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Education can better equip nurses to ‘go bush’

The healthcare industry is quickly expanding, with longer Australian life expectancies and a growing population lifting demand for skilled nursing clinicians. However, much of this demand is not being met in the bush and more funding and training is needed to better equip nurses for practice outside of metropolitan centres.

Australians in rural and remote areas have less access to health care compared with people in urban areas, yet many nurses feel unprepared to transition from metropolitan centres to work in the high-demand, independent and resource scarce settings outside of cities.

Ironically, this is where we need nurses with expert knowledge and skills. According to the Australian Nursing and Midwifery Federation1 “the majority of healthcare providers in these locations are nurses. Therefore, nurse-led health care is an essential component of health care delivery in these areas".

The Australia’s future health workforce – Nurses2 report has predicted that Australia’s demand for nurses will significantly exceed supply over the medium to longer term, with a projected shortfall of approximately 85,000 nurses by 2025, and 123,000 nurses by 2030 under current settings.

While the supply of nurses has increased in recent years, with nursing graduate numbers and nurse registrations at historically high levels, the demand for nurses has also increased. Internet vacancies for nurses have increased strongly over the five years to June 2018 (up by 66%). These job vacancies for registered and enrolled nurses and midwives were all at or near historical peaks in June 2018.3

Yet in certain regional areas, there is already a lack of nurses. In 2015, the overall supply of employed nurses and midwives was 1,138 full-time equivalent (FTE) per 100,000 population across Australia, up from 1,107 in 2011 and around the same as in 2014 (1,135). However, the supply of nurses and midwives varied across geographical areas, with supply the lowest in ‘Outer regional areas’ at 1,083 FTE per 100,000 population.4

So, what can be done to meet this need to educate more nurses and better equip them for practice in rural and remote areas?

Quality education and training programs are key.  It is crucial that higher education providers recognise the importance of upskilling nurses to deliver advanced patient care. Nurses need a comprehensive understanding of the complexities of practice in rural and remote communities, with a focus on health assessment, quality use of medicines and a stronger understanding of the diagnostic reasoning process to deliver effective healthcare.

Nurses need to be able to make rapid and astute decisions in challenging environments where they may be isolated from other professionals. Postgraduate education can arm nurses with greater skills for rural and remote practice and help nurses achieve the best outcomes for their patients.

James Cook University’s (JCU) College of Healthcare Sciences has recently expanded its Master of Nursing program by adding a major in Advanced Practice which can arm nurses with the knowledge and skills they need to enjoy the challenge of providing comprehensive advanced care in locations where nurses are often the primary providers of healthcare services.

The Federal Government has made some positive moves too. The Government will from July 2018 pump funding of approximately $8.3 million over four years into the Nursing in Primary Health Care (NiPHC program), to be delivered by the Australian Primary Health Care Nurses Association (APNA). That program is part of the Government’s Stronger Rural Health Strategy5 which targets expanding the crucial role of nurses in the delivery of team-based and multidisciplinary care in rural and remote settings.

The faster governments and higher education providers act now, the less impact the predicted shortage of nurses is likely to have.

In addition to preparing nurses to practice in diverse and complex settings, there can be career benefits from further study. With a Master’s qualification, nurses can command higher salaries, and are in great demand for a variety of professionally satisfying roles. Nursing managers earned an average weekly wage of $1,952 as at May 20166, compared to $1,382 for registered nurses, highlighting the financial benefits that career progression into management can deliver.

The same ABS data reveals health and welfare services managers earned an average weekly wage of $2,721 as at May 2016. These salaries easily outstrip the average professional’s salary of $1,545.7 So there may be financial benefits associated with postgraduate study, as well as career progression.

Professor Melanie Birks is the head of nursing and midwifery at James Cook University. She has extensive experience and expertise in educational administration, teaching and curriculum design and development in national and international contexts. Her research interests are in the areas of quality, relevant, innovative and accessible education. She is active on numerous expert advisory panels in the professional and educational sectors.



  • http://anmf.org.au/documents/submissions/ANMF_Pre-Budget_Submission_2018-19.pdf
  • https://www.health.gov.au/internet/main/publishing.nsf/Content/34AA7E6FDB8C16AACA257D9500112F25/$File/AFHW%20-%20Nurses%20detailed%20report.pdf
  • https://docs.jobs.gov.au/system/files/doc/other/ausnurses_1.pdf
  • https://www.aihw.gov.au/reports/workforce/nursing-and-midwifery-workforce-2015/contents/how-many-nurses-and-midwives-are-there
  • http://www.health.gov.au/internet/main/publishing.nsf/Content/stronger-rural-health-strategy-strengthening-the-role-of-the-nursing-workforce
  • Employee Earnings and Hours, Australia, May 2016
  • Characteristics of Employment, Australia, August 2016



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