Year 4C students at Swifts Creek with Sue Carroll, Bush Nurse at the Centre

Deb Johnston reports on the Year 4C orientation trip to the mountainous region north of Bairnsdale.

As part of the Year 4C orientation week, students were introduced to Omeo Hospital and Clinic and Swifts Creek Bush Nursing Centre where they will be spending up to two weeks each during the year.

At 8.30am all boarded the bus, driven by our experienced bus driver Deb Johnston (alias Regional Manager East & South Gippsland, ably assisted by the East Gippsland tour guide (alias Marnie Connolly Year 4C Academic Coordinator). Knowing the road is quite curvaceous a frequently (on this road) requested spew bucket was also packed.

The morning dawned as all mornings do in East Gippsland – nothing but blue skies and sunshine – as we headed north-west, with Marnie doing the tour guide job to perfection. We arrived at the Omeo Hospital in time for a tour of the hospital and clinic by Tracey Ah Sam the Medical Centre Office Manager and Annie Kissane the practice nurse.

Students were introduced to staff they would be training with and Tracey told of the many things they could experience whilst on placement: snow at Mt Hotham, horse riding, fishing, white water rafting, bush walking, bike riding and the many community nights held locally. Some students wondered how they would manage to squeeze in their clinic time with all that was on offer. The Omeo Hospital staff supplied us a morning tea of pancakes and savoury scones. We then checked out the student accommodation, said our goodbyes and headed back via Cassilis (the more scenic route) to Swifts Creek for a tour of the Bush Nursing Centre with bush nurse Sue Carroll.

Students will attend Swifts Creek Bush Nursing twice a week and Ensay once a week with the GP from Omeo as part of their placement. Sue outlined what the centre does, the type of patients they see and the distances they travel, and spoke about some of her more hair raising experiences. Sue joined us for lunch but had to be back by 1.30pm to commence student vaccinations.

We then boarded the bus for the trip home. Not many of the students will remember the trip home as all but one slept. We arrived back in Bairnsdale by 4.00pm and, due to the bus driver’s skill at the wheel, the infamous bucket sat gathering dust.

Deb Johnston, Manager, School of Rural Health – East & South Gippsland

2014 student group from both Monash University and Federation University

Delivery of the nursing program at the School of Rural Health – East Gippsland education centre at Bairnsdale continues following the transition of Monash’s Churchill campus to Federation University in January. The program has been well established over the last two and a half years. This year sees 14 students in Bairnsdale – 10 Monash students who enrolled before the changeover and four from Federation University.

Nursing educator/coordinator, Beth Jacob, said the transition has been a smooth one as the program for both groups of students is identical. The nursing program will continue in Bairnsdale after the last Monash students graduate, with Federation University students using Monash’s tutorial rooms and skills lab.

The School of Rural Health – East Gippsland education centre in Bairnsdale will host a special forum  – Just Looking @ Careers in Health – in April to encourage local students, and Indigenous students in particular, to consider a career in health.

This innovative approach to health education is being run in partnership with KIKASS (Keeping Indigenous Kids at Secondary School), a high school support program for Indigenous students at Bairnsdale Secondary College run by the Smith Family.

Students will be given a tour of the school, visit the skills lab and be trained in basic life support with the help of Jimmy, the hi-tech mannequin. They will also hear from nurses, doctors and students about careers in health and have the opportunity to ask questions in a small group setting.

Practice nurses in East Gippsland had the opportunity to update skills at the first Practice Nurse Education Group (PNEG) program workshop in February.

The Practice Nurse Education Group program (based at the School of Rural Health – East Gippsland in Bairnsdale) has been running for the last three years. Designed to give medical practice nurses up-to-date training opportunities, the program is coordinated by Marnie Connolly (Year 4C academic coordinator in Bairnsdale). Participants travel from rural and remote areas of Gippsland to attend, so the workshops provide a positive networking opportunity as well.

February’s workshop focused on basic life support with theoretical and practical workshops which covered an update on Australian Resuscitation Council guidelines and CPR techniques for all age groups, automated external defibrillation (AED) and choking. Robyn Adams from the Gippsland and East Gippsland Aboriginal Cooperative joined Marnie in presenting February’s workshop.

The regular workshops are delivered with the support of local medical practitioners and nurse educators who run the topic discussions and instruction. Previous topics have included management of asthma, structured approach to psychiatric emergencies, and principles of diabetics and its management. Each workshop is evaluated and the feedback is taken into account in developing future workshops. Previous comments noted that the workshops provide positive reinforcement of existing knowledge and cover gaps in knowledge. SimMan received a special mention when he was introduced as a learning tool.

Members of the local Koorie community, ambulance officers and midwives from hospitals across Gippsland (including Sale and Traralgon) attended a two-day workshop in March in obstetrics emergencies within the cultural sensitivity framework.

The Royal Women’s Hospital maternity emergency department in partnership with the Bairnsdale hospital delivered the workshop at the School of Rural Health – East Gippsland education centre in Bairnsdale. Coordinators included a Koorie liaison officer and Koorie  actress who were able to expand on, discuss and clarify the cultural sensitivity relating to maternity emergencies.

Around 40 participants took part in discussion panels on day one covering emergencies for neonates. Day two involved participants in practical skills on intubation for neonates, accessing umbilical veins in neonates and neonate resuscitation.

Library at Central Gippsland Health Service (Sale)

Librarian, Helen Reid, introduces the Sale library which encourages lots of noisy discussion, coffee and pizza.

Through the night, all weekend and of course across each weekday, the lights are on in the library at Central Gippsland Health Service (Sale).

Daytime observations reinforce after-hours access reports of a cross section of disciplines and tiers of students and staff individually and in groups sharing this research and study space.

Library staff encourage food, noise, talk. Group forays for take-away coffee are common as are after-hours deliveries of pizza to the Library door. The water cooler use is a constant. Sustenance is necessary for long day and late night research and study.

Noisy talk is group learning; or communication and teamwork. Quiet study is through ear-plugs and surround sound head-sets.

The food culture and noise enhances sharing across groups and disciplines. Knowledge sharing from group to group (pharmacist to medical student, intern to registrar, home support to nurse, business analyst to allied health practitioner) quickly evolves. Groups meet, mix and move amidst an ethos of knowledge, professional development and ad hoc tutoring. New staff and placement students rapidly become socially engaged and discover collegially the offers of regional learning and living.

Clearly the outcomes are positive. The Sale experience provides opportunity across disciplines to taste the offerings of a regional health service. Many in the mix remain and others consistently return to Sale.

The experience gives method to the full patient care recipe; albeit the occasional spilt coffee or empty pizza boxes.

The second rotation of interns at Bairnsdale Hospital begins in March and as part of their orientation they are must attend an emergency skills workshop. Year 4C and 5D medical students also take advantage of the workshop. Facilitated by local clinicians, workshop stations include asthma, management of an adult trauma, a MET (medical emergency team) call, approach to the unwell child, and basic airway management including LMA (Laryngeal Mask Airway). Interns are required to do at least one rotation in a rural area.

Matthew McGrail

Your name and position
Dr Matthew McGrail
Senior Research Fellow (based at the School of Rural Health – Churchill)

Describe your role
As a full-time researcher I’m leading two major projects: MABEL (Medicine in Australia: Balancing Employment and Life) with the CRE in Medical Workforce Dynamics where I lead the rural medical workforce supply and distribution research theme; and the CRE in Rural and Remote Primary Health Care. The main “deliverable” for this second project is the Index of Access, where I lead our research team on improved measures of access to primary health care services in rural areas.

Why is it important?
As a metro-bred researcher who’s moved to rural, I’m highly conscious of the poorer access rural people have to healthcare services and generally poorer health outcomes. Finding better ways to give people access to the services they need is important for minimising health inequalities.

What is the best aspect of your work with the School of Rural Health?
I love the autonomy I have in my role; I’m given a fairly long leash! My background is in maths, IT and statistics. This role brings together my love of analysing data and using that to improve rural health outcomes.

When you are not at work, what do you enjoy doing?
Janelle and I have twins in grade 6, so I spend a lot of time with them. They’re at a fun age at the moment. I also like long distance running. But right at the moment I’m injured and can’t run, which is a sore point. When I can run, I like getting out and enjoying the outdoors.

What was your most recent holiday destination and why did you choose it?
Can I talk about the holiday coming up in a month? We’re spending three weeks in the USA and taking the kids to visit Disneyland in California while we’re there.

If you were Emperor for a day, what is one thing you would implement?
I’d like fairer distribution of all sorts of resources and opportunities. It’s what drives the Index of Access: making sure rural people get a fair go in their health.

Surprise us! What is something about you that most of your peers would not know?
I’m not a product of a rural upbringing. I went to Melbourne High then Melbourne University so I’m inner-city metro-bred, but I love rural. Where many young people leave rural areas for the city, I ran in the other direction after study and went rural.

The School of Rural Health hosted Sue Berry from the Northern Ontario School of Medicine (NOSM) who was in Australia during February on a study tour. Sue is the Associate Dean (interim) Continuing Health Professional Education at NOSM and is interested in how other medical and health professional schools view “community engagement” in the work that they do.

Squeezing in Monash between visits to James Cook University and Flinders University, she visited Bendigo, Clayton, Churchill and Bairnsdale where she took part in a community engagement workshop hosted by the School of Rural Health – Bairnsdale.

While in Bendigo she met with key staff and, over lunch, described the medical degree offered by NOSM. Of particular interest were the clinical attachments students undertake for weeks at a time in a remote aboriginal settlement. Students sometimes have to fly into these settlements and outside access is very difficult, particularly in harsh weather conditions. In the afternoon, Sue visited a local Bendigo medical practice, Creek Street Medical Practice, with Dr Dennis O’Connor.

As it happens, Sue has a Bendigo connection through her daughter marrying a Bendigo man. Sue and the Bendigo mother-in-law are eagerly awaiting their first grandchild.

The Koorie Men’s Health Day is an innovative mental health delivery model that was trialled in Gippsland.

The PhD research of Anton Isaacs inspired the development of an innovative model of community-based mental health delivery for Koorie men.  Anton’s research highlighted the difficulties faced by Aboriginal men in accessing mental health services and adhering to treatment.  The study also demonstrated the difficulties faced by staff in addressing the unique needs of Aboriginal men who need mental health care.  As a result, the Koorie Men’s Health Day was developed and trialled.

The Koorie Men’s Health Day model was written up in “The Koorie Men’s Health Day: an innovative model for early detection of mental illness among rural Aboriginal men” by Anton Isaacs and Berwyn Lampitt. (DOI: 10.1177/1039856213502241). This paper describes how a mental health clinician, an academic and Aboriginal Elders worked as a team to design and implement an innovative model for early detection of mental illness among Koorie men in Morwell. The model of service is based in the community, overcomes most barriers faced by Koorie men in accessing help for mental health problems, de-stigmatises mental health and services.  The model appears to be cost efficient, being self-sufficient from beginning to end.

Interest in this model is growing.  Two more Koorie Men’s Health Days are planned for March and September in Gippsland with an expression of interest from Echuca.

Anton is a lecturer at the School of Rural Health – MUDRIH.