Learning on the run

Graduate Isabel Dykes gives an insight into the practical advantages of rural graduate placements.

Despite completing my nursing degree at UTS and attending placements at Sydney's metropolitan hospitals it was my rural placements in Bellingen and McLean that I loved the most.

Because of this, I decided I wanted to live and practise as a nurse outside Sydney. My family live in Sydney, so I had no particular inclination to any particular location. I did, however, have a list of attributes regarding my ideal country town; green hills, fresh produce, farmers markets, community sporting events and a social community.

In applying for my new graduate position I kept these things in mind. In the end I received my heartbreaking letter of decline whilst on "practical" at Royal North Shore Hospital.

Upset as I was, I talked to different local health districts (LHD) and eventually managed to secure a place at Gunnedah Hospital in the Hunter New England LHD. Gunnedah was six hours drive north-west of Sydney, a thriving agricultural town and one of NSW's sunflower growing areas, I was hooked.

I moved to Gunnedah in February this year and started work two weeks later. Despite being supernumery for the first two months, I felt like part of the team and I made friends quickly within the hospital walls; outside of the hospital was more difficult but I knew that this would come with time.

In my first two weeks at the hospital I had been involved in two cardiac arrests brought in by ambulance; suffice it to say CPR on a real human being is worlds apart from practising on "Resusci Anne", but I was grateful to have had this experience. By March, I was accredited to cannulate and draw blood and certified in advanced life support. By April, I was flying solo as the only registered nurse on the general ward with two enrolled nurses and student nurses. This felt like a huge step but most staff members are very experienced and happy to assist.

By June I was working in the emergency department as the sole nurse with an on call doctor and assistance from the ward nurses if needed.

I was thrown in doing five days straight in the emergency department and really grew to love the work and such a fast-paced environment. In Gunnedah, "emergencies" encompass different things to different people but in my time here I have cared for both paediatric and adult cardiac and respiratory arrests, chainsaw injuries, lacerations, colds and flu, medication overdoses, snake bites, seizures, and head injuries.

I am the first carer for people arriving at emergency; I assess, triage, treat according to guidelines, cannulate, take blood and notify the on-call doctor.

All hospitals offer a new graduate education and support. Through speaking to colleagues it seems that this is never as expected. Whilst new graduates in metropolitan hospitals don't receive much support because there are so many staff members, catering to a busy ward, in rural hospitals there are so few staff members, similarly in a busy environment, that new graduates are needed as a core team member.

In terms of knowledge, a new graduate will never feel ready for their first year of work, I know I felt like I knew nothing. However, I think that being thrown in the deep end is one of the most important aspects of a new graduate year; one which tells you a lot about yourself as a nurse and which encourages you to realise how much you actually know.

The medications come with time; one day you will be able to immediately associate brand names with generic names and it will surprise you. One day you will be able to answer a patient's question without asking and you will be suitably impressed with yourself, and so you should be, this is a great triumph that should definitely not be taken for granted.

You will make mistakes, but these are learning tools, and you will most likely never make the same one twice. I encourage all graduates to consider rural nursing. An individual develops greater understanding of general nursing, has increased autonomy, authority and responsibility and develops more individual skills. Remember, people are not their illness, body part or operation; they have names, they are thinking, feeling and frightened human beings just like you are. Talk to your patients, pass your knowledge on and help each person in the moment - not in terms of their background, problem or appearance.

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