Embracing the life of remote nursing as an early career nurse

Holly Engelhardt, recipient of the ANMF NT Excellence in Early Career Nurse/Midwife of the Year 2023. Photo supplied

“Have the courage to believe in yourself”, is the message from Holly Engelhardt, recipient of the ANMF NT Excellence in Early Career Nurse/Midwife of the Year 2023, to her peers.

“It came as a surprise. I was nominated by service manager and DON educator – to have them recognise my work it means so much because I look up to them,” says Holly on receiving the award.

Holly Engelhardt, from Darwin, has embraced the life of remote nursing and gone above what is expected of an early career nurse.

Following a 12-month graduate program in Alice Springs in 2021, Holly took the plunge to work in a remote outreach N2 position in primary health in Central Australia. Her plan was to return to Darwin after the grad program when she saw the six-month N2 position advertised.

As an ‘outdoorsy’ person, who loves camping and fishing, the call of the remote appealed to her adventurous side. “I grew up in Darwin, I was always interested in going ‘out bush’. I thought: ‘that’s enough information for me – flying and driving 4WDs!

“It was working alongside a doctor doing the work up on a patient – doing their obs, bloods, ECG. I spent 10 months with the doctors, initially flying in Central Australia. I fell in love with the primary care side of things.”

Holly is based in Hermannsburg, also known as Ntaria, an Aboriginal community in Ljirapinta 125 kilometres west southwest of Alice Springs with some 300-400 living in and around the township and another 600 living in camps beyond the community.

The award recognised Holly’s culturally safe practice and her humble manner. She ensures Aboriginal Health Practitioners [AHPs] and local workers are utilised as the key stakeholders and cultural knowledge brokers on her visits to remote and recognises their value in contributing to better health outcomes for their communities.

“They [AHPs, AHWs] provide a different perspective to how we see things sometimes. It’s so helpful to have that local knowledge – if someone hasn’t shown up or if they’ve gone elsewhere they know when they’ll be back. They’re so underappreciated – we’d be so far behind the eight-ball without them.”

Holly Engelhardt. Photo supplied.

Holly started as a N3 or ‘baby RAN’ (remote area nurse) eight weeks ago, doing consults on her own. “I use CARPA and there’s always a doctor to consult with or ROCC – the Remote Outreach Consult Centre. There is also a medical retrieval service.”

Contracted to Hermannsburg until November, Holly is undertaking post graduate studies to improve the way she can deliver services to remote health clients. Holly plans to do her N4 which is a fully fledged RAN in the NT, where she can be first on-call triage. Then she might return to Darwin and/or do fly in fly out. She is drawn to Central Australia and the Top End.

“There’s something special about Central Australia. I’ll always be drawn to remote nursing, I love it. Even these last eight weeks I’ve learnt so much more with different presentations. It would be very different going back to a hospital.”

Holly has wanted to become a RN since she was 16 years old and did a school work experience placement at the Darwin Private Hospital, where her mum, also a RN, works.

“I spent each day on a different ward. It was incredible. As a 16 year old, I was like ‘yep this is what I want to do’. I stayed on one day an extra five hours to watch a woman I’d been looking after give birth. For me as a student, it was a once in a lifetime opportunity.”

Holly credits having good mentors, along with having belief in herself, to have the courage to go beyond her comfort zone early in her nursing career.

“On placement I was on the rehab ward looking after a man who was quite unwell. His wife was a DON of a hospital, I was a bit star struck. She came up to me one day and said: ‘because of the nursing care you are giving to my husband, he will get better’. It was then that I thought: ‘I can actually do this, I can be a really good nurse someday’.”

Her patient hadn’t eaten in four days and Holly had made it her mission to make him drink something he liked one afternoon shift. He liked banana smoothies and so she managed a concoction with banana fortisip and custard.

On that placement, Holly also experienced how confronting nursing can be in looking after a 57-year old woman with terminal cancer.

“I spent time with her one afternoon shift and she didn’t seem too unwell. The next day I found out that she had passed away overnight. It made me realise how hard this job is going to be at times but I was thankful for the connection we’d had and the time I had spent with her. I felt like I could be a good nurse.”

Holly has learnt some tricks of the trade in combating some of the challenges of remote area nursing, including isolation. She speaks to her mum on the phone and she has a Red Heeler Cooper who is her absolute best friend. She’s also aware of the CRANAplus Bush Support  Line if she needs it and is in contact with her friends regularly.

“I think it’s important in my job to look after myself – if I cannot look after myself I cannot look after other people. We’re in such a unique job. I want to be the best nurse I can be.”

If you want to get out of your comfort zone, then consider remote nursing, says Holly.

“Time and time again we hear not to apply unless you’ve got five years’ experience in the ED, or ICU. I think there’s other options. Going somewhere like Alice Springs for a graduate program and working on a busy medical ward to learn the foundations and how to manage five very sick patients at once, you get thrown into the deep end and develop a lot of resilience working with different nurses and other staff.

“Working as a remote N2 for six months in Central Australia has been an amazing learning opportunity. It’s also been a fabulous transition from N2 to N3 – to work in remote Australia in a really safe way.

Holly says some of the attributes needed are being open to learning and developing resilience.

“Be open to hearing other opinions – you’ll come across some strong-minded people but have the courage to make your own decisions. People will do things differently as long as the patient is safe.

“Be open to constructive criticism. Have a really good attitude that you want to learn and ask questions.”

Holly Engelhardt works as a remote outreach practice nurse in public and primary health care in the Central Australia region.

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