In the vast landscapes of Australia’s regional and remote areas, access to healthcare is a lifeline that often hangs on by a thread. Here, where the nearest hospital can be hundreds of kilometres away, nurses play an indispensable role.

Nursing is the single largest health profession in Australia, making up 54 percent of total health industry employment in the country. However, the current distribution of nurses is not meeting the demand in remote and regional areas. Recent National Rural Health Alliance (NRHA) figures show that the lack of remote and rural primary healthcare has led to more hospitalisations. In some of these places around the country, nurses are the only ones available to provide essential care.

Professor Shelley Nowlan, Deputy National Rural Health Commissioner for Nursing and Midwifery for the Australian Government, tells upstart that rural healthcare providers are struggling to keep up with an increased demand.

“Whilst the number [of healthcare workers] are growing, the needs of the community are growing at a higher rate,” she says.

According to the Australian Institute of Health and Welfare, 73 percent of the population are concentrated in major cities. Unfortunately, according to Professor Nowlan, the 27 percent that live in rural or very remote areas are burdened with an increased risk of disease and infection because it is harder for them to access primary healthcare.

“We know that there are limited resources and infrastructure that isn’t to the same degree as we have in urban areas, and that sometimes means that it compounds the needs of the community with the balance of resources available to them, and therefore access and equity of access is a real challenge,” she says.

Alice Springs is 1,500km away from any major city and is the halfway point between Darwin and Adelaide on the Stuart Highway. Surrounded by nothing but barren desert, containing a population of 26,000, the town is everything a remote place can be.

The Alice Springs Hospital is one of the most remote in Australia providing to a large population. They deal with some of the country’s most vulnerable, admitting over 65,000 patients every year, 84 percent of those being First Nations people. Their services cover over 60 percent of the Northern Territory and the inner regions of South Australia and Western Australia.

Rebecca Schulz, the Senior Director of Nursing and Midwifery at the Alice Springs Hospital, says there can be benefits to working in rural healthcare.

“You get to come and practice the most amazing nursing and medical care of people that you wouldn’t normally see in Australia, and you get to do it in first-world conditions with really good resources because we see conditions that don’t really exist in Australia,” she tells upstart.

Professor Nowlan says that working remotely and rurally has many factors that are also attractive to Registered Nurses (RNs) who might be looking to expand their knowledge and skills.

“As a rule, [as a] remote nurse you are practising to a higher degree of autonomy,” she says.

“So, we see that that is an attraction factor from nurses who have got experience and really want to grow and develop in that unique generalist role.”

She also highlights the singular experience that is working in remote regions.

“[These areas are] diverse in cultural and geographic contexts, and each of the rural remote areas have its own uniqueness and attracts the nurse in those areas where they may have increased degrees of specialty,” she says.

Professor Nowlan chaired the Steering Committee of the National Rural and Remote Nursing Generalist Framework, which focused on developing a model to contextualise the unique practices and core capabilities that inform the skill set needed by rural and remote nurses. It emphasises culturally safe practice, clinically capable decision-making and highlights the importance of forming partnerships with clients, families and communities. Professor Nowlan says that there are pathways and programs running in Australia to provide further education for nurses curious about working rurally.

“The Commonwealth has provided a significant investment into nurses scholarships and the Australian College of Nurse Practitioners is actually undertaking the administration of those scholarships,” she says.

“There’s also nursing and primary healthcare programs and other national programs that are ran out of CRANAplus or the Australian Primary Health Care Nurses Association.”

Some tertiary institutions like La Trobe University are also offering free training for RNs to tailor their skills towards rural nursing. The program allows a RN to learn about the “five micro-credentials” needed as a rural nurse including information on digital health and assessments for adult, paediatric and elderly patients. La Trobe is part of the Australian Rural Health Education Network which is the national association for the 19 University Departments of Rural Health in remote regions of Australia that collaborate together to progress initiatives.

When Rebecca Schulz worked as a Remote Area Nurse earlier in her career, she found that the difference in environment made her love the job so much more, and strongly encourages other nurses to make the move.

“The smallest thing you do as a nurse could make the biggest difference to a patient here. And you just don’t see that in the urban settings.”

Article: Hayley Wapper is a third-year Bachelor of Media and Communications (Sports Media and Marketing) student at La Trobe University. You can follow her on Twitter @hayleywapper906.

Photo: Supplied by Janine Wapper.