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For registered nurse and health researcher Hannah Beks, rural practice was something that came onto her radar after hearing about the experiences of family and friends who had headed rural after completing their studies.

Following suit, Hannah made the decision to work in far west NSW as part of NSW Health after completing her nursing degree at the University of Wollongong in 2013.

“Perhaps there was a bit of an adventurous sort-of view that I had of going rural,” Hannah said.

“I had a few clinical placements that were rural. It was a very exciting time having those placements, so that’s what set me up to want to eventually work in a rural area.”

In the years since, rural nursing and health practice have played an essential role in Hannah’s career progression, which now involves research projects, an Associate Research Fellow position and ongoing PhD study as part of Deakin University’s Deakin Rural Health in South West Victoria and the Grampians region.

In the following Q&A, Hannah talks to the ANMJ about how her early placements readied her for a career in nursing, and the passion she has for rural practice.

ANMJ: How did you make that immediate decision when you finished study to go and work rural [in far west NSW]?

Hannah Beks (HB): I understood at the time, that working in rural nursing, you had to have quite a broad scope of practice, you had to be quite flexible and adapt to uncertain conditions, you had less support — all of those things appealed to me… I saw that you had autonomy.

Aside from those clinical carrots, there was also a sense of being financially better off – the rent was cheaper than a city area, and at the time, I really just wanted to live by myself with my dog and escape the city.

I knew I couldn’t afford to rent a small house [in a city] on my own and have that lifestyle which was what I was after… There were other factors that played into that decision, I can’t say it was purely clinical, it was a lifestyle decision for me.

ANMJ: Obviously you have practiced in a variety of different areas and places before arriving at research, could you talk through that journey?

HB: In the early days, I completed my transition to practice year — that was a 12 month program — out in far west NSW, so I did a few clinical rotations.

My first rotation was in a town of 150 people, which was accessible through a dirt track from where I was living, or an asphalt road 200kms to the nearest town. That was my first four months of nursing: working in this multi-purpose facility, with the Royal Flying Doctor Service, and delivering health care to this rural community.

Then I completed a rotation through a mental health unit and emergency department. I really enjoyed critical care, I liked the excitement of it and every day was different, but during the early days of the clinical rotations I was getting really frustrated with the challenges experienced by the health care system, particularly in the rural context.

ANMJ: How did your subsequent interest in research emerge as a result of this period in Far West NSW?

HB: I started studying a Masters of Public Health through distance learning… I really enjoyed that and that was my first exposure to research through that course. I kept working clinically in emergency critical care and then I started working in a small research role with the health service there as a Clinical Trials Coordinator.

I ended up moving from that health service to South West Victoria, where I now live, kept working clinically, and then landed my ideal job as an Associate Research Fellow with Deakin Rural Health, a University Department of Rural Health. [Part of the federally funded Rural Health Multidisciplinary Training Program].

The purpose of the department I work with, is that we look at building up the nursing, allied health and medical workforce [of the area], and part of that is we undertake research with health services. I’ve been working with this department for the last, almost-five years, and am part of the research program there. I also maintain my clinical competency working with a health service in the region.

ANMJ: What do you think is key to embracing and succeeding within the rural health setting?

HB: At the heart of rural is community, and this is something I think nurses grasp generally really well. They are great advocates for people and that’s something I’m really proud of with the profession as a whole. I think [what is needed] to thrive in this rural setting is a sense of being part of people’s lives and being an advocate for people’s healthcare as well.

That becomes a lifestyle over time, and I think when we talk about nursing workforce sustainability in rural areas, there is a sense that you serve a rural community, but you also become a part of that community, and that becomes a part of your identity.

ANMJ: What kind of tips and tricks do students and early career graduates need to hear before going out to practice in a rural setting?

HB: You need hobbies, and it’s a great way to connect with people.

Your job is a big part of your identity but, whether it be sport, or arts and crafts, or going to the gym, you need that for your own emotional and mental wellbeing, particularly when you’re in a small community.

Get amongst it, join the sporting clubs, go out, meet people, and I think it’s a great time also to do some extra study if you’re interested in doing some online education.

ANMJ: If lifestyle factors created your initial decision to move from Wollongong to Far West NSW, what has sustained your ongoing work and interest in rural practice?

HB: It still is a lifestyle decision — I like living in a rural area, I love rural communities, I love people, but also what’s developed over time is that there are certain needs that rural populations have which can be met through responsive and effective health services.

That’s where clinically I’ve found that I’ve shifted from, in the early days of wanting to work in that really exciting rural emergency scenario to now working in research, where I’m looking at health programs and innovative models of health care.

It’s become [a matter of] looking at the big picture of what do rural people need, and how can healthcare adapt to provide for those needs.