Going Remote: The Essentials

Pro­fes­sion­al Preparation

In the remote set­ting, effec­tive, safe, and qual­i­ty care requires an under­stand­ing of the unique needs of the com­mu­ni­ty with­in its cul­tur­al con­text. There­fore, your pro­fes­sion­al role and respon­si­bil­i­ties and scope of prac­tice will dif­fer, influ­enced by the needs of the com­mu­ni­ty and health service’s loca­tion.

In remote and iso­lat­ed areas, nurs­es, mid­wives and Abo­rig­i­nal and Tor­res Strait Islander Health Prac­ti­tion­ers and Work­ers deliv­er most of the front­line health care. Pro­fes­sion­al prac­tice in this con­text requires gen­er­al­ist clin­i­cal exper­tise, inte­grat­ing a com­pre­hen­sive pri­ma­ry health­care approach, inclu­sive of acute and emer­gency care, chron­ic dis­ease, and pub­lic health, across the life span.

When prepar­ing to prac­tise in a remote set­ting for the first time you can and should do some research on the con­text and health needs of the com­mu­ni­ty. Con­tact­ing your poten­tial employ­er or health ser­vice staff can be one great way to help under­stand your role. You may be able to ask some­one who has worked in the com­mu­ni­ty for infor­ma­tion and you can often gath­er ser­vice and demo­graph­ic detail online.

Ques­tions to ask include the following:

• What ser­vices are avail­able at the health service/​clinic? e.g., phys­io­ther­a­py, men­tal health, pre- or post­na­tal care, emer­gency care, immunisation.
• What are the health pri­or­i­ties in the community?
• What is the com­po­si­tion of the local clin­i­cal health team? Become famil­iar with the role of Abo­rig­i­nal and Tor­res Strait Islander Health Prac­ti­tion­ers & Workers.
• What knowl­edge, skills and expe­ri­ence do I need to work in this com­mu­ni­ty (includ­ing capac­i­ty to dri­ve a 4WD/​manual ambu­lance if needed)?
• How do I go about fill­ing skill, knowl­edge or expe­ri­ence gaps and updat­ing my skills and edu­ca­tion? Are there a pre­ferred cours­es or programs?
• What sup­ports are avail­able for me with­in the community?
• What are the ​‘on-call’ and ​‘after-hours’ requirements?
• What are the health service’s safe­ty and secu­ri­ty poli­cies, par­tic­u­lar­ly around work­ing alone?
• What is the avail­abil­i­ty and nature of accommodation?
• Will I have inter­net access and what is access like?
• Can I take my part­ner, chil­dren or pets? Capac­i­ty of accom­mo­da­tion, school­ing, and resources for ani­mals may mean this is not possible.

Get to know your com­mu­ni­ty and your environment

Cul­tur­al­ly Safe Practice

Gain­ing a sol­id under­stand­ing and appre­ci­a­tion of a spe­cif­ic remote com­mu­ni­ty con­text takes a long time. It is both essen­tial and respect­ful to approach the cul­tur­al con­text of the com­mu­ni­ty with humil­i­ty. Build­ing good rela­tion­ships requires lis­ten­ing and waiting.

• Find out about the demo­graph­ics of the local com­mu­ni­ty and sur­round­ing area. This should include a his­to­ry of the com­mu­ni­ty (impor­tant in terms of the impact of coloni­sa­tion, the forced removal of gen­er­a­tions of Abo­rig­i­nal and Tor­res Strait Islander chil­dren and asso­ci­at­ed inter­gen­er­a­tional trauma).
• Ask oth­ers ​‘What do I need to know about this com­mu­ni­ty?’ and seek to under­stand what cul­tur­al infor­ma­tion will help you to prac­tise and live respect­ful­ly when work­ing in this community.
• Ask to be pro­vid­ed with a cul­tur­al ori­en­ta­tion to the community.
• Ask to be intro­duced to com­mu­ni­ty lead­ers and peo­ple of importance.
• Is the com­mu­ni­ty dry (no alco­hol)? You will need to meet the expec­ta­tions of the community.
• Seek to devel­op an aware­ness of, and respect for, cul­tur­al places and practices.

CRANAplus strong­ly rec­om­mends that nurs­es and mid­wives ade­quate­ly pre­pare them­selves for Cul­tur­al­ly Safe prac­tice. Such prepa­ra­tion can include the CATSI­NaM train­ing pack­age Mur­ra Mul­lan­gari or CRANAplus’
Intro­duc­tion to Cul­tur­al­ly Safe and Inclu­sive Prac­tice mod­ule.

The envi­ron­ment

Remote Aus­tralia is envi­ron­men­tal­ly diverse. It comes with beau­ti­ful loca­tions to see and expe­ri­ence, along with chal­lenges and risks to be pre­pared for. Con­sid­er the following:

• What is the year­ly weath­er cycle and what resources are there to man­age the cli­mate such as air con­di­tion­ing, par­tic­u­lar­ly in accom­mo­da­tion? Con­sid­er wet/​dry sea­sons, fires, iso­la­tion and inter­mit­tent road access, heat and cold, and more.
• Be aware of cli­mate safe­ty prac­tices applic­a­ble in your com­mu­ni­ty. Car­ry water when trav­el­ling, pro­tec­tive cloth­ing and footwear, and have fire pro­tec­tion strate­gies in place.
• What oth­er ser­vices exist besides health ser­vices, e.g., police, ser­vice sta­tion, fuel access and type, school, recre­ation cen­tre, and landline/​satellite mobile/​internet access?
• The range and scope of food avail­able in remote com­mu­ni­ties is lim­it­ed com­pared to urban cen­tres. If you have dietary require­ments or pref­er­ences, you may need to con­firm these can be met. Be aware you will pay more than you are accus­tomed to and there is often a lim­it­ed range of goods.
• Is there com­mu­ni­ty access by road/​air? If you arrive by air, is there access to trans­port for you while you are in the com­mu­ni­ty? If you are arriv­ing by car what is the state of the roads and is your car suit­able? You may be required to under­take 4WD and two-way radio train­ing cours­es pri­or to com­menc­ing employ­ment or once employed.
• There is often less pri­va­cy in shared accommodation.

Con­tin­u­ing Pro­fes­sion­al Development

Remote health pro­fes­sion­als require advanced skills because of the unique cir­cum­stances in which they work, includ­ing resource lim­i­ta­tions, dis­tance from sup­port, and col­lab­o­ra­tion with retrieval services.

To sup­port the devel­op­ment of these skills, your employ­er may offer a struc­tured pro­gram, pro­vide inter­nal train­ing or facil­i­tate train­ing via an exter­nal organ­i­sa­tion. Staff may also proac­tive­ly seek out addi­tion­al upskilling and will often be sup­port­ed to do so by their workplace.

CRANAplus offers cours­es with a spe­cial­ist focus on clin­i­cal pre­sen­ta­tions and com­pli­ca­tions com­mon­ly faced by remote health pro­fes­sion­als. Our sched­ule includes region­al, rur­al and remote loca­tions in every state and ter­ri­to­ry (exclud­ing ACT). 

CRANAplus Cours­es include:

• Remote Emer­gency Care. Teach­ing the skills to respond to emer­gency sit­u­a­tions and to deliv­er safe, qual­i­ty care.
• Mater­ni­ty Emer­gency Care. Teach­ing the skills to pro­vide unplanned mater­ni­ty and emer­gency care for women and their babies.
• Advanced Life Sup­port. Teach­ing the skills to man­age the patient pri­or, dur­ing and after a car­diores­pi­ra­to­ry arrest.
• Triage Emer­gency Care. Teach­ing skills to assess patients and apply the Aus­tralasian Triage Scale to allo­cate an appro­pri­ate triage category.

A full range of our cours­es can be found on our edu­ca­tion web­pages.

Oth­er pro­fes­sion­al devel­op­ment options include:

• Men­tor­ing Pro­grams, such as our LINKS Pro­gram
• Clin­i­cian Round­ta­bles to con­nect with fel­low professionals
• Grants and schol­ar­ships to fund course atten­dance or post-grad­u­ate qual­i­fi­ca­tions, such as those offered by CRANAplus and oth­er organ­i­sa­tions, as list­ed at crana​.org​.au/​p​a​t​h​w​a​y​-​i​n​c​e​n​tives
• Free webi­na­rs on remote health topics.

Per­son­al plan­ning and self-care 

Going remote, par­tic­u­lar­ly for the first time, can be excit­ing. To get the most of your time, it’s impor­tant to recog­nise you will need to change and adapt your nor­mal self-care rou­tine. Iso­la­tion can be a chal­lenge and your nor­mal healthy actions may take more plan­ning. Antic­i­pat­ing chal­lenges is a help­ful start to min­imis­ing them. Below is an incom­plete list of things to con­sid­er. As you go along you may think of more. Don’t ignore these; make a plan!

• Does my phone car­ri­er offer cov­er­age in com­mu­ni­ty? Check with some­one in the com­mu­ni­ty, your employ­er or your mobile car­ri­er. You may need to switch provider.
• Take a sup­ply of your pre­scrip­tion med­ica­tion. Delays in deliv­er­ies are not unheard of.
• Talk with fam­i­ly, friends, and sup­ports about your expec­ta­tions and make plans to main­tain rela­tion­ships from a dis­tance (video calls, phone calls, snail mail).
• Ser­vice your car before leav­ing if dri­ving and ensure some­one knows when and where you will arrive. Check how far it is and how long it will take so you are not sur­prised by the distance!
• Some hob­bies will be able to con­tin­ue in com­mu­ni­ty; oth­ers may not be suit­able. Con­sid­er pos­si­ble new hob­bies that will help you ​‘decom­press’.
• Inves­ti­gate self-care strate­gies and sup­ports. CRANAplus has a range of help­ful resources. These include:
  • The Bush Sup­port Line, a free 24/7 tele­phone coun­selling sup­port line for the cur­rent and emerg­ing remote health work­force and their families.
  • Mind­ful Mon­day, a week­ly email newslet­ter writ­ten by Bush Sup­port Line psychologists.
  • A guide to ​‘Look­ing after your­self as a rur­al and remote health work­er’
  • A guide to ​‘Liv­ing and work­ing remote­ly’

More about CRANAplus

CRANAplus is the peak pro­fes­sion­al body for the remote and iso­lat­ed health work­force. Our not-for-prof­it organ­i­sa­tion pro­vides edu­ca­tion, men­tal health and well­be­ing sup­port, advo­ca­cy and pro­fes­sion­al ser­vices for nurs­es, mid­wives & oth­er health pro­fes­sion­als to ensure the deliv­ery of safe, high-qual­i­ty pri­ma­ry health­care to remote and iso­lat­ed areas of Aus­tralia. By becom­ing a mem­ber of CRANAplus, you can help us to sup­port the work­force, and access ben­e­fits such as course dis­counts and a sub­scrip­tion to CRANAplus Magazine.

For fur­ther enquiries, con­tact professionalservices@​crana.​org.​au