Why do I wish to do rural and remote training?
As a mature age nursing student, my path to becoming a nurse hasn’t followed the “traditional” trajectory. I’m a wife and mother of three children who all attend Sale Catholic schools and are heavily involved in local sports teams. I was raised in Heyfield, went to school here, married a local boy and am delighted to be doing my Graduate Nursing Year in 2022 at Central Gippsland Health, Sale. Growing up in a small country town, I now have the privilege to give back to those in their time of need through our wider regional health care system. I was guided by many community and likeminded residents through my educational, sporting avenues and being a member of our small community that I am now seeing those faces again. This time the life circle is evolving, and it is my pleasure to have the opportunity to return the kindness, love and support that was shown to me growing up.
In 2014 my beloved Nan passed away whilst a patient at CGH in Sale and I was privileged to be alone with her when she died. That experience awakened in me a burning desire to one day work in the specialist field of palliative care and so began my journey.
I started by undertaking a short Personal Care Attendant course which then led to employment at Laurina Lodge in Heyfield, where I have continued to work whilst studying my B. Nursing through Federation University at Churchill. These past five years have been enormously challenging – juggling work, University study, parenthood, domestic duties and with the added stress of the pandemic and its impact on both mine and my children’s’ education has been stressful and yet I have never wavered in my commitment to my goals. I am a firm believer in the mantra “teamwork makes the dream work” which essentially is an enormous part of the nursing career. Working in a regional area provides the opportunity to be a crucial team member in a multidisciplinary team. It broadens horizons caring for many walks of life and provides exposure to various ailments, diseases, and comorbidities. I have spoken with many medical professionals over time who have been fortunate to complete their regional placements in our area and I must agree, regional healthcare is a special area of the profession. All presentations aren’t the same. It provides endless opportunities to expand your knowledge, requires critical thinking and use our clinical skills.
Working at Laurina Lodge with vulnerable older people for the past six years has taught me the importance of treating all patients, no matter their age, socioeconomic status, or mental capacity, with respect, dignity and professionalism. I have learned so much from my colleagues there and have loved the relationships I’ve forged with the residents and their families. My desire to continue working in regional nursing has only been strengthened by the years I’ve spent at Laurina Lodge – high quality nursing at every stage of life enables regional families to enjoy the same level of healthcare enjoyed by those in our major cities and means the regions remain viable, vibrant places to raise a family and beyond that, to enjoy a safe and comfortable old age without needing to relocate away from family members and the familiarity of place and community.
Final (University) Rural Report
Prior to the completion of my degree in December 2021, I completed 5 weeks of clinical placement at Central Gippsland Health in the Critical Care Unit during October/November. With my 5th year of study beginning to wrap up, I had the opportunity to consolidate my theoretical learning and put in into practice via observation of my amazing mentors and completing tasks myself under supervision. Working in the Critical Care Unit wasn’t on my radar at all whilst studying, I had not developed an interest, there was no fire in my belly for CCU. I had formed my own misconceptions that it was a specialised area and not for Graduate Nurses “you’d need a few years under your belt for CCU nursing” and “it’d be a long 12-hour shift monitoring and caring for 1 or 2 patients”. Gosh! How far from the truth this is and I’m so very grateful that I had the opportunity to experience this specialised field prior to beginning my nursing career and had my misconceptions adjusted accordingly! It would be an area that I could possibly pursue. I have formed a genuine interest. It was such a positive eye opener, CCU and their staff are a very important area of the hospital and are depended on greatly – throughout the entire service. A CCU nurse isn’t always monitoring 1 patient. They are involved in that and so much more as I learned. They are a pivotal part of the hospital and multidisciplinary team 24/7.
At the time COVID 19 had reared its ugly head again, especially in the Gippsland area. Latrobe Regional Hospital was nominated as the main regional hospital for COVID positive patients. CGH were managing many COVID patients and isolating positive patients in CCU prior to them being transferred. The isolation bed in CCU was never empty in my whole 5 weeks. CGH were delivered a personal ventilation hood used over hospital beds. These hoods were being used in most Victorian metropolitan hospitals. The hoods contain droplet spread of COVID and were a great initiative for hospitals that didn’t have multiple negative pressure rooms or isolation rooms were a capacity. As COVID numbers rose CGH had to transform part of their medical ward to an isolated area to accommodate the influx during my placement. Despite the pandemic and the uncertain circumstances, it bought, as a student who was about to fly solo in less than 3 months, it was a fantastic opportunity to have insight to what this pandemic was doing to our healthcare system holistically. We had to become adaptable very quickly for the ever changing & evolving circumstances. It gave true meaning to multidisciplinary teamwork. Personally, I was very good at donning, doffing, and transferring patients without contamination by the end of the 5 weeks!
That was in addition to the regular running of the CCU including MET calls, ventilation, haemodialysis, managing newly diagnosed heart attack and stroke patients, recovering high risk patients’ post-surgery, high dependency patients and short stay patients. CCU nurses are very versatile and relied upon regularly by their peers from other wards for their extensive knowledge and skill base. I felt so privileged to be exposed to so much during my placement. I also learned that there is definitely room for Graduate nurses in CCU, such an amazing specialist area I would consider in the future!
So, today as I prepare myself for my next journey – beginning my graduate year and the start of what I anticipate be a long career in rural nursing, I have a feeling of mixed emotions. I’m excited and nervous and can’t wait to begin. To find my feet instead of visualising in my head what my graduate year will look like! I am nervous about leaving my comfort zone of not being the “student nurse” anymore. I begin my first rotation in the Emergency Department at CGH and I’m really looking forward to joining their team. I’m looking forward to further consolidation of the skill and knowledge base I have gained through my study and excited to broaden my skills and knowledge further under the guidance of the CGH team.
Post Grad Rural Placement Report
My second rotation has seen me return to where my health care journey began – Heyfield Hospital/ Laurina Lodge. During our graduate rotation with CGH we are all required to undertake an Aged Care rotation. By any stretch of the imagination Aged care certainly isn’t glamorous, there isn’t a lot of opportunities to use our new clinical skills like venepuncture, intravenous cannulation, intravenous therapy, all the new “nursing” skills we’ve learned and eager to put into practice. What it has demonstrated is the versatility of nursing and how other aspects of nursing is crucial in meeting care needs of patients and/or residents.
Aged Care nursing is very tiring and exhausting – its hard work as the spotlight doesn’t shine brightly in that area like it does for Emergency Nurses, Midwives, Theatre Nurses ect. At times there is a wave of feeling undervalued, unappreciated, and excluded from the nursing fraternity. Along with that wave is guilt for “feeling” like that. That feeling changes the moment you look at your elderly patient or resident and hold their hand and they smile, their eyes light up just to see your presence and hear your kind words, receive a hug, or for some a bit of banter. Aged care is very rewarding in that sense. The rapport that you build with your residents and their families, the relationships that you form, and making their last days earthside peaceful and pain free. The skill of constant, clear and concise communication is required because as the RN the hard conversations with your patient and their family need to be had and lead by you! Some of these conversations can be very hard, difficult and emotional. At times you are the interpreter after Drs rounds, you are the safety net and comforter to these people when they don’t understand what is happening to their loved one, you are the advocate on so many levels, your care and recommendations to other medical professionals is so important. Your residents and patients are generally long term, unlike an acute setting or ward. Back to our university days when studying communication for a semester didn’t rock our world and seemed at the time to be a wasted subject is more important now than ever. This is where your clinical skills, judgement, voice, and advocacy are more important than ever – just as important as IV cannulation, venepuncture and all the other “nursery skills” we want to use. This is being a “Real Nurse” too. After my time in ED, my role as an Aged Care nurse is just as important as an ED nurse. The role is just as tiring, exhausting, fulfilling, and rewarding.
A Registered Nurse in Aged Care requires you to be a great leader and lead by example. There are numerous times that you have a team of EN’s and PCA’s working alongside you (I refuse to use the term “under”. We are a team, no one is more superior or important than any other!) As the Registered Nurse it is your role to lead, encourage and ensure care needs are met. I’ve had so many opportunities of this during my time in Heyfield. I feel I have been able to use my clinical judgement to implement changes. My clinical judgement is required when colleagues come to me as the senior person for advice. This too has been a very rewarding role to see changes implemented due to care needs or best practice. It is satisfying to see amazing teamwork, staff pulling and working together positively. Without sounding like a broken record – Aged Care is tough. I have been a PCA prior to me receiving my registration. I know what they are feeling, I understand the workload, I too wanted nursing ratios in Aged care (I still do!). Therefore, I knew I needed to be the leader, inject some positivity, and pull the team together – once again be the voice and advocate for my colleagues too. As an RN they rely on you to be their voice too. Another very important role and skill that I have been able to work on during my time at Heyfield. I feel proud and happy that I’m able to. As a Graduate Nurse it is very daunting and confronting but, like our IV cannulation (Sounding like a broken record again) it requires a lot of practice and patience. It is a very important skill and tool to have in our Nursing toolbox.
I have really enjoyed my time in Heyfield. It has been a challenge but, very rewarding all the same. My passion for aged and palliative care reignited and I loved being apart of that team. I hope one day that Aged Care Nurses get the recognition that they deserve and it too becomes an area that new nurses want to pursue. My next rotation is in the Medical Ward in Sale and I am looking forward to spending the last 4 moths there. I will be exposed to Aged, Rehabilitation, Palliative, Alcohol and Drug Rehabilitation and medical patients. I feel very lucky to be able to experience all these roles as a Registered Nurse. I’m enjoying this journey and hand on my heart I still have not woken up not wanting to go to work. Nursing is my passion, I am balancing it with my family life and I feel very privileged to be a Registered Nurse at Central Gippsland Health.