Introduction
The most disadvantaged people in matters regarding health in Australia are those hailing from rural and remote areas. From research, the two most affected indigenous communities in Australia are the Torres Strait Islanders and Aboriginals compared to those already urbanized (Bishop et al., 2016). Mainly, these rural dwellers face the challenges of higher illness rates, repeated or extended hospital stays, deaths, and serious injuries. More so, as the government continues to neglect rural patients, their conditions further deteriorate and increase due to their poor economic well-being. That is why it is crucial for the healthcare sector to intervene in the remote areas to ease the burden facing them. Nonetheless, it is also important to understand that the nurses sent in these regions face multiple challenges due to inadequate health resource amidst other problems, thus requiring regulatory bodies to intervene and provide a more conducive environment for them. Therefore, the illnesses in remote Australia are a real crisis, thus the need to understand the best intervention strategies and confront the problems facing the healthcare professionals in these indigenous communities.
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Apparently, indigenous Australians are repeatedly faced with critical health issues, which require serious intervention strategies from all the involved governmental bodies. The first step towards improving rural health is remodeling the existing primary care policies to cater to the needs of those in remote regions (Menadue, 2014). By so doing, the indigenous communities can begin to benefit from the established wellness maintenance programs enacted in place and delivered safely by developing health care teams. Moreover, individuals and families will become more responsible for their health with the care and help of personalized professionals. If this intervention strategy is adhered to, then the waiting lists in hospitals and delays in emergency departments will be eliminated while the indigenous people from Australia will benefit from the chronic care and prevention strategies implemented for their wellbeing.
The second intervention plan is to initiate and implementing more vigilant nursing care reforms. In this initiative, nurses will get the freedom to work anywhere across the region instead of being harbored under restrictive working practices that have proved inefficient over the centuries. In addition, the school curriculum should also consider training more assistant doctors and introduce other attractive nursing fields that can hold a large range of nurses. However, in Australia, it is clear that there is no shortage of physicians, but their uneven distribution continues to propagate rural health inadequacy (Menadue, 2014). Therefore, the government, the prime regulatory body, should ensure that doctors are hired as per demand. Only those willing to work in poor areas should be provided with working opportunities in the public sector.
The third intervention strategy should be based on ensuring that people from remote locations are provided with equitable health choices and education resources. In fact, it is only through improved education that indigenous communities are assured of benefiting from all social, economic, and health platforms, which are the primary determinants of a healthy community. Regarding health issues, education will improve the literacy levels of individuals and communities in remote regions, thus facilitating health awareness promotions and illness prevention strategies within these areas (Barclay, 2013). Moreover, educations pave the way for increased job opportunities that eradicate or reduce high poverty levels, ensure that people live in decent homes and eat balanced diets for the good of their health.
Poor health delivery in rural Australia also requires the government to take more Medicare services to the remote areas. Mostly, private companies or the Medicare scheme, which does not provide subsidies as required, provides medical insurance. In this case, people are accorded funds by location, availability of a physician, and one’s financial ability (Barclay, 2013). As a result, the poor indigenous people find it hard to take up an insurance policy, and hospital billing becomes an almost impossible ability that further deteriorates their health. That is why localizing Medicare funds is crucial since the funds sent to these regions are served according to the needs of the people.
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In Australia, myriads of issues confront nurses in remote regions (Paliadelis et al., 2012). As a result, most nurses opt to leave their jobs and seek for friendlier working environments, a situation that lead to an acute shortage in the number of nurses offering care to indigenous populations. On the other hand, reliable specialized health care providers are left with a large workload, thus eliminating the boundary between specializing and generalizing practice, an issue that inherently leads to deskilling (National Rural Health Alliance, 2013). In addition, workforce challenges lead to poor duty allocation strategies as few nurses are expected to provide services for underemployed working stations alongside providing timely reports and keeping records.
Another major challenge facing nurses in rural areas is inequitable access to opportunities (Paliadelis et al., 2012). Nursing professionals find it hard to obtain educational advancement opportunities and develop their careers at the same time as the rural regions have inadequate learning facilities and space to improve their specialized skills or seek mentorship from experienced colleagues. In addition, those working in remote areas are governed by reluctant administrations, which neglect their remuneration concerns, thus paying them poorly, unlike those in metropolitan regions.
It is worth noting that nursing practice in rural Australia faces contextual challenges of living in geographically isolated areas where at times, they have to survive under terrible climatic changes and live in devastating conditions like those facing their patients (Paliadelis et al., 2012). Nurses in rural areas live a life of great isolation from their peers as hospitals are located in distanced radiuses away from the urban areas. As a result, there is a major effect on their career growth and psychological well-being (National Rural Health Alliance, 2013). Moreover, due to geographical roughness, nurses travel a lot to reach out to their patients, thus adding to their cost of living, as they have to find decent accommodation, which is sometimes very expensive.
The other challenge facing nursing practice in remote areas is inadequate resources and especially those related to information technology (IT), for excellent recording and provision of evidence-based practices (Paliadelis et al., 2012). While digitalization is crucial in ensuring that nurses acquire the right education and eliminate the idea of isolation, the Australian government has completely neglected them,, thus leaving rural nurses unfamiliar with IT integrated practice. On the other hand, available machines are ignored and often go for long periods without maintenance, a process that further delineates remote nurses from their metropolitan counterparts.
Resolving Nursing Practice Challenges in Remote Areas
Therefore, to help reduce the impact of the great challenges facing nurses in remote areas, the Australian government should consider the following strategies:
- Remunerating nurses in the countryside, according to their specialty skills, experience, and training.
- Improve their working conditions by ensuring that they live in safe and well-developed incentive accommodations.
- Ensure that staffs in indigenous regions are provided with leaves to have family and personal space.
- Consider introducing IT related materials and technical support whenever needed.
- Ensure that the nursing sector adds training centers in the rural regions to help nurses familiarize with remote areas and advance their education in the comfort of their workstations without having to travel widely for decent curriculum programs.
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Australians are perhaps the most advantaged inhabitants, as their government has put in place effective policies to ensure that all its citizens access equitable health procedures. For that reason, this region has the highest life expectancy in the world. In fact, the policy makers put aside a significant amount of money to cater for Medicare services, primary care, and different hospital services like those of a specialist and the diagnosis (National Rural Health Alliance Inc., 2011). In addition, Australians are supposed to be offered friendly services while in non-acute hospitalization and same-day hospital care. Nonetheless, equitable access to health care in rural Australia is yet to be realized as the indigenous inhabitants still face myriads of challenges in acquiring primary health care services in their regions. As a result, remote Australians continue to languish in poverty, illnesses, high living standards, and inequitable resource distribution.
From the National Rural Health Alliance Inc. (NRHAI) report of 2011, people living in rural areas in 2006-2007 had fewer numbers of health care services by a margin of 12.6 billion, and their Medical Benefits Schedules (MBS) were lagging behind from urban hospitals by 811 million dollars. By 2011, the MBS shortfall had fallen further, up to 1 billion dollars (National Rural Health Alliance Inc., 2011). Notably, according to the NRHAI report of 2011, the health services provided in the rural sector are inequitable since the relevant departments, like those of dentistry, medication, medical appliances, legal aids, and allied treatment care, are largely neglected. In 2015 this country’s rural deficits in the health sector was still lagging behind in amounts as large as 2.1 billion dollars (Thomas et al., 2015). With this kind of statistics, it is clear that the government continues to underspend on the crucial health care practitioners situated in remote regions. On the other hand, money is overspent on hospitals instead of directing it to the primary health care service providers who are best placed to care for the rural inhabitants.
However, recent legislative bodies have initiated policies that gradually eliminate the health inequitable issue in the rural regions (Thomas et al., 2015). With this approach, rural individuals and communities now enjoy PHC services at all levels as health service networks are now closely relating to the needs of patients at community levels, unlike the past. In earlier years, Medicare was universal and simplified health care, but it was inequitably accessible and inefficient. For instance, urban regions were accorded at least $145 annually, while remote areas only got $92 (Stratigos, 2010). Therefore, most indigenous people did not acquire the required share of Medicare since it could only cover 20% of the population (Stratigos, 2010). Nonetheless, with new PHC policies, people in rural regions now fully enjoy Medicare rebates, reimbursed according to need, not the size of an area or geographical location.
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Nursing in a rural Australia shows that practicing in this region is not only challenging but also complex in nature. Notably, most nurses in the countryside provide general services instead of the specialized care they received in school. For that reason, they take care of all kinds of illnesses ranging from chronically ill patients, health promotion initiatives, disease prevention activities, and treating mild or complex diseases. In addition to challenging practice procedures, nurses in rural regions face significant difficulties of surviving with scarce resources due to the existing inequitable distribution (Jennings, 2008). For instance, nurses barely have enough reference books to provide service on an evidence-based practice approach.
Moreover, remote regions’ hospitals are mismanaged, a problem that is reflected through disorganized manuals, timetables, contact details, and IT appliances. Nursing is also complicated due to high-stress levels based on workload burnouts, challenging treatment procedures, and problems in balancing both families and work obligations. In addition, the workforce in rural Australia faces severe shortages as the work in this area continues to increase due to a significant portion of an aging population in the health care sector and general population (Wakerman & Humpreys, 2008). Moreover, most nurses in these remote areas lack contextual knowledge of the challenges facing indigenous people and rough geographical topographies. Consequently, it becomes hard to relate properly to rural resident, a problem that exposes them to danger and animosity from the indigenous communities.
Conclusion
Apparently, rural Australians are faced by myriads of challenges both in the economic and health contexts. Hence, it is crucial that regulatory bodies intervene in this situation by remodeling the existing primary care policies, reforming nursing training and practice bodies, ensuring equitable distribution of resources, and making sure that Medicare serves its purpose. Consequently, rural nurses face various challenges, including minimal career development space, little exposure to a particular practice, the high cost of living, and poor infrastructure. As such, nurses should be remunerated effectively, live in good working conditions, have IT at their disposal, and ensure that they have open opportunities to advance their education to familiarize with rural regions. Significantly, Australia has vast resources to cater for equitable health access ranging from Medicare, primary care, specialist and diagnostic services, hospital visits, and stays. However, to date, rural regions still struggle to cater adequately for the insurance needs of native residents and nurses thus, these areas always record shortfalls in their annual rebates and benefit schedules. Lastly, it is crucial to note that rural nursing practice is primarily complex in nature, as stress, work overloads, inadequate personal safety, workforce shortage, mismanagement, and resource scarcity characterize its environment.
References
Barclay, L. (2013). Shining a light on rural and remote health. National Rural Health Alliance Inc. Retrieved from http://ruralhealth.org.au/news/shining-light-rural-and-remote-health-0
Bishop, L, Martin, L, & Gale, L. (2016). Providing aeromedical care to remote indigenous communities. Royal Flying Doctors Service, 1-116.
Jennings, B. M. (2008). Work stress and burnout among nurses: Role of the work environment and working conditions. An Evidence- Based Handbook for Nurses, 2, 137-158.
Menadue, J. (2014). Opinion piece: How to improve health services in the bush in the next ten years. National Rural Health Alliance Inc. Retrieved from http://ruralhealth.org.au/news/opinion-piece-how-improve-health-services-bush-next-ten-years
National Rural Health Alliance Inc. (2011). An overview of the shortage of primary care services in rural and remote areas. Australian Journal of Rural Health, 1-11.
National Rural Health Alliance. (2013). Advance nursing practice in rural and remote areas. National Rural Health Alliance Inc., 1-25.
Paliadelis PS, Parmenter G, Parker V, Giles M, Higgins I. (2012). The challenges confronting clinicians in rural acute care settings: a participatory research project. Rural and Remote Health. Retrieved from: http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=2017
Stratigos, S. (2010). Equal is not Equitable: Medicare in the bush. Rural Doctors Association of Australia, 1-17.
Thomas, L, S, Wakerman, J & Humphreys, S, J. (2015). Ensuring equity of access to primary health care in rural and remote Australia: What core services should be locally available? International Journal for Equity in Health, 14(111), 1-8.
Wakerman, J & Humpreys, J. (2008) Rural and remote health: Definitions, policy and priorities. A textbook of Australian Rural Health, 13-30.
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