Carole Taylor, Chief Executive Officer, CRANAplus - Remote Health: Key Nursing Workforce Challenges


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Carole Taylor, Chief Executive Officer, CRANAplus delivered this presentation at the 2012 Clinical Training & Workforce Planning Summit.

The 2012 Clinical Training & Workforce Planning Summit discussed the future of Australia's nursing workforce, exploring ways to ensure the capacity and experience to provide high quality care for our nation's increasing healthcare needs.

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Carole Taylor, Chief Executive Officer, CRANAplus - Remote Health: Key Nursing Workforce Challenges

  1. 1. CRANAplus is a member based organisation that was established in 1982 by a group of remote area nurses. We started as the Council for Remote Area Nurses Australia (CRANA). In 2008 we changed our constitution and became CRANAplus, the professional organisation for all those who work in remote health - across Australia and her territories.
  2. 2. We are the only member based National organisation in health with a sole remote focus. We are alone in this space.
  3. 3. …what does CRANAplus do? We educate, we support all remote health professionals & their families, & we advocate for the sector.
  4. 4. Who are remote health professionals and what does the sector look like?
  5. 5. The sector is varied
  6. 6. The traditional view
  7. 7. Clinics can be inside.. or not
  8. 8. It covers the Islands off the coast of Australia
  9. 9. Oil rigs off shore
  10. 10. With challenging Medivacs in high seas
  11. 11. The numerous mining sites
  12. 12. Even the odd holiday resort …
  13. 13. The sector is tough ...
  14. 14. As a cohort the majority of people are Remote Area Nurses (RAN’s) in the 45 - 55 age bracket. Along with Aboriginal Health Workers they make up around 85% of the remote health workforce. The remainder is made up of GP’s, visiting specialists and Allied Health Professionals The Workforce
  15. 15. But this is changing • There is now much more reliance on short term locums • Workforce from urban hospitals and rural settings • Issues around training and cultural awareness • Matters of continuity and trust particularly in Aboriginal communities • There seems to be a view that fly in fly out can be a model in itself
  16. 16. Models of Care • Fly in fly out services are a vital part of the remote health matrix • Specialist care • Visiting Allied health and GP services…..but • They are not a model in themselves • Need to look at the ‘team’ and the overall mix • Must have residential services - as the foundation of services, where possible
  17. 17. Recruitment • Recruitment itself is not really that hard • People want to do this for a variety of reasons • Romanticised • Save the world • Escape • Medical tourism • Autonomy is attractive
  18. 18. Recruitment vs Good recruitment • People who understand the meaning of ‘team’ • With sufficient skill • Who have the right motivation • Who are able to make decisions • Who understand that they are on someone else’s country • Who are respectful of other cultures
  19. 19. People who are a bit bomb proof
  20. 20. Different world view People who wish to work in remote Aboriginal communities, need to understand a little of the very different cultures and the difference in world view.
  21. 21. Language & Cultures Vary
  22. 22. Our Worlds This is the view of the modern western world. Man is top of the food chain and in control of his world
  23. 23. This is mine - Everything is equal and interconnected Our Worlds
  24. 24. Retention • There is a great deal of discussion about recruitment • The big issue is retention • What do we mean by retention • What is the professional life span in remote • Retention requires support in so many ways
  25. 25. • to be heard • to have their scope of practice acknowledged • to be respected for what they do • to be properly paid • support, support and support. If we want to keep them they need:
  26. 26. 1800 805 391
  27. 27. Training CENA conference September 2011
  28. 28. They need Advice • Listen and don’t assume • Aboriginal communities are their home and you are just a visitor • When you cross the entry gate - you are in the lounge room so act accordingly • Work with people not to or at them • Respect and understand the culture and know the parts of it that affect your service delivery
  29. 29. • Are seriously resourced strapped • Can rarely get backfill • Have trouble getting out for R&R • Have challenges finding and attending professional development • Often have trouble getting paid on time • Are often not properly prepared Remote Health Professionals:
  30. 30. So why would you bother? • Because it is an amazing way of life • Because of the expanded skill base • Because of the autonomy • Because you believe in equity • Because you can make a difference
  31. 31. The positives aren’t promoted! The experiences are rich The expanded skill base is unique You can go places others will never see The people you serve are poor in resources but rich in culture!
  32. 32. But is it sustainable? • How do we attract new people to the sector? • How do we support those who are there? • How do we keep up their skills? • How can we continue to integrate them into communities? • How do we house them? • How do we accommodate students and give them a good experience
  33. 33. Where to from here • We need to have a good look at the models that work • We must realize that there is no one size fits all • We must ensure that resources are properly spent and that we cut out the duplication • We have to recognise that remote is and always will be expensive • We must look at the challenges of structures such as Medicare Locals
  34. 34. We need to teach students to work as a part of a team and get rid of the snobbery around professions We need Governments to understand the sector We need YOU to understand the sector And we need to decide if health equity matters
  35. 35. Who cares? Unlike the rest of the health sector there are no votes in remote But - We are all entitled Most people care – they just don’t know