I already define myself as a rural nurse as I have grown up in Latrobe Valley, studied my double degree in Churchill and undertaken my clinical practice in rural hospitals. In order to better understand who I am, I feel this question needs to be tweaked to Why do I want to continue as a rural nurse and midwife?

The most important factor for me is nursing people from my community. I love being able to go down the street and seeing the family of a baby I delivered and getting an update on their growth or coming to handover and seeing the you delivered the woman in labours previous baby. Being able to provide that type of continuity is a privilege rarely seen in metropolitan hospitals.

Working in a rural hospital means you have the opportunity to become skilled in multiple different areas. For me I can work as a nurse/midwife and develop my confidence in both areas in multiple different wards. For example, I can work as a medical/surgical nurse one shift and the next be in the labour ward or paediatrics. These opportunities allow me to see and treat a diverse patient mix, brings variety to my working week and keeps me on my toes as I never know what is going to walk through the door.

Being an employee at a rural hospital means being a valued member of a multidisciplinary team. Everyone works cohesively to provide optimal patient care. It’s the small things in this team that sets it aside from a metropolitan hospital. This can be from being on a first name basis with the doctors or knowing that the dietitian isn’t available between 12-1 on Fridays because she has lunch with her son. This type of work environment means I can develop close working relationships and lifelong friendships.

Being a rural nurse means having greater responsibility and autonomy. We don’t always have the resource of a doctor available 24 hours a day forcing us to think critically and be resourceful in many areas. The up side to this is it an opportunity to improve leadership skills leading to better supervisory skills. Greater responsibility and autonomy also gives me a chance to enhance my confidence, helps develop resilience in all hospital settings and gives me the qualities of adaptability and innovation.

In conclusion, rural nursing will help me become the best nurse/midwife that I can be. It comes with its own set of challenges but through the challenges comes skills, experience and confidence. I am excited to start my journey with Central Gippsland Health Service as a nurse/midwife graduate next year and look forward to becoming a valued member of the team.

My last placement block for my double degree was at Sale hospital in the Critical Care Unit (CCU), a ward that I requested due to multiple good experiences from fellow students. I had the options of emergency, CCU, paediatrics or operating theatres, all areas that interest me due to their diversity and high acuity skills. I was pleased to learn that I would be spending four weeks in CCU as I was looking forward to gaining some experience and witnessing cases that I had yet to see. All of my nursing placements had so far been low acuity and/or community experience and I felt that I was lacking the hospital experience necessary for a 4^th year student nearing the end of her education.

The first week of my placement was all over the place as CCU was getting a refurbishment. I was annoyed that my first week would not run like a typical CCU but I understood that everyone was doing their best under the circumstances. Day 1 was just transferring equipment from one ward to another and helping set up and settle in a couple of patients. The week we were in our temporary ward did not see many interesting cases. Most patients were just flagged anaesthetic risk or cardiac monitoring. Although one patient did have necrotising fasciitis which was interesting to look at. I was excited for week 2 as CCU would return to its usual location and routine would be restored along with feeling like I had settled into the ward. Week 2 was also very quiet. I was becoming disappointed that my skills were not being practised apart from regular observation, medication rounds and IV antibiotics. I was eager to see MET calls and critically ill patients and witness how a team came together to stabilise these patients. The staff continuously apologised for how quiet it was and were trying their best to accommodate me with education sessions, activities or books to read when it was quiet.

On numerous quiet periods I was floated down to the Emergency Department (ED). Although ED is a high area of interest for me, I didn’t enjoy my experience there. This had nothing to do with the department, staff or patients but with my own personal insecurities. I felt like I was an intruder and like I was stepping on the other student’s toes. I didn’t know how the department ran, the paperwork or who I could turn to for help. I was in over my head and could feel the confidence I was building in the CCU, slowly disappearing in the ED. Even though on the inside I was terrified and felt lost I still managed to take the experience and participate in a serious methamphetamine overdose, a stroke MET and gain some insight on how the ED runs.

Week 3 I got to witness an intubation, participate in the care of the intubated patient and then watch the extubation. It was great to be there for the whole process as it gave me an opportunity to learn the whole process, get to know the family and their wishes and consolidate some of the skills I had practiced in the lab. At times the one on one care for an intubated patient became repetitive especially as this care was further divided between the nurse and myself. I did learn how to give medication to the intubated patient given they can’t swallow, how to use their inhalers, clearing the intubation tubes and gained a clearer understanding of how the respirator worked. It was nice to see the patient wake up, recover and go home with their family all within the week.

Week 4 was another quiet week. I was floated down to ED again and spent a lot of time refreshing knowledge through reading and education on interpreting ECG’s. The most interesting thing in week 4 was watching a cardioversion for atrial fibrillation. The staff were really great at explaining the ECG and the importance of timing when it came to administering the shock. I was surprised at how quickly the patient recovered and how he instantly felt better.

Overall my experience in CCU was not as highly paced as I was expecting with a lot of down time and slow periods. This may just be the timing of my placement and a little bit of bad luck. There were times that I felt I was in the way and not experienced enough to participate. This experience and knowledge obviously comes with post graduate studies but I certainly felt the huge knowledge gap. I did however still gain valuable skills and experience that I will utilise in the graduate year such a broader understanding of medications, interpreting ECG’s, confidence in using IV pumps and drug calculations, routine and a better grasp on CGHS’s policies and procedures.