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.