The Expectations vs. The Realities of Rural Nursing

In all honesty, I came out here with the idea that I would conquer my chosen profession of nursing and gain valuable experience to help me conquer the world – saving lives, improving the state in which people live. It’s my dream to one day work for something like MSF or the Red Cross. Quite the fantasy. This is one area in which rural nursing has met my expectations. It seems to be the kind of place where many people come to ‘up-skill’. The need for nurses out here lends opportunity to those willing to venture out.

What I didn’t expect was the amount of aged-care work we would doing. Rural Australia has an ageing population (surprise, surprise – much like the rest of the western world), with younger people moving to cities and a low birth rate. Having already worked in aged care for two years now, I had thought I’d be leaving home for something a little more exciting.

However, building (professional) relationships with my oldies has been one of the best parts of my job here. The positive in having aged-care here is that the residents can stay in their home town as they get older and it is actually quite a fast-paced working environment. From what I have seen so far, if there were only acute patients or emergency patients, my days might be more… dare I say it? The ‘Q’ word. We have been able to help with BBQs and Easter morning teas, as well as social events for the residents and their families and sundae treats organised by the lovely activities coordinator. One resident sometimes sings us songs as we help her to get ready for bed in the evenings.

There have also been instances where we needed something particular for a patient like a dressing or a specific medication which we haven’t had. I’d previously thought that these kinds of things would be readily available. Luckily are easily able to order anything we need, it’s just a matter of time to get it. The local pharmacy has also been an incredible asset to the town and the hospital.

In a larger metro hospital we could just call a doctor or any allied health and there they’d be but things are a little different here. It’s very lucky that we have a doctor here. There is one GP who services the whole town and is also the treating physician for any patients or residents of the hospital. He is basically permanently on-call and attends to any emergencies where the nurses might require more consistent and immediate assistance from a doctor. When he goes away on holiday or sick leave we use the Royal Flying Doctor Service (RFDS) which has been great!

During my second month here, there was a town-wide Telstra outage (one of the major telecom companies in Australia) for almost three days. Most people living in places like this use Telstra as it provides the best coverage in rural Australia, so when we ran out of phone coverage it was a big deal. It wasn’t just the mobiles either – it was the landlines too. Each of us as new grads were cut off from the outside world without any phone service. There was about half a day in the middle somewhere that the phones began to work again and then just like that *snapping fingers*, the phones were dead again. During the night shift, an emergency came in and one of the nurses had to go to his house to get him so that he could attend and provide medication orders.

Starting as a new nurse has been challenging. When I decided to become a nurse I knew that it wouldn’t be easy – it would be challenging in a way that starting any new job is but I didn’t expect to make so many mistakes so early on. They were nothing major but it definitely knocked my confidence a little. So something which I learnt quite early on, was to own it – mistakes are going to be made and it’s better if you can learn from it. I have done incident reports on myself to make sure that even though something has happened, I can provide safe care for my patients and myself.

While I’m not in the most remote of places, this experience so far has definitely left my expectations of rural nursing misaligned with the reality. I hope that being out here will help me to become a better nurse but more importantly, I hope that I don’t fail rural Australia and that rural Australia can survive the healthcare challenges it faces.

Next week in Part Two of The Expectations vs. The Realities, I write on what it’s like living in a rural town!

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