Rachel Schreuder
Rachel Schreuder

Rachel Schreuder

Rotary Club of Sale
Rural Nursing Scholarship 2021

Federation University, Gippsland Campus, Vic
Final Rural Placement – Barinsdale Regional Hospital
Post Grad Placement – Barinsdale Regional Hospital

Past Rural Nursing & Medical Scholarships Program

Why do I wish to do rural and remote training?

From a child of six or seven years old, I remember saying that I was always going to be a nurse. I completed my original nursing training as an Enrolled Nurse Endorsed in 2009 while we were living in the southwest Victorian town of Warrnambool. For the past eleven years, I have worked in rural and regional areas of Victoria as a nurse, most recently the Grampians and Gippsland regions. As a result of my nursing experience as an Enrolled Nurse, I have developed a strong passion for rural nursing. It comes with so many rewards and challenges – and I love a challenge!

Having grown up in rural areas throughout Victoria, my family has settled in East Gippsland. I come from a large family, and six out of my nine siblings are also nurses in the area (although I was the original nurse among us!). I live in the small community of Clifton Creek, about ten minutes out of Bairnsdale on a one-hundred-acre hobby farm with our animals and pets. My whole family definitely consider ourselves ‘country people’, having a great love for the outdoors, farm life, and all the advantages that come with the rural lifestyle.

Even when I graduated as an Enrolled Nurse, I always wanted to become a Registered Nurse, but until last year, the opportunity had not afforded me. As an undergraduate student, I have studied for and completed amazing rural clinical rotations in Sale and Bairnsdale, all while continuing to work at Bairnsdale Regional Health Service, going through the drought and bushfires last summer, and now living and working through a pandemic. Despite its challenges, I have worked diligently through my studies and achieved high distinctions, as well as commendation letters from the university. I have enjoyed every bit of studying, as it is something I have always felt that I ‘need to finish’ (Bachelor of Nursing), so that I can progress my career as a rural nurse.

The opportunity to continue nursing in the rural health care setting is one that genuinely excites me, knowing that I will be of great value to the local  communities I serve. For me, nursing in rural areas brings such a sense of joy and accomplishment, knowing the people I am caring for deserve the high-quality care that I can provide them with, and knowing that we have like-passions driving us to be the people and community that we are.

Working and studying in rural Gippsland, I have found that nursing and health care is very much collaborative and a team-effort, to achieve health outcomes for and with the people in the community we serve – something I am very passionate about. In the future, I can see rural healthcare growing substantially, with our nursing roles expanding as we develop the ability to provide higher levels of care to the local communities we live. This is exciting as a rural nurse because it means my drive to develop my clinical competencies, my scope of practice, and my involvement in rural nursing will continue to grow.

I am genuinely excited to be starting a graduate year at Bairnsdale Regional Health Service next year and thank the local community and hospital for supporting me by retaining me in the rural nursing workforce. I look forward to providing you updates as I progress through my graduate year!

Final (University) Rural Report

I am thrilled to say that completed my final clinical placement as an undergraduate nursing student at Bairnsdale Regional Health Service at the end of November and am now working as a Registered Nurse, after more than eleven years of nursing as an Enrolled Nurse Endorsed in rural areas of Victoria! I thoroughly enjoyed the experience of my final clinical placement. The privilege of working in the well-organised Oncology Unit caring for cancer patients was especially rewarding and gave me an insight into an area of nursing I previously had little experience in. Our community certainly deserves the expert cancer care provided through the local Oncology Unit, without the added stress of having to travel to the city for their cancer treatments. How lucky we are to have such a specialised unit in Bairnsdale! Something that particularly impressed upon me was how organised and streamlined the unit was, and the strict processes that necessarily must be followed. My eyes were also opened to the extensive range of chemotherapy medications and treatment regimes that patients are on. Working in the Oncology Unit felt very fulfilling, and the patients were very appreciative of the care, compassion, and expertise of the nursing staff. Seeing patients eagerly complete their cancer treatments and get the ‘all clear’ from the oncologist is a highlight of working in this unit. Plus, I definitely felt like I was welcomed as part of the team!

The second half of my clinical placement saw me undertake experience in the High Dependency Unit, caring for very acutely unwell medical and surgical patients. Once again, our rural community really benefits from a local specialised unit that is able to care for patients who in the past would have been transferred to a larger/tertiary hospital away from their family and hometown. Reflecting on this, I was able to appreciate the importance highly-trained nurses working in rural communities. It is something that I think will interest me in my career as a Registered Nurse. The experience and competencies I attained on this placement are going to ultimately benefit my patients in my graduate year and into the future, as I was able to complete several competencies in critical skills, for an example, management of Central Lines (used in caring for critically unwell patients).

At the end of the six-week clinical experience, my skills and knowledge base had undoubtedly broadened my scope of practice. The feedback I received was both constructive and positive. I have a deep respect and appreciation for rural nurses who provide expert care in critical fields of nursing in our local community. I certainly aspire to be one of them in the near future! In the meantime, I was very pleased to receive an offer of a graduate year at Bairnsdale Regional Health Service! I have just commenced my first rotation as a Registered Nurse, and look forward to the experiences and challenges ahead!

Post Grad Rural Placement Report

Where has the year gone! And what a year it has been ….

Already I am halfway through my second rotation working in the Emergency Department at BRHS and am immensely enjoying being part of the highly-skilled, diverse team of health care professionals. I have always considered being a nurse and caring for my community as both a privilege and a responsibility. For me, rural nursing remains where I see myself continuing to work and grow as a Registered Nurse.

The Emergency Department is one of the most crucial services provided to the East Gippsland community and we receive patients from near and far. The sense of responsibility felt towards the patients presenting to the department for care actually makes me realise just how important my work is. We are the front-line. We provide a public service that people depend on and trust. This instills a great sense of responsibility and duty of care towards the people of our community.

One of the things I love about working in the Emergency Department is the constant change! It’s something that I didn’t previously think I would like that much, and something that would once have given me a little anxiety; but, I’m actually loving the fact that the work is predictably unpredictable! Every shift, and even every hour, is different. I have to think on my feet, as the saying goes, and use a whole range of skills, including: assessment skills, clinical skills, communication and psychology skills, interview skills, and liaising and teamwork skills. This keeps the work interesting all the time – never a dull moment working in an emergency department.

More than ever before, the pressure and stress of the increased presentations to the Emergency Department has been quite overwhelming at times. Compounding this, the fact that resources are stretched and staffing shifts is always an issue, makes some days quite difficult. Learning self-care strategies and managing that work/life balance is really important for me to continue enjoying the work I do. I ensure that on my days off, I find the time to look after myself and keep up my hobbies and other enjoyments in life. Over the upcoming summer, I’m hoping to do some more camping in the High Country for example and have bought myself some new gear in preparation for this! I am really looking forward to some summer adventures. All the same, I feel a sense of responsibility towards my workplace and colleagues to help out as much as I can with filling shifts and being as much a teammate to my colleagues and friends as I can be.

Something that has really struck me working in the Emergency Department is how much the small things mean to patients. Showing that you really care about the person might be as simple as asking if they want you to call their family, offering them a cuppa or warm blanket, having a five-minute chat about something other than their medical ailment, or asking them if anything is worrying them. Going out of your way or going that extra mile for someone really isn’t that much most of the time, yet makes such a difference my patients’ experience. The many thanks and expressions of gratitude that I receive from my patients is very heart-warming and makes the difficult days worth it.

Because I have already been nursing (albeit in the ward settings) for many years, coming to ED the majority of my assessment, clinical and technical skills transferred across with me. However, taking that critical thinking to the next level is something that I’ve been able to work on in the setting of emergency presentations. I have nursed some very critically unwell patients who have required stabilising before being transferred to our High Dependency Unit at BRHs, or to other tertiary hospitals. Managing very unwell patients with complex conditions and complex medical/nursing interventions always makes me both a bit nervous but then excited when I start to see them respond to treatment and stabilise or improve, as the case may be. There have been several circumstances where I have had to employ patient-advocacy skills and be assertive to bring about the outcomes my patient need. Emergency Departments can be an overwhelming, stressful environment, particularly when things get extremely busy and everyone is trying their best to manage their patients and workload. I have found that building trusted, professional relationships with the doctors (many of whom are locums or visiting doctors), is really important so that I can get the outcomes I need for my patients.

You’ll probably be happy to learn that I have been successful in my application for a Transition Year at BRHS next year. Most likely I’ll be working in the Operating Theatres for six months, starting in January. This will afford me the opportunity to gain experience in anaesthetic nursing and managing patients’ airways and breathing. The skills I will learn and become proficient at by working in theatre will be invaluable to my future career as an RN and in undertaking a Post-Graduate Certificate the following year. Thank you again for your support and the Rural Nursing Scholarship for which I am grateful.

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