Sharon has spent the past four years working as an NP in the mobile health service across a 162,000km² area between Katherine, Northern Territory and WA right through to the Tanami Desert in northern Australia, which is often described as the most isolated and arid areas on earth.
Working alongside her husband who is an RN, Sharon’s role takes her to set up clinics in properties, cattle stations, roadhouses, ranger stations and small indigenous communities that are so remote, without Sharon and her husband visiting they wouldn’t receive any medical care.
By driving around 40,000kms a year to visit stations twice a year to provide essential mobile health care services, Sharon is focused on caring for primary health of the myriad of conditions found in Australia’s outback. Before working as an NP in a rural setting, Sharon and her husband have worked for the past 20 years in the NT community as registered nurses and have six kids who are now all grown up and having families of their own.
Can you share a little about the community you are working in and the nursing you are providing to patients?
Our community is not in one place it is scattered across the whole region, and our patients are exceptionally geographically isolated and work in cattle stations in intensive rounds during their work time, which means there is no downtime unless it is an emergency.
We do offer useful primary health care for all age groups across the lifespan, and a bulk of the people we see are mid-teens to late 20’s individuals who are the ringers in a cattle station setting or young families who are living on the land in a rural setting. Interesting, our patients are 50/50 men and women, due to the fact that there is a range of work out there and a mix of health needs from pap smears through to issues with chronic disease.
Sometimes we see people at station buildings and stock camps which have a more formalised clinic feel, and other times if we are visiting one of our small Aboriginal communities, we will work under our favourite shady tree.
The community I work in are no-fuss kind of people, they rarely have, and if they do, they are just trying to get the job done and don’t really seek health care unless it is an absolute emergency. For example, I saw a girl the other day who tore the ligaments in her knee - she decided she would go into the nearest clinic to get her knee treated however when I saw her at the station she just wanted me to strap it so that she could finish mustering for the next two days on her horse and then once that job was complete she would go in and see a specialist to repair the knee.
What is unique about your role in the community?
Our offering is nurse-led, we work in a mobile position and are on the road all week and when the week ends we come into town and replenish our stock, take in pathology and create follow up treatments for our patients.
They run clinics across a vast region that made health care more accessible, the remote stations and can ring for acute instances and get emergency via medical boxes on the station.
We focus on primary health care, and health prevention and our service arrives right on our patient’s doorstep and allows them to talk privately about their health in a safe environment so we can provide the respect they need to ensure their health care plans are in place.
We set up clinics under a tree sometimes or in the middle of a paddock in remote communities, and while we don’t have state of the art clinics, the communities we visit provide the respect and privacy patients need so we can work out a way to provide a confidential consultation.
In a community like ours, where you can be 4 to 6 hours from town, or even 2 days from town in some cases when you go to town you have a big list for the station, the last thing is going to the doctor. Arriving on their doorstep to offer the opportunity to sit down and chat is genuinely appreciated and often being an outsider is good to offload your health concerns.
I feel like primary health care is quite unique and affords me the opportunity to use all of primary healthcare skills across the lifespan of patients. We work on improving health knowledge, and for the younger age group, this is an important thing to do.
We offer two orientations for newcomers to the stations and introduce the service, so they understand what we offer. We introduce ourselves to prompt conversation and talk about things that would otherwise be left and ignored in a remote setting.
What is a typical day for you in your NP role?
In my typical day, there is a lot of dust! We travel to stations, unpack our gear and set up often we are up before dawn to do pathology on fasting bloods before patients head out to do their jobs and muster. Once we complete our day, we pack up, move to our next locations and do it again!
Mental health support is a significant focus in our role, there is a very vulnerable population, and there is a lot of stress which can lead to mental health issues. Sometimes we are the right people in the right place. Normalising and asking people how they are feeling helps to support community socially and emotionally in areas that are alarmingly isolated.
A lot of our work is connecting people into the health network in our region, we have GPs, specialists and allied health and linking them to the people they need to see.
Why did you decide to become a nurse practitioner?
My main reason for becoming a nurse practitioner is because I wanted to remain a clinical hands-on person and I loved rural practice. I enjoyed the challenge but to be generalist you need a lot of training, and there is a never-ending variety of things that can come your way. I started the learning process to help in remote health practice, and I enjoyed the learning, and it was very relevant, and I could see how I could apply it and I enjoyed becoming an NP.
The study to become an NP was really enjoyable, and I felt much more useful. I wanted to empower people with medical health services. We don’t work alone in remote health care, but we do need reasonable diagnostics skills and I owed it to the people I was working with to have the best experience and qualifications I could obtain to provide superior healthcare in Australia’s most isolated communities.
If you weren’t an NP, what would you be doing?
If I weren’t in my current role I would still be doing something hands-on in a clinical role I would expect, or I would retire and become a gardener and a professional grandma!
At the end of the day, I just want to provide a useful service and one that the population suits and is flexible for their needs. I want to ensure I am useful and that the remote and isolated communities that we visit get the value of high-quality medical care.
If you were to use a few words to describe an NP what would they be?
When I get asked what I do I usually say I am fortunate to have a nursing job that has a vast range of practice and, using my training and skills, I serve the rural communities.
Being an NP is the soul of clinical nursing, you work really hard and try to be the best clinical nurse you can be.