A remote area nursing adventure

rthe journey so far After 7 years of frustration, I decided to escape the insanity of suburbia and accept a one month contract working as a nurse on a remote island up in the Northern Territory of Australia. This is my story. Day One Three days of education and being holed up on my own in a lonely hotel in Darwin...hot and pleasantly muggy outside, and arctic freezing as soon as you enter a building! Every shop seems to be competing to see who can turn their air conditioning up highest...I ended up switching off the one in my hotel room and opening the window so I could listen to the sounds of the evening rain. First day was cultural education....Richard, a seriously interesting bloke with "one little arm and one big one" as he put it... a traditional land owner of the Larrakia people (which has a lot more significance than I realized at first...I had the uneasy feeling all along that I was listening to someone I should really be paying attention to...kept on being caught between feeling I should just shut up and listen respectfully and the need to blurt out something terribly deep that had just dawned on me about the parallels between Indigenous culture and the white pagan one that is so much more my world than the narrow modern post Christian one he kept talking about. But more about that later!) Rich has worked with the legal system traveling all over the top end, helping to bridge the gap for whites and his own people for many years..which has given him deep insights into both cultures..he took us for a bush walk first up, showing up an amazingly wide variety of bush tucker and medicinal plants just in the little bit of bush land next to the university, and ending up down on the beach looking out to the Dreaming birth place of his people. Perfect intro...and so amusing watching the confused faces on the young medical students who were also part of the group, as they struggled to get their heads around concepts of culture and healing that had been discarded and looked down upon in white society for centuries....very different from what they had been taught about health at uni! Relationships guided by ancient tradition, that gives you a skin name at birth, that tells you your place in society. Who you are responsible for, who you can marry, who gets to teach you right from wrong (your mothers brother in this case!) It also tells you which plants and animals you are kin with...and with that a relatedness to the world around you as well as the human kin. Stories of traditional healers called "Nunquarries" who heal by laying on of hands, and sending their energy out to find the ones that have been lost by a sick person. Tales of Blessings and Curses, "Payback" as the traditional system of swift, immediate and carefully controlled and organized justice for wrong doings.... So much information, much of it familiar in feel for a western pagan like myself, but so complex and fascinatingly detailed that I get the feeling I will need a lifetime to understand it properly..... Day Two The second day was back to my more familiar western world..supposedly anyway, though I was actually more at home discussing herbs and animal totems, grin! Taught by a very sweet doctor who has been working in the NT for many years...a quiet rather shy lady who came to life as she spoke about her experiences out in the bush where she lived with her husband and 2 children before finally returning to white civilization a few years ago. This day was filled with practical medical stuff. What kind of problems I was likely to encounter and how best to treat them....I'm beginning to realize that up here, there is no more pretense of there being a difference between a "nursing diagnosis" and a medical one. Nurses are treated as health professionals and expected to make clinical decisions, prescribe medications and treat sick people! What a breath of fresh air! And how amazingly daunting! Suddenly I'm panicking a bit and wondering how in Hell I'm going to do this! Luckily the Northern Territory has come up with one of the most practical and helpful systems to assist remote area nurses in the world. The CARPA manuals. Almost a form of medicine for dummies, this hold book for RANS is an incredibly common sense manual of how to recognize, diagnose and treat pretty much everything from measles to snake bites, with a "how to deliver a baby in 5 easy steps" chapter along the way. It's a western modern day equivalent of the infamous "Barefoot Doctors Manual" used in Mao's China, and I have a hard bound copy sitting comfortingly in my backpack now! It also allows me to prescribe and administer medications and the heady sense of freedom of no longer having to persuade a doctor to sign the medication chart I have already filled out (including the dose I have corrected for them on their previous entry) is quite...mind boggling. Day Three A long day of computer education. The NT has moved to the computer age with a state wide system that allows people's medical records to be accessed from different clinics, which makes perfect sense for a largely Indigenous and nomadic population. The system itself is complicated and cumbersome...but compared to the insanely complex and dis functional piece of garbage NSW health recently inflicted on its hospital, it's a thing of beauty! The main difference seems to be that each bit of it had to be passed and accepted by a clinical works committee before it could be implemented. And this committee is obviously made up of actual doctors and nurses who work on the floor with real patients! I so want to show it to the idiot NSW bureaucrats who think a system that needs a separate web page to explain all the symbols used in the main pages is ever going to work! Anyway, got through that, managed to convince Optus to unlock my iPhone so I can install a Telstra one and actually have reception out on the island, and now I'm sitting in a tiny plane above the pacific ocean on my way out to Groote Eylandt and will be landing in Grove along the way, island hopping...... Free chips and chockies, they obviously like to keep the miners happy (who make up the largest part of the travelers on board). They even serve beer! Seems a large number of my patients will be white miners rather than interesting black fellas, but they'll still be a damn site nicer and easier to deal with than the narrow minded white picket fence suburbanites I've put up with for the last 7 years....the mood on board is happy with lots of laughter and friendliness. Everyone likes the chockies!