Theresa Beech might be a practicing nurse, but she’s also a jack of all trades. The clinical management nurse works at the isolated West Australian Kellerberrin Memorial Hospital, where there’s never a dull moment. In charge of 14 full and time part nurses, Theresa could be working at a desk one moment; then called in to assess a burns patient the next.

Welcome to rural and remote nursing, where adaptability is the name of the game. For Theresa, it’s a challenge she relishes. But it’s not a life that all nurses are cut out for, she admits.

“Living in a rural community means you have to be a jack of all trades and be prepared to roll your sleeves up and do what’s needed. That’s just how it is in country hospitals. You’re in an office doing paperwork one minute and next you’re dealing with someone who has been through a family abuse situation because there’s no social worker. Obviously, there are challenges.”

Theresa is based 200kms east of Perth at Kellerberrin; a tiny remote township centrally located in Western Australia’s wheat-belt, which is home to 1,200 people. The member of the Royal College of Nursing Australia (RCNA) Rural Nursing and Midwifery Faculty says nurses working in rural and remote areas face issues that their city colleagues wouldn’t even consider – even accommodation is a long-running problem out here, she says.

Shared bathrooms and somewhat sparse living quarters is the norm. “That sort of accommodation was acceptable once upon a time, but not anymore. Better accommodation options are desperately needed,” Theresa says.

The accommodation problem stems from the fact that many rural and remote townships don’t have private rental homes available.

And while the issue in on the agenda for the (RCNA), change is yet to come.

Debra Cerasa, CEO, RCNA, says sub-standard living arrangements are being ignored by the political parties.

She recently called on all sides of politics to commit to undertaking a national assessment of rural nursing and midwifery work environments and lifestyles as a critical step toward addressing the many and pressing rural workforce issues. “Not only are rural nurses and midwives under great pressure at work, in many places they also ensure poor living arrangements and lifestyles,” Cerasa says.

“They often have poor, if any, access to continuing professional development programs, are under pressure to diversify and expand services in the absence of additional resources and may lack access to professional supports. And away from work, they commonly experience poor accommodation and have few social options.”

But calls for better living standards are a world away from everyday life for Theresa. Accommodation is one issue, but there are many others. Overseas-born nurses are commonplace in rural and remote communities, and while these centres are grateful that overseas nurses come to work in the bush, the resulting culture shock often brings up a whole range of new issues. “When overseas nurses arrive, life here isn’t often what they expect. Many have come from 400 or 500-bed hospitals and come to the bush often just to get their Visas. That’s just how it is in country hospitals.”

Working as a nurse in a rural or remote area can invade your personal space.”

These far-fetched areas also often struggle to attract doctors, placing added strain on nurses. Theresa says the community of Kellerberrin doesn’t have a doctor on weekends. “Obviously that’s a challenge within itself. But because it’s the norm here, we have systems in place to deal with this.”

Continuity of care for patients is excellent; and access to the internet has opened up a new world of online training possibilities, she says. “But having to travel into Perth for training would put a huge strain on us. There’s just no one available to back-fill that position with while someone is off having training.”

“At the end of the day, you get out of what you put into nursing.”