![Stephanie Merton](https://austrotaryhealth.b-cdn.net/wp-content/uploads/2024/01/Stephanie-Merton-291x300.jpg)
Stephanie Merton
PDG Joe Scorer
Rural Nursing Scholarship 2024
University of Wollongong, NSW
Final Rural Placement – Bowral Public Hospital
Post Grad Placement – South-East Regional Hospital (Bega)
Why do I wish to do rural and remote training?
I am passionate about nursing and giving back to my community. I have lived in the area for most of my life excluding 2 years in Western Australia. It was here I began to appreciate the disparity of remove locations. I feel fortunate to have the opportunity to study directly across the road from where I attended High School. I never imagined I would go on to gain a tertiary education and am the first in my family to do so.
I had originally summited an EOI for my final placement at Broken Hill Hospital. I was looking forward to working in a centre with a large Indigenous population and where the Rural Flying Doctor operates. This was not to be, but I was given the chance to change placement from Bowral to Bega when a position became available but I declined as I intended to hopefully work at South East Regional Hospital. I wanted to have exposure to other workplaces to be able to bring that experience to the workplace. Even though this decision came at a significant financial cost and being away from home for 5 weeks, I enjoyed my time in Bowral ICU.
As a mature-aged student, the last twee years of full time study commitment have seen many sacrifices. COVID lockdowns and housing crisis have caused 3 relocations during this time.
Final (University) Rural Report
I feel so very fortunate to be chosen for the Joe Scorer Rural Nursing scholarship. My deepest, heartfelt thank you for your generous contribution to my education and journey as a Registered Nurse in a small regional community.
I am reflecting on my final year of university a week before I start my New Graduate position. I have been placed in the Mental Health department, one of my preference areas. I am equal parts excited and nervous. I chose mental health as my elective last year after I found studying the subject in my second year interesting and thought-provoking. I was chosen to be a part of Recovery Camp in Mount Evelyn Victoria for my compulsory mental health placement, so I have minimal experience in the clinical setting.
My first-semester placement was in the Emergency Department at my local hospital, South East Regional in Bega. The placement period was for 4 weeks and consisted of alternating weeks of morning and evening shifts. I was looking forward to staying locally and maintaining a relatively normal home routine. I was also aware that I would be working alongside some personal friends and most likely also know people presenting to the hospital. I was questioning my knowledge and abilities and knew I would need to keep up in a fast-paced, changing environment. I quickly realised I knew more than I thought with the pressure of not having much time to think about it. This came as a nice surprise and boosted my confidence. I enjoyed being able to quickly build a rapport with the people that were being admitted as you were the first point of contact. They hadn’t yet repeated their story to multiple people and began to guard their vulnerability. I found this refreshing. Also, the turnover of people was mostly very quick with treatments, discharges, admitted to the ward or transported to Canberra via patient transport or airlift. This gave me a sense of satisfaction with progress, even though I struggled with not being able to follow up on cases. The other thing I liked about being in the Emergency Department was the teamwork among nurses and doctors. Doctors were readily available and friendly and took the time to explain things to me. I felt supported and valued.
While on my way to Bega to visit a friend before work placement, I came upon a road accident between a car and a motorbike. I was able to assist with emergency services and then speak to the patient when I arrived for my shift while they were in the resuscitation bay. It was a surreal moment and later was mentioned in a newspaper report.
I was introduced to Technology Enabled Care Services (TECS) with mental health admissions. Patients were placed in a designated part of the hospital and had safeguards in place for monitoring. It was interesting to see the process of these types of admissions, with the next mental health ward at the same capacity as Bega being Goulbourn over 200 kilometres away. According to the AIHW, mental health presentations account for up to 5% of ED admissions and this number reflects principal diagnoses that fall within the mental and behaviour disorder category. This number has also trended up in the last 5 years.
My second semester placement was in the Intensive Care Unit at Bowral Public Hospital. This final placement was for 5 weeks. I was assigned all morning shifts for the duration. Bowral is 270 kilometres from where I live and I stayed in an Air BNB accommodation alone without visitors or driving home for the whole period. I was changed to ICU a few weeks before I arrived from the surgical ward which I was pleased about. I felt extremely lucky to gain a critical care placement. The Nurse Unit Manager made me feel very welcome and held an active position on the floor of the ward. I began to implement a routine of walking in the afternoon and planning activities in the area to make sure I was getting a work-life balance and engaged in some self-care activities. The ICU was busy and a lot of cases were transferred to Liverpool or Campbelltown for treatment. I made many connections with the people I cared for on the ward. The ICU was a great place to consolidate knowledge from my final year practical skills. I challenged myself to get out of my comfort zone, performed handover every day and took charge of patient care. An unexpected reflection was the care I provided to people who were admitted with pre-existing mental health histories. A young male had a panic attack and I was able to calm him down quickly which I found really rewarding. This situation also gained me recognition from the buddy nurse and the feedback made me realise I had a passion for this type of work. I have found I engage and build a rapport easily with consumers. I enjoyed my time in Bowral and the ICU and found more focused care satisfying in being able to implement more interventions, tests and treatments.
During the summer, I travelled to Bali and completed my yoga teacher training. It has always been a goal of mine to deepen my yoga practice by studying. When returning home, I began teaching yoga and gained a new perspective and skills I had hoped to bring to not only my self-care routine but also the mental health space. I did not know at the time of those ideas that I was to spend my first rotation in the mental health unit. I am excited about my future development at South East Regional Hospital.
Post Grad Rural Placement Report
I have achieved my goal of working more in the High Dependency Unit of the Mental Health ward. I felt supported and ready for this progress and enjoyed experiencing the difference in this higher acuity section. I began to develop an understanding of psychosis presentations, the admission process, the Mental Health Act and medication administration. I particularly enjoyed having a closer working relationship in the HDU with the ratio being one nurse to up to two consumers. This allowed more one-on-one time with the people I cared for, allowing me to give people my full attention. This same sentiment being extended to the nursing staff in the HDU. The ability to have one-on-one time to discuss treatment plans, trauma-informed care, minimising restrictive practice and many other educational conversations. It was also great to hear people’s passion and their career paths.
I had the opportunity to be a part of a restraint where my responsibility was to talk to the consumer and explain that I was to give an intramuscular injection. Being a part of scenarios where you are delivering care to someone against their will is confronting. I can now appreciate that sometimes the best treatment is assertive management to minimise the suffering of the person experiencing an acute deterioration in their mental state and the safety of that person and all others in the ward. My time in the Mental Health Inpatient Unit was rewarding and compliments my next rotation in Community Mental health.
Since starting CMH, I have been completing mandatory training and education as part of the orientation process. There is a lot to learn in the outpatient setting with more autonomy and individual responsibility. I have my own office space and attend meetings with district Mental Health teams to discuss cases. It has been interesting to get the opportunity to follow up on the next step of people’s care that I have met in the MHIU. I am looking forward to working with experienced staff and learning all I can. I am a part of the adult team but have the opportunity to learn from the older persons and child and adolescent teams. I have been able to attend and observe assessments in the Emergency Department and looking forward to doing my own assessments under supervision. It has been rewarding to be a part of people’s recovery after their initial presentations to services.
I am now working regular business hours with a 3-day weekend. This is the first time in my working life I have had this schedule. I surprisingly did enjoy the night shifts while working in the MHIU. I began a 3am self-care routine where I would brush my teeth and hair and moisturise to freshen up. I would make an effort to stay hydrated and sometimes meditate on my break. It is important for me to have a positive work/life balance. I have begun teaching more yoga classes and would love to one-day run classes at the hospital for staff wellness.