Reflections on rural Australia

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Pharmacy Student of the Year Jessica Bailey shares some thoughts on her recent pharmacy placement in outback NSW

Jessica Bailey is a pharmacy student at Monash University, currently finishing her fourth and final year of university.

Just recently, I completed a six-week rural/remote placement in Broken Hill, NSW.

The six-week placement was divided into:

  • Four weeks in an community pharmacy in Broken Hill;
  • One week in Broken Hill Hospital; and
  • One week in a remote community pharmacy.

Overall my experience was a very positive introduction into healthcare in a remote setting. Throughout the placement I visited several healthcare sites and got involved in a variety of different services. These included: The Royal Flying Doctors service, Maari Ma Aboriginal Health Service, Temby’s Outback Pharmacy, Menindee Pharmacy, a local aged care facility, Broken Hill Hospital, Wilcannia Health Service and Home Medication Reviews (HMRs).

The remote setting poses many challenges to deliver medication to patients living in remote locations.

A particular highlight for me was The Royal Flying Doctors Service (RFDS) – we visited the base at Broken Hill airport and were given a thorough history and explanation of logistics of the operation.

In addition, we had a tutorial later by an ex-RFDS doctor focusing on the RFDS Medical Chest. There are approximately 4000 chests located throughout Australia containing essential medicines. The RFDS manage these chests and they contain everything from Gaviscon to morphine ampoules. The doctor also asked us for feedback on the list of medications, and we discussed medications we thought should have been in the chest and vice versa.

RFDS medical chest
RFDS Medical Chest. Source: Royal Flying Doctor Service.

It was also interesting to learn about the criteria required to qualify for an RFDS emergency flight. The RFDS doctors ask the caller specific questions to determine to gauge the severity. It can take up to two hours to get the plane to the person, even if the flight is only approximately 45 minutes – the rest is preparation time.

Another highlight was engaging with nursing staff at a residential aged care facility based in Broken Hill.

At the facility we gave a presentation on constipation (signs, symptoms and management) to the staff and to the residents. We also completed a medication audit on PRN medication.

Afterwards we chatted to the nursing staff about how they administered certain medications, for example, an insulin round, patches round etc. It was the policy of the home to do these medications at the same time to reduce error.

Jessica Bailey with her award.

Perhaps the most unique experience was spending a week in Menindee. Menindee is a very remote community approximately 110km from Broken Hill. The town consists of approximately 500 people, I don’t think I had ever travelled to somewhere so remote.

I got to go to the local school and have a chat with the students about moving to university and studying to be a healthcare professional. I also enjoyed chatting with the locals and those travelling through.

I enjoyed the experience but being in the middle of nowhere was a shock to the system!

As a young healthcare professional, it’s a great experience to get outside your comfort zone.

But ultimately my favourite visit was to Maari Ma Aboriginal Health Service.

There I predominantly shadowed the pharmacist conducting medication reviews.

In between the sessions, the pharmacist introduced me to other health professionals.

In particular I had a great chat with a GP in regard to his personal ‘top five drugs of all time’.

There was also a dietitian, dentist, podiatrist, diabetes educator, and psychologists all on site. Often clients have multiple appointments booked consecutively. This made it easier for clients travelling a long distance to get to the service.

My experience at the Maari Ma health service emphasised the importance of collaborating with other healthcare professionals in a primary care setting in the future. It really made me think about whether this model of healthcare could be applied to metropolitan and non-aboriginal populations as well.

For example, imagine if every 12 months we could have a quick screening by a GP, dentist, dietitian, pharmacist and psychologist all in the one place, where sessions would focus on health promotion, while referrals and ongoing management could be followed up if required.

I think this would make for a much healthier population and might even be more economic too!

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