Practitioners in the bush

Recent years have demanded more from Australia’s health workforce than at any other time.

In rural and remote communities, the pressures of isolation, workforce shortages and, at times, needing to be all things to all members of a community can multiply the challenges but, often, also the rewards.

We have heard from many health practitioners and students about their strong commitment to putting their patients at the centre of everything they do. They will often need to provide a greater range of services than city counterparts, who may work more within a specialty or niche. Often it is out of necessity, as they might be one of only a small number of practitioners in their area. Safe health care is always the focus.

Medical student Harry Gaffney reflects positively on his time in Strathalbyn, a rural town in South Australia. He recalls a moment when he was helping set up for the day as a local came calling for help at the unopened clinic.

‘I was going to help turn on the computer and vacuum, and I ended up preventing heart attack from happening. It was really intense,’ he said.

Broome pharmacist Hannah Mann travels across Western Australia, including to many Aboriginal Health Services.

‘What’s kind of different for pharmacy in rural areas is the community relationships you have. The whole community is your patient and you have these amazing relationships with community members who trust and rely on you so much,’ she said.

As prominent and trusted members of their communities, health practitioners perform roles they didn’t think possible when they became registered practitioners.

‘Some days I will work in clinics and I will finish at the end of the day and think, “I don’t know if I was a pharmacist today, I don’t know if the work I did was a pharmacist’s work,” do you know what I mean?’ Ms Mann said.

‘It’s education, it’s support, it’s advocacy, it’s a whole heap of other things where you think “you know what, we are not just pharmacists in rural and remote Australia”.’

The COVID-19 pandemic has seen health practitioners remain among the few constants for many people. Even then, the capacity for patients to visit practitioners became harder amid social distancing and public health restrictions. Telehealth was a saviour for many, but the isolation was, at times, felt on both sides.

Psychiatrist and medical educator, Associate Professor Rob Selzer, reflected on the shift to telehealth saying that there are ‘a lot of things that audiovisual communication cannot replace.’

‘Touch is so important among friends and family – a hug or a handshake – and we can’t do that now … All of these social norms that we’re so used to as a species have stopped. And it’s very hard for us to get our heads around that,’ he said.

On the flip side, the increased use of telehealth enables more people to access psychological treatment from the comfort and safety of their homes, no matter where they are across the country.

‘Telehealth enables people to access care wherever they are comfortable, and I think that’s a great thing,’ psychologist Dr Gemma Sharp said.

The extra work, and adapting to new ways of working, has impacted practitioners as well as their patients, with many feeling a strain on their workplace as well as their own mental wellbeing.

Nurse Ashley Scoular shared with us the life of her colleagues during the height of the pandemic.

‘The majority of our workforce in the unit are women with young families and so you have got nurses and doctors working 12- or 14-hour shifts and then also going home to care for children who might otherwise be in school,’ she said.

‘That stress, plus any other stresses, like partners losing jobs, it’s sort of a unique time and highlights the importance of looking after each other.’

For Harry Gaffney though, the exposure to these communities, and the professional and life lessons that come with it, is a privilege.

‘I entered into an extremely welcoming and supportive community that had me actually feeling anything but isolated. In fact, I kinda feel more connected to a society and community than I ever have before,’ he said.

You can listen to more healthcare stories from rural and remote communities and other areas of health care on Ahpra and the National Board’s podcast, Taking care.