industry & reform
Remote area nurse Terrie Ivanhoe . Source : Supplied
“ This job has taught me to shut up and listen .
Listen and learn
Life as a remote area nurse in Australia ’ s most isolated communities .
By Eleanor Campbell
Across the vast , red desert of northwest South Australia , Terrie Ivanhoe is helping to deliver the COVID-19 response in the country ’ s most remote Indigenous communities .
“ I think out of everything I ’ ve done over the last 11 years this has probably been the hardest ,” Terrie told Nursing Review .
“ If you look at access to care and our specialist services , they all slowed down , and a lot of people were not able to come into the communities .”
A veteran remote nurse practitioner , Terrie has spent over two decades with the Nganampa Health Council , an Aboriginalcontrolled primary health care service .
Situated on the Anangu Pitjantjatjara Yankunytjatjara ( APY ) Lands , the organisation works with around 3,000 people living across six remote Aboriginal communities .
The vast landscape stretches over thousands of kilometres and is roughly the size of Iceland .
“ People speak their own language , which was a shock for me when I got out there . I was shocked at my own naivety that I had never thought about it .”
Over the past 18 months , Terrie has worked with a handful of practitioners to deliver COVID-19 information , vaccinations and testing across the region .
“ Our pandemic response really has been a gold standard and just as good as anywhere in the country ,” she says .
For her service , Terrie was awarded the 2021 CRANAplus Aurora Award , which is the highest possible accolade for nurses in remote and isolated health .
She says she has learnt countless lessons in her experience as a remote area nurse , including the most important one – knowing when to “ shut up and listen ”.
“ I think this job has taught me to shut up and listen : don ’ t fill every space with words . Sit back and listen and seek to understand first before you make any comments .”
CLOSING THE GAP Terrie began her career as an emergency nurse in Perth over 20 years ago .
When she was sent to work out-of-state by an agency , she took one glance at the desert mountain ranges and never looked back .
Since then , Terrie has overseen Nganampa ’ s Chronic Disease Program , which works to address the disproportionate rates of chronic disease in remote Aboriginal communities .
“ Our rates of acute rheumatic fever are shameful and they are completely undermined by the social determinants of health ,” she said .
As part of the national Closing the Gap strategy , the South Australian government released its first implementation plan to improve health outcomes in Indigenous communities .
Of the 200 targets , the government promised to develop more communitycontrolled health services , including establishing an Aboriginal mental health and wellbeing centre .
Terrie says that based on what she ’ s seen , the program has “ not done a whole lot ” to improve health inequity .
“ It is my view that we are very good at providing secondary and tertiary care , but we ’ re very bad at delivering primary health care and addressing the social determinants of health ,” she said .
“ There ’ s lots of rhetoric around it . But doing something about it is really hard , and my role as the chronic disease coordinator is actually trying to address some of those things .”
Throughout her career , Terrie has spent years visiting her clients , listening to their stories , and taking the time to get to know their families .
Developing relationships with her clients has been key to establishing trust as a non- Indigenous medical practitioner , she says .
“ One of the things that I think we don ’ t always pay enough attention to is that therapeutic relationship ,” she says .
“ We assess the patient , we see the patient , we look after them , but we don ’ t actually try to build a relationship with them .
“ If you haven ’ t got a good relationship with people … they will never trust you .”
Remote Indigenous communities in the APY lands are among the most economically and socially disadvantaged in Australia , with some of the lowest rates of life expectancy in the country .
Terrie says she looks to her own childhood experiences to understand the cycle of poverty .
“ I come from a very poor family , and I think that I ’ d always been embarrassed about that ,” she says .
“ As I ’ ve got older , I ’ ve realised what a privilege it was to be poor . Because I ’ m able to see the world through different eyes .
“ I live a very privileged life , of course , but most white fellas do , even if you ’ re a poor white fella .”
After 20-odd years on and off the job , Terrie plans to transition into part-time retirement next year to spend time with her 10 grandchildren .
Reflecting on her time in remote area nursing , she says the profession “ fell into her lap ”, but she wouldn ’ t have had it any other way .
“ We all have a purpose in life and I would believe that my purpose has been to be of service .” ■ nursingreview . com . au | 17