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Going Remote: The Essentials
This quick guide covers the things you need to plan for before a short or limited length placement in a remote area health care setting. Practising and living in remote settings is an entirely different experience from metropolitan, regional and even rural settings, in terms of climate, culture, language, your personal and professional roles, and what you can take for granted. Remote practice requires openness to change. Preparation, flexibility and adaptation are the foundation of a rewarding experience.
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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.
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/pathway-incentives
- 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 email@example.com