A phone call in Novem­ber 1994, three days before his wed­ding, ask­ing Army Reserve Nurs­ing Offi­cer David Innes to join a mis­sion in Rwan­da was a once-in-a-life­time oppor­tu­ni­ty. Or so he and his wife-to-be thought.

So, six weeks after get­ting mar­ried, David left for a nine-month deploy­ment with Australia’s mil­i­tary con­tri­bu­tion to the UN Assis­tance Mis­sion on Oper­a­tion TAMAR. 

It was the tail end of geno­cide and civ­il war in Rwan­da and the coun­try was in des­per­ate need – its infra­struc­ture destroyed, its peo­ple dis­placed, and thou­sands of orphans left in the wake of the geno­cide.

David, a Major in the Aus­tralian Army, has since served over­seas in places like Tim­or Leste, Solomon Islands, Ban­da Aceh and Iraq. With­in Aus­tralia, his deploy­ments to remote com­mu­ni­ties in the North­ern Ter­ri­to­ry have includ­ed Kather­ine and Tiwi Islands, and the Vic­to­ri­an bush­fires.

Remote nurs­ing, David observes, mir­rors many aspects of his stints as a mil­i­tary nurse. Whether serv­ing in Rwan­da, Aceh after the tsuna­mi, or remote Aus­tralia, he found him­self in sit­u­a­tions where resources were scarce, infra­struc­ture was min­i­mal, team­work was essen­tial and self-suf­fi­cien­cy was key.

​“For remote nurs­es, I have seen how dif­fi­cult their con­di­tions are,” he says. ​“It is hot, they are in the mid­dle of nowhere, they face the unex­pect­ed and they deal with it,” he says.

​“It attracts a par­tic­u­lar type of per­son and I hold them in high regard.”

David’s nurs­ing career began in 1984 in Mel­bourne before he moved to South Aus­tralia for post­grad­u­ate stud­ies. There, a friend intro­duced him to the Army Reserve.
​“I loved the Army Reserve, learn­ing about field med­i­cine,” he says.

“As a nurse, you bring your med­ical skills and exper­tise to the sit­u­a­tion, while the Defence expe­ri­ence teach­es you about lead­er­ship, team work and resilience. Win – win.”

David sees five key val­ues shared between Defence and remote nurs­ing: striv­ing for excel­lence, ser­vice, respect, courage and integrity.

“Whether in a com­bat zone or an iso­lat­ed clin­ic, nurs­es strive to deliv­er the high­est lev­el of care. In remote set­tings, they must be resource­ful and adapt­able, often act­ing as the sole clin­i­cian on-site,” says David.

“Work­ing alone in a remote com­mu­ni­ty requires the same resilience as being deployed in an aus­tere environment.

“Nurs­es must make crit­i­cal time-sen­si­tive deci­sions with lim­it­ed back­up, often rely­ing on a sin­gle line of com­mu­ni­ca­tion for support.

“And, in extreme sit­u­a­tions, integri­ty is cru­cial. Whether treat­ing a crit­i­cal­ly ill patient in an ambu­lance or man­ag­ing a pub­lic health cri­sis in an iso­lat­ed com­mu­ni­ty, nurs­es must rely on their train­ing, expe­ri­ence, and eth­i­cal judgment.”

Since Rwan­da, David has bal­anced his mil­i­tary career, nurs­ing and his work with Ambu­lance Vic­to­ria, where he con­tin­ues to work as a Mobile Inten­sive Care Ambu­lance (MICA) paramedic.

These peo­ple are high­ly trained med­ical pro­fes­sion­als who can per­form advanced med­ical pro­ce­dures, work­ing in ambu­lances to pro­vide hos­pi­tal-lev­el care to patients in their homes, work­places, and on the streets.

“I have seen first­hand the ben­e­fits of the Army Reserve to both Defence and civil­ian med­i­cine,” says David.

“Defence med­ical per­son­nel, from ICU nurs­es to car­dio­tho­racic sur­geons, refine their skills in high-stakes envi­ron­ments,” he says, ​“tak­ing that exper­tise back to their civil­ian jobs. Like­wise, the mil­i­tary ben­e­fits from the advanced clin­i­cal skills and inno­va­tion devel­oped in hos­pi­tals. It’s a mutu­al­ly ben­e­fi­cial rela­tion­ship that enhances the qual­i­ty of care in both domains.”

Self-suf­fi­cien­cy is a key attribute shared by mil­i­tary med­ical per­son­nel and remote nurs­es, says David.

“The abil­i­ty to prob­lem-solve under pres­sure, adapt quick­ly, and remain calm in adver­si­ty is what makes both mil­i­tary med­ical per­son­nel and remote nurs­es high­ly capa­ble professionals.”

David believes that nurs­ing – whether in a war­zone, an out­back clin­ic, or a met­ro­pol­i­tan hos­pi­tal – demands a com­mit­ment to ser­vice. The Roy­al Aus­tralian Army Nurs­ing Corps mot­to, For Human­i­ty, encap­su­lates the self­less­ness required in both mil­i­tary and remote health care, he says.

Life con­tin­ues to be full of action for David. This inter­view was the morn­ing after a 16-hour shift treat­ing a crit­i­cal­ly unwell patient who need­ed to be accom­pa­nied to hos­pi­tal an hour away.
​“It hap­pened at the end of my shift – but you can’t just down tools,” he says. ​“It’s not that uncom­mon. It’s the nature of the job.”

His final com­ment: ​“You are always capa­ble of so much more. You think you have reached the lim­it of what you are capa­ble of. You always have more to give. Nurs­es are bril­liant at that. They face chal­lenges, learn lessons and apply them. You end up with this amaz­ing abil­i­ty to meet chal­lenges and work your way through them.”