For the last week I have hardly set foot outside the door here at Peppimenarti of which I should be abjectly ashamed, but I am not! It's my first down-time in almost a year so a bit of self indulgence is warranted.
Not that I have been idle by no means. I spent the first few days just investigating accommodation and airfares for our next trip in 3 weeks. We are off to Bangkok for 5 weeks then stopping off in Kuala Lumpur for 5 days and finishing off with a few days in Bali. From there we are flying back to Darwin then the long drive back to Tennant Creek.
For the last 2 weeks Jo's mum and dad will be joining us so there was airfares and accommodation to book for them as well. I actually enjoy the planning of routes and researching different types of accommodation for trips so the task wasn't too tiresome.
We have decided to base ourselves in Bangkok in an Airbnb almost right on the banks of the Chao Phraya River but probably do at least one or two short trips from there. We always enjoy Chiang Mai so that will be on the list and this time will be doing some research into long-term accommodation there. There is a germ of a plan to move to Chiang Mai for a year or so maybe next year but still continue to do some short contracts back in Australia from time to time.
As we will be in Thailand for more than 30 days unless we can arrange a 60 day visa at the airport will have to do a "visa run" out of the country to stay the rest of the time. Anyway we are both counting the days until we leave, which reminds me I must print off a countdown to holidays calendar for the fridge door.
I have been accessing a website for inspiration from other travel bloggers for sometime now. The site is feedspot.com and I have found it a wonderful resource for a variety of special interest websites. My focus, of course, is travel and particularly the more mature aged traveller which feedspot caters for extremely well.
There is an opportunity for bloggers to submit there own sites for possible inclusion in the "top (so many) travel bloggers etc list. With some trepidation I submitted our details a while back thinking, I hope I don't embarrass myself here! A week ago I received and email from the site's founder Anuj informing me we had made the list!!!
I was so pleased and somehow felt although my efforts in maintaining a web page are mainly for my own pleasure, that being included was validation that...yeah I could contribute something to other like minded travellers. Any way check out feedspot.com no matter what your interest I'm sure you'll find something of interest too.
Use this link to view the page.
As it is said, plans were made to be changed/amended..whatever and so it was with ours. I finished work in Tennant Creek but decided at the last minute to forego my trip to Perth in order to take a more leisurely pace on the drive back to Peppimenarti. Not that there is much to see along the way that I haven't seen many times before so I set off at lunchtime Friday and was in Katherine by dinner time. Overnighted in The Beagle which is our accomodation of choice in Katherine and after quick load up of, hopefully, 4 weeks of groceries set off again.
At the turn-off to Edith Falls I wheeled off the highway to relive an event from nearly 35 years ago. I was working at Katherine Gorge, as it was known then, as a tour guide and had a lot of contact with the local indigenous people. One in particular, name withheld for privacy reasons, asked one day if I would like to see some rock paintings that no tourists had ever seen. I was very keen so took him up on the offer and we set off towards Edith Falls with my guide directing the way.
Shortly after turning off the highway he got me to stop the vehicle and we walked only a few hundred metres off the road to some rocky outcrops. Here was found a variety of rock art, some pretty ordinary but some quite reasonable
One outcrop had a huge boulder leaning at an angle on another rock making quite a sheltered area underneath and my guide said that the "old people" used to live here.
Long story short, 35 years later I was able to locate the outcrops with the art still as it was all those years ago. Since my original visit there has been a high voltage power line run quite near the site. I wondered if any of the workers had investigated these rocks and were they even aware of the ancient artwork's presence next to where they were working. As I walked back to my car the contrail of a high level passenger jet was passing overhead and I couldn't help but wonder what other changes these painting will see over the coming years.
Well 12 weeks is nearly up and looking forward to moving on even if just for the sake of moving. Not that I haven't had enough travel over the past week or so. Jo finished at Ali Curung so managed to coincide a trip I had there for work to be able to pick her up and bring her back to Tennant Creek.
We had a public holiday here last Wednesday for Anzac Day so I took the next 2 days off as well and was able to drive her, and the dogs, to the next place for us both, Peppimenarti. Peppi is situated in the Top End of the Territory in the Daly River region and neither of us have been there before.
It's a 1,000 klm trip each way from Tennant so we broke it up into 2 days staying the night in Katherine. The last 100klm or so was pretty ordinary dirt road with lots of corrugations and washaways so we took our time arriving mid afternoon on Thursday. I stayed until lunchtime Saturday then retraced the journey back to Tennant Creek which was uneventful and saw me back home Sunday afternoon again. Jo is here for 3 weeks then I will join her for another 3 weeks before we take some time off for a HOLIDAY.
First real break we have had in over a year so both are really hanging out for it. Haven't made any concrete plans yet except to contain ourselves to SE Asia somewhere and a time limit of 3-4 weeks. I will finish here next Friday and drive to Alice Springs, about 500 klms, on Saturday then fly to Perth on Sunday to catch up with my son and his girlfriend. But only for 3 night as I will then fly back to Alice on Wednesday to start the drive back to Peppimenarti again on Thursday about 1500 klm's!! That will total over 4,000 klm's of driving to move us both into the next job but most, if not all really, is straight, flat driving where the speed limit is 130 KPH so it passes quite easily.
Well time has gone reasonably quickly, 2 months down and 1 to go. I have fallen into a comfortable routine with my job, eking out the small amount of work needed to be done so that it lasts the week. Since Jo has been in Ali Curung at least I have been able to drive down there on Friday after work then back to Tennant Creek on Sunday afternoon. Jo only has 1 week to go before flying back home for a few days then heading to Pepperminati in the Top-End to start our next contract then I will join her after finishing here.
Life is very comfortable here but not at all challenging and certainly no clinical work. I was visiting the Elliott Clinic the other day on one of my fortnightly visits to engage with the 1 client I have there. As I walked into the waiting area there were a few people waiting to be seen and I felt like I was back home, where-ever that might be!!!
For anyone reading this without an idea what a Remote Area Nurse actually does I will give a quick synopsis. Remote Indigenous communities of anything from a few hundred to a few thousand people will have their own Health Clinic. Depending on the community size it may have anything from 2 nurses with a visiting Doctor maybe once a month up to 7-8 nurses and a permanent Doctor.
Even those with a permanent Dr it is usual for the Dr not to be called out afterhours even for emergencies unless it really is life or death. RAN's will see anything that comes in the door, from doing annual health checks to heart-attacks and everything in between. Suicides by hanging, assaults, rapes, births....anything!!! RAN's complete higher training in order to deal with these types of presentations.
We work from a manual called the CARPA which enables us to dispense medications, antibiotics and stronger pain relief as long as we follow the criteria set out in CARPA. If no Dr is available to consult with we are able to contact an oncall Dr to consult with over the phone. We also use a computer platform that the Dr can see our notes as well as the results of any investigations we have conducted in the clinic in order to come up with a diagnosis.
If all else fails and despite our treatment plan things go South we will call in the retrieval service be it the Royal Flying Doctor Service or Careflight in the Top End to evacuate the person. Depending on the condition of the client this may take anything from 2 hours to 24 hours during which we will have to manage the client and keep the Dr informed of any changes in condition.
It is a rewarding job with lots of challenges and discomforts. It can be infuriating and at times can get the adrenalin pumping. Certain additions to policies have made it safer but still nurses get assaulted and threatened on a regular basis too often. Had I my time over again I would have "gone remote" in my twenties before having children. Earned a bucket load of money, and there is a bucket to earn, paid cash for a house then had the luxury of deciding where and how much I worked from then on.
But time is something we can't have over again unfortunately.
Jo has been blown away by cyclone Marcus this week, almost literally! Marcus slipped down the western coast of the Northern Territory dumping huge amounts of rain with high winds that caused plenty of havoc in Darwin. Palumpa escaped any property damage by the winds but caused plenty of inconvenience. Unfortunately timing is everything and one chap had the bad luck to be bitten by a snake just the cyclone went passed. Snake bites are always flown out for management in hospital but as the cyclone was still raging about the Careflight plane was grounded until the Darwin airport opened again.
That meant Jo had an all-nighter in the clinic monitoring the unlucky guy. Although he was quite stable she had to stay awake, while he and the second responder had a lovely nights sleep. Jo was able to handover the next nurse at 8:00 AM to go home and try to catch up on her sleep. Although it sounds a simple process of closing the blinds and just passing out due to exhaustion but the reality is different. You are usually lucky to catch a few hours sleep before your body clock says it's time to wake up again. That's not usually too much of an inconvenience but at 11:30 PM Jo gat another call-out from the other Nurse as there was a head injury coming in and the usual second responder was unable to attend. So another broken sleep for her as she wasn't finished until 3:30 AM!
Jo had to be back on board at 8;00 AM as the GP was flying in for his weekly visit as well as the usual clinic manager who was returning from leave, Jo had been filling in for her. So a few hours sleep, work for a full day, fly to Darwin, night in hotel, up at 6:00 AM for flight to Alice Springs, night in hotel, flight to Tennant Creek, night with me then drive to Ali Curung where she will be for the next 3 weeks. At least for the next 3 weeks Jo will be only one and a half hours drive away from me so I will be able to drive there every week end. Hopefully we can sign up some contracts together after these have finished.
For those unfamiliar with the term Gayle's Law I will give a little background. March 23rd 2016 in the remote indigenous community of Fregon, South Australia, Gayle Woodford, a Remote Area Nurse, was on-call for afterhours emergencies. At around 9:00 PM Gayle and her husband, Keith, went to bed as usual and that was the last time Keith saw his wife alive. Around 11:30 PM Gayle must have been called to their front door, without Keith waking and somehow was lured outside the security cage that surrounds most nurses accommodation by a plea from a man stating that his Grandmother was ill.
That man was Dudley Davey who has since been jailed for life for her murder. He lured her away from the safety of her home with a plea which struck at the core of Gayle's instinct to help the sick. He overpowered Gayle and taking her and the clinic ambulance took off into the bush where he raped then murdered her, burying her in a shallow grave that was discovered 3 days after her disappearance.
This disgusting crime instigated other Remote Nurses and Keith to petition the SA Government to bring in legislation what has come to be known as "Gayle's Law" meaning no nurse should attend any call-out alone and all one nurse clinics should be closed unless extra staff be employed. "Never Alone" was the catch-cry sounded by nurses from all walks of life, from the cities to the outback that enough was enough and this abomination will not happen again.
A TV report aired on the ABC a few nights ago refreshing the memories of Gayle Woodford's heinous murder and the fact was revealed that Safework SA which is responsible for providing work health and safety, public safety and state-based industrial relations services across South Australia has deemed Gayle's death as being not "work related" and as such no workers compensation will be paid to the family.
There are about 1,000 remote area nurses in Australia and our work is challenging. Doctors are usually present only a few days a month and rarely available for afterhours assistance, clinics can be chaotically busy, and RAN's can be called upon for everything from a toothache or a wound needing stitches, to medical evacuation, childbirth or domestic violence-related injuries. The fact that Gayle was expected to be on-call that night and was expected by her employers and the community to use her skills to help anyone in need of medical care that night surely this cannot be classed as "not work related".
This finding has only rubbed salt in the wounds of all RAN's to discover that if something happens to us between our homes and arriving in the clinic afterhours that we will not be covered by workers compensation. There was a huge outcry from nurses of all callings after the program aired via social media but as to whether any of us will be listened to is yet to be discovered.
Watching the program only served to underscore the fine edge that RAN's walk sometimes in these extremely remote settings and only served to refresh the horror that Gayle must have endured that night.
RIP Gayle Woodford- Never Alone.
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.