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 there are some things to con­sid­er. 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:

• Will you be pro­vid­ed with a full ori­en­ta­tion, inclu­sive of cul­tur­al orientation?
• What kinds of ser­vices are avail­able at the health service/​clinic? E.g., phys­io­ther­a­py, men­tal health, pre/​postnatal care, emer­gency care, immu­ni­sa­tion, etc.
• What are the health pri­or­i­ties in the community?
• What is the com­po­si­tion of the local clin­i­cal health team? Become famil­iar with the impor­tant role of Abo­rig­i­nal Health Work­er and Abo­rig­i­nal Health Prac­ti­tion­er. Start you research with this NAAT­SI­H­WP resource.
• What knowl­edge, skills and expe­ri­ence do I need to work in this com­mu­ni­ty (includ­ing capac­i­ty to dri­ve 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 kinds of sup­port are avail­able for me with­in the community?
• What are the ​‘on‐​call’ and ​‘after‐​hours’ requirements?
• What are the health ser­vice safe­ty and secu­ri­ty poli­cies, par­tic­u­lar­ly ​‘always accom­pa­nied’ policies?
• What is the avail­abil­i­ty and nature of accommodation?
• Will I have inter­net access and what is access like?
• If you are con­sid­er­ing tak­ing part­ners, chil­dren and pets ensure you check this is pos­si­ble. Capac­i­ty for employ­ment, accom­mo­da­tion, school­ing, and resources for ani­mals may mean this is not pos­si­ble in the community.

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?’
• Ask what cul­tur­al infor­ma­tion you need to know 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. Enrol­ments open on Mon­day 14^th March.

The envi­ron­ment

Remote Aus­tralia is envi­ron­men­tal­ly diverse and comes with beau­ti­ful loca­tions to see and expe­ri­ence along with some chal­lenges and risks you should be aware of and pre­pared for:

• What is the year­ly weath­er cycle like in com­mu­ni­ty and what resources are there to man­age the cli­mate such as air con­di­tion­ing, par­tic­u­lar­ly in accom­mo­da­tion (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 sup­plies when trav­el­ling, pro­tec­tive cloth­ing and footwear and fire pro­tec­tion strategies
• 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 not like major urban cen­tres. If you have spe­cif­ic dietary require­ments or pref­er­ences, you may need to con­firm these can be met in the com­mu­ni­ty. 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.

Per­son­al plan­ning and self-care 

Going remote, par­tic­u­lar­ly for the first time, can be excit­ing. To get the most of your time prac­tis­ing in a remote set­ting it is a good idea to plan, recog­nis­ing you may need to adapt and change your usu­al self-care prac­tices. Iso­la­tion can be a chal­lenge and your nor­mal healthy actions may take a bit more plan­ning. Antic­i­pat­ing chal­lenges is a help­ful start to min­imis­ing them where pos­si­ble. The fol­low­ing is an incom­plete list of things to con­sid­er. As you go along you may think of more. Don’t ignore these; make a plan to suit you:

• Does my phone car­ri­er offer cov­er­age in com­mu­ni­ty (check with some­one in the com­mu­ni­ty such as your employ­er, and 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 con­crete plans on how you will main­tain these 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 you have will be able to con­tin­ue in com­mu­ni­ty, oth­er may not be suit­able. If not pos­si­ble, con­sid­er try­ing a new hob­by 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’

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