Introduction
Every country has its unique approach for the development of a well-balanced health care system that is able to adapt to the changes in the society. Australia has made essential medicines readily available to the entire population laying the groundwork for a stable health care system. Its robust private health care sector complements the balance shared between individuals and the government with over 43% of the population enjoying a private health care coverage taking some pressure off public services. Yet in the middle of this modernity, rural health movement has just gained momentum in the last 15 years. Rural and remote health nursing soon saw the need to reach out to the indigenous communities. In cooperation with the federal government’s aim to provide optimum health for all its constituent enough focus is now targeted to the needs of the citizens in the rural and remote areas of Australia. Rural health nursing identifies the national values of reaching out to the entire population and in particular to the marginalized citizens living in the far-flung areas.
The role of nurses and health care to both the rural and remote communities
The national values of nurses are in question when the current health of indigenous and laid back communities is left unattended. A well-developed country cannot claim credit as well for a stable health system when part of its constituents is left forsaken. In Australia, the rural citizens and aboriginal communities as an indigenous population of the continent suffer issues of chronic mental illness, circulatory diseases, infant and maternal mortality rates, lack of preventive health steps, due to an inadequate numbers of local health care providers that is identified as a barrier to health (Grogan, 1987; 96). The cacophony of health problem reflected in a 2002 study and in a recent 2006 survey (Australian Institute of Heath and Welfare, 2006) revealed certain diseases as indicators that reflect and underestimation on the prevalence of diseases in the indigenous population. Public health has therefore identified the problems that pre-meditate the health issues currently suffered by the indigenous community and therefore cannot allow such issues to mar its movement for optimum health (Dunn,1989:12). The nursing sector in response aims to treat the health problem at its root and provide equal access to health services to the indigenous communities (Bishop, 1998: 1.42). However, these indigenous communities are reluctant to leave their homelands to seek treatment of their health problems. Bringing the health services to the far-flung communities is the main aim of the rural health nursing in conjunction with the federal government.
Rural and remote health nursing compared to mainstream practice
Rural health nursing and mainstream nursing practice has a fundamental objective of providing equal access to health to the recipients of their services. Rural and remote nurses however serve the underserved populations in the underserved areas (Dunn, 1989:12). Compared to the mainstream nursing, rural health nurses equate optimum health through preventive measures while mainstream nursing practice provide systematic care defined in their actual areas of practice. The professional category of rural and remote area nursing works to alleviate the problems in the far flung distances where health care is made accessible to the marginalized sectors of the country (Francis and Humphreys, 1999:35). Mainstream nursing practice however are most likely are geographically distributed around health institutions and primary sites. Likewise, rural and remote health nursing practice employ their own strategic planning and actions guided by abstract planning with the aid of tools and training in recognizing the needs of the culturally diverse population under her care. Mainstream nursing are often guided by structured principles and work together with a trained medical team for the well-being of her patient (Milio, 1989:317).
Rural and remote from a nursing perspective
Rural and remote nurses are decision makers who seek to build community alliances in order to promote public health education to their consumers. They employ strategic planning and awareness to influence cooperation with other community groups to support programs that define the health status of their target group. As a whole, the rural health nurse has health related values that encourage communication from the health recipient to the public policy health makers. Likewise they empower the community and seek the involvement of people in their health decisions for the good of everyone. The Remote Area Nurse has a day-to-day practice that encompasses all or most aspects of primary health care. Often she is working in the isolated or geographical remote location and is more likely responsible or is a member of a small team (Hegney, 1997:10). Remote Areas Nurses are vital to the delivery of health care in Australia’s isolated remote and rural communities (Cramar, 200:29). They are viewed as experts in risk adoption measures and strategies relevant to the health and safety of the constituents in the rural areas (Goold, 1998:127). They possess complex communication skills that allow them to approach the diverse population and are highly trained and equipped to handle their own personal safety and coping skills. Thus rural health nurses and remote area nurses are readily provided with an effective role in the promotion and enactment of legislative laws that promote constituencies with the state lawmakers in coordination with activities of various organizations(Grogan, 1987:86).
Strategies to assist families
For the nurse:
The importance of rural and remote area nurses is recognized by the Australian government. In the face of a global nursing shortage issue, the government demonstrates their commitment to prepare and support nurses in the complex practice (Hegney, 1997:10). The scope of practice in the rural and remote area promotes to build a professional status for the nurses (Milio,1989:316). The government has also placed emphasis on the providing appropriate personal support for remote health nurses and their families. Likewise, continuing education and access to a well-supported and customized professional development is made available for the workforce (Cramar, 2000:35).
For the patient and his family:
The nurse in the rural and remote health setting is equipped with training and skills to handle the diverse needs of culturally diverse families (Goold, 1998:121). Initial research and data is gathered to effectively gather the immediate needs of the target population with careful identification of values and tradition that may pose as a relevant factor in the delivery of care. The physical environment is likewise assessed in collaboration with other professional health teams is an essential approach. Members of the community are then enhanced to participate in with emphasis on the impact on their minority, racial, ethnic and language backgrounds (Goold,121). The basic unit of the society, often the family is then considered as the main target of care where often the father or the mother is the decision-maker (Bishop, 1998: 1.41). This is the initial and main strategy of the rural and remote area nursing practice that works hand in hand for equal access to health among the diverse minority groups in Australia (Dunn, 1989:12).
Nurses for the culturally diverse population
The first lesson taught in nursing schools is treating the person wholly including his differing beliefs about health and illness (Francis and Humphreys,1999:129).Any cultural difference is not a hindrance to the delivery of quality care considering the diverse population in Australia (Francis and Humphreys:128). Nurses as the front liners of the medical team understand, respect and accommodate the features of different cultures, traditions and practices and are trained to handle the diverse patients under her care (Cramar, 2000:30). In the remote setting, rural nurses consider this as a large part of her role; after all they are exposed to working with different patients. They become more culturally sensitive to the differences of most patients and learn to adapt to them (Chandler, 2001:91). Nurses who have lived in a multicultural and economically diverse setting are also easily adjusted to people with differing backgrounds and generally do well in attending patients with varied cultures and lifestyles (Chandler, 2001:91). Likewise providing care to a culturally diverse population needs sensitive care that goes beyond allowing the patient to make his own decisions (Cramar, 2000:29). Education and experience is considered as the preparatory tools for the nurse to be able to handle her exposure to the community and to be alert and sensitive to the needs of the patients. Certain tools and strategies are provided in training for the rural and remote nurses in dealing with the needs of specific populations (Dunn, 1989:12). Using these tools efficiently provides the nurse the capacity to respect the cultural preferences and traditions of patients in helping them attain the kind of care that patients need.
Rural and remote nursing: From a nursing student’s point of view
Rural and remote nursing is enhanced by the Commonwealth Government of Australia to provide primary health care benefits to the individuals and families in the regional, rural and remote parts of Australia. This is designed to provide rural health workers to the disadvantage and marginalized sectors of the country as a social justice perspective. The marginalized communities are characterised by high Aboriginal and Torres Strait Islander population with a growing aged population; increasing mental health issues(Dunn, 1989:12); difficulties in accessing services, transport and accommodation; variable economic situation. Such problems are the compounded areas that health care system needs to address. The government and the nursing program has therefore enhanced the multiple roles and responsibilities of the rural and remote nurses to draw their attention into providing care and dealing with situations in the environment for the safety and development of the local communities(Francis and Humphreys, 1999:130). Her duty encompasses all the aspect of primary health care in the provision of comprehensive and coordinated health care to that population (Cramar, 2000:35). With adequate education and training the nursing student is prepared to tackle the responsibilities of the rural and remote area nurse providing enough protection for herself and her client (Chandler, 2001:91).
Works Cited
Bishop, D. (1998). A career in health – cool. 4th Biennial Australian Rural and Remote Scientific Conference Proceedings, 27-28 August, pp. 1.41-1.48.
Chandler, T.(2001). Outback and in again – a new graduate’s experience of rural and remote nursing. 6th National Rural Health Conference Abstracts Handbook, p. 91.
Cramar, J.(2000). The extended role: implications for nursing in isolated practice settings. 5th Biennial Australian Rural Remote Health Scientific Conference Proceedings, Infront Outback, 24-26 Feb,pp.29-36.
Dunn, P. (1989). Rural Australia: are you standing in it? Rural Welfare Research Bulletin, 2, pp.12-13.
Francis B. & Humphreys J. (1999). Enrolled nurses and the professionalisation of nursing: a comparison of nurse education and skill-mix in Australia and the UK. International Journal of Nursing Studies, 36(2), pp.127-35.
Goold, S. (1998). Caring for Aboriginal people- realty or myth? AARN 7th National Conference Rural Nurses in Australia Lessons from History: Shaping our New Millennium Conference Proceedings, 12-14th March, Adelaide, pp.121-127.
Grogan, N. (1997). Personal perspective of the diverse roles of sole nurse practitioners in a rural community. 5th National Conference of the Association for Australian Rural Nurses, “Rural Nursing: Celebrating Diversity” Conference Proceedings, 1-3 Feb, pp.85-98.
Hall, J. (1997). Perspectives about nursing: the experience of nurses and persons who are recipients of nursing care in the home. 5th National Conference of the Association for Australian Rural Nurses, “Rural Nursing: Celebrating Diversity” Conference Proceedings, 1-3 Feb, pp. 77-84.
Hegney, D. (1997). The differences of rural nursing practice. 5th National Conference of the Association for Australian Rural Nurses, “Rural Nursing: Celebrating Diversity” Conference Proceedings, 1-3 Feb, pp. 9-24.
Milio, N. (1989). Developing nursing leadership in health policy. Journal of Professional Nursing, 5(6), 315-321.
Australia. Australian Statistician and Australian Institute of Health and Welfare. (2006). Australian Bureau of Statistics.
