Robbie Bedbrook, aka ‘Nurse Robbie’, has worked hard to carve a career in primary health that is outside the norm.
He shared his journey with the ANMJ and what he loves most about the profession.
What inspired you to become a nurse?
I knew I wanted to help people but didn’t know how.
It dawned on me one day in my final year of high-school that I should be a nurse and then I couldn’t shake the notion.
I realise now that so much of that choice was linked to my experience growing up.
I have severe haemophilia and was in and out of hospital a lot as a child.
The people who always had the greatest positive impact for me were the nurses.
I actually had a lot of negative experiences of the healthcare system, including with clinicians, but almost never with the nurses.
I think nursing for me is a full-circle way of giving back.
Why did you choose primary healthcare?
I wanted a role that put autonomy and global health at its forefront.
I knew that I couldn’t work long-term in the acute sector; it didn’t suit my skill-set and I found it hard to practice empathy and person-centred care in such a rigid, task-based environment.
I applied for a paediatric new grad, which I didn’t get, but was offered a new grad to a major adult trauma hospital in Sydney which was set to begin six months after graduating.
Not knowing what to do, I took an interim job in primary health to buy some time. Almost immediately I fell in love with the field, turned down my new grad position, and never looked back.
What does a typical day on the job look like?
I work part-time clinically, in general practice. I have worked as a GP nurse (otherwise known as a ‘practice nurse’) my whole career, sub-specialising in sexual health.
A typical day could be creating chronic disease management plans, chronic illness education and monitoring, wound care, emergency presentations, immunisations, mental health support, performing diagnostic tests such as ECGs and spirometry, sexual health screening and treatment, and much more.
I also work for myself part-time, which I have no other way of describing other than ‘Nurse Robbie.’
‘Nurse Robbie’ was born out of Hot on Health, a social media video-series that is no longer active, which covered various health topics.
I am essentially a health educator; I create content, write articles, and travel nationally and internationally giving presentations on a variety of themes like sexual health, emotional intelligence and leadership.
What are your objectives as a primary health care nurse?
What I want to achieve through my work is positive impact for people who are suffering.
This might be at the clinic level, such as a patient with a chronic illness who needs education, a person with sexual health concerns who needs support, or a person with a wound that needs closing.
Recently I have been doing more writing and speaking around topics like vulnerability, burnout, empathy, and emotional intelligence; I want to teach people about the important work we need to do internally, and that being well is so much more than not being sick.
As ‘Nurse Robbie’, I’m hoping to demonstrate the breadth of knowledge required to be a nurse, advocate for the nursing profession and increase representation of nursing in the media.
There is so much evidence demonstrating that PHC nurses improve patient outcomes, reduce the burden on our GPs, and used effectively, even generate greater income for a service.
Research shows 1 in 4 PHC nurses believe they are under-utilised. The Nursing Education Review underlined primary health as a key future focus. What are the biggest challenges facing the speciality?
The two greatest challenges facing PHC nursing in Australia are also its greatest opportunities for change.
The first is our outdated funding model in general practice. Medicare is incredible and undoubtedly revolutionised Australian healthcare.
However, it’s also a fee-for-service model which, as we see trends in healthcare shifting, is no longer working.
We are living under the burden of rising chronic illness. We need flexible funding that empowers an entire team, not a funding model that ensures our GPs can’t relinquish patient-care for fear of lost income, therefore simultaneously giving them huge amounts of pressure.
The fee-for-service has become restrictive. Practice nurses, excluding Nurse Practitioners, cannot bill under Medicare; it’s very hard to empower a workforce to assist with this global healthcare burden when we don’t have a funding model that reflects this.
If we can revolutionise funding into primary healthcare we will allow all primary healthcare clinicians to practice to their full scope and make significant steps towards Universal Health Care (UHC).
The other challenge is a lack of exposure to primary health through the tertiary system.
I know some institutions that strongly value PHC nursing, and work tirelessly to integrate it into the curriculum, and others that barely mention it.
This is unacceptable; we need national-level commitment to expose our nursing students to the dynamic, growing specialty of primary health.
What do you love most about primary health?
The most rewarding part is the moments that you are truly working to full scope.
There have been times where I am performing a complex clinical skill, or talking a patient through a difficult experience, and I can feel my intellect, creativity and empathy all firing at once.
What advice would you give early career nurses considering primary health?
Whether at the beginning of your career or in mid-career transition, my advice is to not do it alone.
I fell headfirst into primary health and I was completely alone; it was a steep, scary learning curve.
It is so different to what we are conditioned to view as nursing, and we don’t get taught a lot of the necessary clinical skills for PHC.
Reach out to APNA; get some information and then attend one of their workshops.
Try and work in a clinic that already has a nurse, or if that’s not possible then try and find a mentor of some kind before you start.
There are some excellent online communities through Facebook and other social media that will connect PHC nurses together.
What does the road ahead look like for primary health care nursing?
We will continue to see a steady rise in the PHC nursing workforce.
As advocacy grows, there will be greater pressure for government support that is tailored to primary health care nursing.
What I hope this means is newer, more comprehensive funding models, as well as a push for tertiary institutions to expand their teaching scope.
I hope to see two things. Firstly, a workforce full of nurses at the beginning of their career.
Primary health care nursing is a valid, important choice. It’s hard-work, and it’s so much fun, and we need a workforce who can provide a long-term commitment to the profession.
Secondly, I want to see the idea of ‘primary health nurse’ and ‘practice nurse’ (in fact, ‘nurse’ in general) turned inside-out and upside-down.
I want PHC nurses in places that seem unconventional doing roles previously denied to them.
Become a radio host, start a blog, create a schools-program, develop an app, or an exercise club, or a community event.
Nursing is about humanity and we should not be scared to fill up all of those different spaces and scream about how much change our profession can make.
Follow ‘Nurse Robbie’ at http://www.nurserobbie.com/ and on Instagram and Twitter @nurse_robbie