Or Alcohol and Other Drugs in Tennant Creek for those not up on their acronyms. My start in Tennant coincided with the town making the headlines for all the wrong reasons unfortunately. There had been two incidents that made the national news and prompted a crisis meeting with the powers of government in Tennant Creek itself. Seems like the usual political guff, a lot of talk and promises of which only a small percentage will probably be implemented. Also the changes being mooted are ones that sound good, "we will pledge X million dollars for the upgrading of X and Y services" that probably make no difference to the issues in the end. I may sound a little jaded but over the years we have seen these issues come and go with no real improvement and they just seem to die a natural death when something just as confronting comes along.

That off my chest, it is quite nice being back in Tennant Creek again, it's been 3 or 4 years since we were here and really nothing has changed much as you would expect. The new job is going very smoothly and is something I probably needed after not having a real break from remote work for nearly a year. Mind you most people would call Tennant Creek remote but it's all relative isn't it? When you are used to only having one small store with very limited selection and no options to eat out anywhere this seems like a virtual metropolis.

What I am relishing most is being able to go home, with no chance of the phone going off in the middle of the night and not knowing what will be on the other end, a sore toe or a multi casualty MVA. I was talking to Jo at lunchtime today and she was waiting for a call from the retrieval Dr about a young baby with Bronchiolitis and a respiratory rate through the roof and I thought......all I've got is to prepare for my education talk on Monday. That sort of thing may become a little mundane after a while and there is a part of me that enjoys the challenge of managing very ill people but for the time being.....will I put the video on before or after the coffee break??

Well the end of the contract at Yuendumu has come, Jo finished up last week and has gone to Palumpa in the Top End. Apparently it hasn't stopped raining there since she arrived, such a difference from the central desert. The weekend she flew out we drove into Alice Springs where the thermometer on the cars dash reached 46 degrees most of the time. 

I drove back to Yuendumu to finish off my contract for 1 more week and it was a bit of a killer. I drove back Sunday night then wasn't on-call until Tuesday night luckily as I have been feeling quite tired the last week or so. Tuesday saw myself and the second on-call nurse out until 2:30 AM on Wednesday morning with an RFDS evacuation. I had really only just got back to sleep when the phone went again at 4:30 AM  with a lady with abdominal pain. That call-out took us through until 6:30 AM so that day was shot as we are supposed to get a 10 hour break after being called out. 

I enjoyed having the day off but still didn't really catch up on the sleep I had missed out on. Wednesday was just a normal busy day then I was back on-call Thursday night and as it was my last night on-call night had resolved myself to having another big night and I wasn't wrong!

We worked from knock off time until around 8:00 PM then was just about to get ready for bed when we were called out to a client we flew out for further investigations but the plane didn't arrive until around 11:30 PM. I had just got into a deep sleep when the phone went again around 2:30 AM with a call from the local Police to attend to a house which didn't develop into anything but still took an hour to resolve.

That meant I wasn't to start until 1:30 PM but as I was supposed to drive into Alice at lunch time it meant I didn't have to actually work in the clinic again. I still didn't sleep in  Friday and was up only slightly later to finish off the cleaning of the house and do a last load of washing. Must say I am really looking forward to having a few months where there is no on call and no weekend work.

On the whole, if I have to work as a nurse then working in a remote clinic is infinitely more attractive than hospital work. To be subjected to the restrictions and scrutiny of a huge bureaucratic type organisation would be unbearable. That said, remote does have it own problems of a similar ilk.

I have read reports over the years of various management level discussions of the issues associated with attracting and then retaining remote area nurses. Suggestions that regularly surface are things like having internet access to all accomodation in remote communities, job sharing options, more flexible working arrangements, regular, paid time out of communities and a few other  ideas. As I have worked as a full-time Department employee as well as a casual contract worker I have seen the difficulty associated with staffing levels.

This was underscored again this week when the clinic we are working in at the moment has undergone another large change of staff. Truth be told, if it wasn't for agency nursing staff then a large number of remote clinic would have to close. Even with casual nurses there is usually a few clinic throughout the Northern Territory that are closed for various lengths of time due to lack of staff.

​At the moment, as Jo has left this week to start her next contract in the Top End, we have myself, 3 other experienced nurses, one of which is leaving Friday, 2 brand new to remote nurses, one of which is unable to do on call. So next week we will be  severely understaffed with experienced nurses which means the possibility of us becoming fatigued due to the amount of after hours call outs is very possible. One nurse already has 30 hours overtime so far this week, another has 18 hours. I was out until 2:00 AM this morning which took myself and another nurse out of the mix until 12:00 as we have to have a 10 hour break after our last on call.

The 10 hour break may sound reasonable but if you have 2-3 late nights a week it doesn't matter getting to sleep in late a bit, you just never really recover. It is also a restriction that if you reach a certain level of overtime hours in 1 week that you are then taken off the on call roster. Again reasonable, but that then loads up the remaining staff to take up the slack and round and round it goes. It is all well and good to put in place measures to try to relieve over worked staff but when there is not the supply of fresh nurses to relieve fatigued staff then it doesn't work in the long term. Something needs to change to attract more nurses to work remote and until the Department tries to actually address some of the identified issues nothing will change.