From the city to the outback

A nursing student’s life-changing experience in remote Australia.

Dani Neal, APNA Communications and Campaigns Coordinator

Source: APNA Primary Times Winter 2024

APNA is tackling the complex problem of workforce shortages in primary health care with its National Nursing Clinical Placements Program. As part of the program, nursing student Elise Sims recently completed a placement in Maningrida, a remote Indigenous community in the Northern Territory. Elise embraced this opportunity for hands-on learning in a unique setting and is now planning a career in remote area nursing. We caught up with Elise to hear about her experience.

Early one morning in July, third-year Bachelor of Nursing student Elise Sims entered the Royal Flying Doctor Service hanger in Darwin. This was the final stage of her long journey from Melbourne to Maningrida, a remote Indigenous community of 2,500 people in the Northern Territory. Elise boarded a small plane alongside other healthcare professionals. They stopped at several remote communities on the way to her ultimate destination in West Arnhem, the Mala’la Health Service Aboriginal Corporation (MHSAC), where the Kunibídji people are the Traditional Owners of the land. Elise was about to commence a four-week clinical placement.

Her long journey had actually started several weeks earlier, at a ‘Lunch and Learn’ session hosted by APNA at the Holmesglen Institute of TAFE in Moorabbin. This was the first time she had heard about the possibility of student nurse clinical placements in remote Australian communities. Holmesglen had approached APNA earlier in the year to facilitate the placements following requests from their students, something the National Nursing Clinical Placements Program was keen to help with.

‘We know that primary health care isn’t just something that happens in general practice or community health contexts in metropolitan areas,’ says Jane Hollier, Clinical and Education Lead for the Clinical Placements Program. ‘It’s something that occurs throughout Australia, including rural and remote areas.'

‘I think the importance of having placements such as this one in Maningrida is that we ensure that we are providing comprehensive primary health care exposure for our students.’

A remote placement had previously seemed out of reach for Elise, and she immediately expressed an interest in the program. APNA then swung into action.

‘One of the biggest challenges was the tight time frame,’ says Jane. ‘Elise had completed her coursework and needed to get on placement within a tight time frame, so we had to move quickly.’

‘There were also compliance issues. Different states have different requirements and different things that students need to submit. And of course, we had to make sure that Elise herself was prepared before we sent her off on placement.’

Thanks to Jane’s support and expertise, Elise was soon ready to pack her bags and head north.

Putting learning into practice

Once Elise had settled into Maningrida and met her new colleagues at MHSAC, she was able to start her placement. This involved putting into practice everything she had learned so far in her course work and consolidating theory into practice in a primary health care setting.

‘We were treating both acute and chronic illness, and focusing on community involvement, patient centred care and really encouraging the individual to take their health into their own hands,’ Elise says.

She worked on projects centred around rheumatic heart disease, chronic condition management, and early childhood health. Elise was able to consolidate many clinical skills on her remote placement. The clinical environment gave her opportunities that are sometimes not found in acute settings.

Challenges of remote nursing

Despite the rewarding experience, remote nursing came with its challenges. Elise says being the only student nurse was tough.

‘When you’re in a hospital, you’ve usually got a number of students that are with you. And in a remote placement, you are by yourself, and you have to advocate for yourself ... to get the most out of the placement.’ Elise also had to be mindful of cultural differences during her time in Maningrida.

‘Clinical safety and cultural competence came into play in all aspects of delivering health care. I learnt that making eye contact could be seen as disrespectful and I had to be mindful in the way I communicated with Elders and Traditional Owners.’

This was doubly important in her final week when she was given the opportunity to do assessments under supervision.

‘We learnt all that in books, but it’s so different to witness it in real life and to put those things into practice.’

What next for Elise?

Elise felt warmly welcomed by the community, who were curious about her background and what brought her to Maningrida. ‘They were happy to have a chat and teach me about the community and about their culture.’ Getting to know the community in Maningrida, alongside the clinical aspects of the placement, led to a change of career plans. Once intending to go into palliative care, Elise started researching options to complete her graduate years in rural and remote communities instead.

‘After this experience, I’ve fallen in love with remote area nursing, and that’s what I want to do,’ she says.

She says APNA’s support was crucial to her experience, as the team worked with existing resources and community alliances to ensure she got the best experience. ‘I couldn’t have done it without them. It was amazing support, and I’m eternally grateful.’

Elise’s advice is simple for any student nurse contemplating a similar placement with APNA: ‘Go for it! You won’t regret it. You’ll learn more in those four weeks than you will in all your other placements. I guarantee it.'

Join the National Nursing Clinical Placements Program and show the next generation of student nurses why primary health care is the place to be. Workplaces earn up to $1,000 per placement and receive APNA’s full clinical and educational support. And best of all, APNA will organise everything for you!

Complete an expression of interest form today.