing in remote loca­tions – it’s absolute paradise!

My years work­ing as a locum required bal­anc­ing per­son­al and pro­fes­sion­al life. This can be tricky. I think it’s impor­tant to find a healthy bal­ance of time away on a con­tract ver­sus time at home con­nect­ing with friends and family.

Was it always your goal to be an NP? When did you first set this goal and what inspired you to pur­sue it?

I became a Nurse Prac­ti­tion­er to expand my knowl­edge, skills and scope of prac­tice with the aim of con­tribut­ing to improved access to health­care for patients, par­tic­u­lar­ly in a remote set­ting. I first set the goal for myself about five years before I was accept­ed into the course. This gave me plen­ty of time to pre­pare, com­plete rel­e­vant stud­ies, upskill and find
a suit­able workplace.

What does your cur­rent role entail? What does the aver­age day’ look like, if there is such a thing? Paint us a picture!

In my cur­rent role, I work for NT Health in the Big Rivers Region. I live in Kather­ine and ser­vice the Num­bul­war Pri­ma­ry Health Care Cen­tre which is sit­u­at­ed in the Gulf of Car­pen­taria
in the North­ern Ter­ri­to­ry. An aver­age day includes direct client care in chron­ic con­di­tions man­age­ment, com­plet­ing com­pre­hen­sive assess­ments, review­ing man­age­ment plans, pre­scrib­ing med­ica­tions, order­ing tests and under­tak­ing inves­ti­ga­tions. I also refer on to spe­cial­ists and pro­vide patient health education.

My spe­cial­ty is focused in pri­ma­ry health care and chron­ic and com­plex case management.

I do how­ev­er see clients for acute and emer­gency pre­sen­ta­tions and sup­port the team in those sit­u­a­tions as well. Whilst work­ing inde­pen­dent­ly, a big part of my role is to col­lab­o­rate with the entire health­care team includ­ing GPs, Remote Area Nurs­es, Abo­rig­i­nal Health Prac­ti­tion­ers, Spe­cial­ists and Allied Health staff.

All health pro­fes­sion­als can refer clients who are not meet­ing tar­gets in care or man­age­ment plans to the Nurse Prac­ti­tion­er. How­ev­er, refer­rals aren’t always required as I will also see any client who walks in on the day.

Day to day, my work can vary depend­ing on the staff avail­able, unfore­seen events such as cul­tur­al cer­e­monies or emer­gen­cies – we have def­i­nite­ly had cyclones trav­el­ling towards the com­mu­ni­ty. Things can change dra­mat­i­cal­ly from one day to the next which keeps life interesting.

What aspects of your job bring you the most pro­fes­sion­al sat­is­fac­tion?

I enjoy work­ing in a diverse envi­ron­ment, build­ing rela­tion­ships with clients and see­ing improve­ments in chron­ic dis­ease man­age­ment and in turn pos­i­tive patient out­comes. Hav­ing a yarn’ with clients can be spe­cial – hear­ing people’s sto­ries and learn­ing about their rich cul­tures and tra­di­tions.

Can you elab­o­rate on the chron­ic dis­ease man­age­ment aspect of your role? Do you work with spe­cial­ists close­ly?


Chron­ic and com­plex case man­age­ment involves direct client care in pop­u­la­tion groups with chron­ic or com­plex ill­ness includ­ing dia­betes, Chron­ic Kid­ney Dis­ease, car­diac con­di­tions and res­pi­ra­to­ry con­di­tions. I feel strong­ly about cre­at­ing a whole team approach to care, to achieve good holis­tic pri­ma­ry health care in the community.

I work close­ly with spe­cial­ists – this can be both planned tele­health con­sults, case con­fer­enc­ing or ad hoc reviews. These reviews occur most­ly with an Endocri­nol­o­gist, Gen­er­al Physi­cian and a Renal Physi­cian based in Mel­bourne.

Many aspects of your role (e.g. out­reach, chron­ic dis­ease man­age­ment) help peo­ple to receive care where they live and lim­it evacuation/​hospitalisations. The ben­e­fits are obvi­ous,
but we’d love to hear your per­spec­tive on the impor­tance of these out­comes.

Nurse Prac­ti­tion­ers (as well as the whole health­care team) boost health­care avail­abil­i­ty and ser­vice deliv­ery in region­al and remote areas, help­ing to improve access to health patient-cen­tred care and chron­ic dis­ease man­age­ment as close to home as pos­si­ble.

Good chron­ic dis­ease man­age­ment helps reduce some patient evac­u­a­tions and hos­pi­tal­i­sa­tions as we are able to treat and care for our clients in com­mu­ni­ty. Col­lab­o­ra­tion with the entire health­care team is cru­cial for holis­tic patient care. I see Nurse Prac­ti­tion­ers as part of the solu­tion to improv­ing health out­comes. There is plen­ty of work for all health­care pro­fes­sion­als and we need the right skilled peo­ple on the ground to pro­vide evi­dence-based, cul­tur­al­ly safe care.

Have your burn­ing ques­tions answered in these addi­tion­al Q&As on remote safe­ty and becom­ing a nurse edu­ca­tor.