Today I am shocked and saddened by the murder of a fellow remote area nurse, I never work with Gayle but I have potentially been in her shoes on many occasions and fortunately walked away every time. On Thursday Gayle was not so lucky and it should be a wake up call for us all.

I have often thought about the dangers of working in remote communities, the times when you go out on your own and there is no other nurse or health-worker or driver around. There is often no obligation on any-one else to be around, nurses usually work 1^st on call and you are not encouraged to call the 2nd (if there is one) without a valid clinical reason. Nurses will usually help each other out if you ask but sometimes you just don’t see issues coming, there is always potential to misjudge when some-one is under the effects of drugs or alcohol or just plain psychotic and you will find yourself with no back up and no way of getting help. There are not commonly duress buttons and if there is they ring some one a couple of hours down the road, mobile phone coverage is erratic and police none existent.

The health system has permitted the abuse of nurses for so long that it is normalised in many areas, doctors can verbally abuse nurses and there is rarely any come back, patients verbally abusing nurses is so common that most of us pretend that we are immune to it… but I’m not really, every time I get called a derogatory name it builds a little piece of anger inside me that I try to ignore. I am sure it is the same for other people.

Verbal abuse doesn’t just happen in remote communities, it happens in hospital wards on a daily basis and in emergency and mental health areas it can be even more frequent, with almost every interaction with some patients (or families) resulting in the verbal abuse of a nurse and or threats of physical violence.  By the end of a shift you are edgy and in an aggressive frame of mind that doesn’t take much to set off.  Often because people can’t take this aggression out on the patients…  they take it out on their colleagues. The younger nurse from the medical ward who doesn’t have as much clinical knowledge as the ED nurse has to prove they are superior when handing over or the ward that asks for a 30 min break before receiving a patient because they are having a hard shift and need a breather gets an eye roll and a complaint.

There has been a lot said about the toxic nature of nursing, the common saying is that nurses eat their young. I have been thinking about this as a manager and certainly I was ‘trained’ to be unforgiving of other specialties and nurses. To deride rather then support and taught bullying as a management technique. In fact my first couple of management ‘mentors’ specialised in bullying as a form of controlling the health service staff. It was a management technique that I was never comfortable with but it seemed to work for those in charge and there didn’t seem to be many alternate options presented.

Fortunately over the last few years I have met some amazing managers who have taught me many different management techniques and styles. I have also done my own learning and through this process developed healthy coping mechanisms for when I am on the receiving end of some-one else’s bad behaviour.

The horrific event in the community of Fregon that has resulted in a remote area nurses death should have been avoided and unfortunately follows a series of sexual assaults recently in other communities. There seems to be an increasing trend for physical and sexual abuse to be more prevalent and directed towards nurses. Nurses should not have to tolerate any form of abuse in the workplace and we certainly should not be placed in environments with no support network or back-up.

I am currently working in the most remote area of Australia and I have more support then I had in Arnhem Land or Horn Island. I have state of the art satellite phones with 24/7 answering service, I have a radio with an emergency call button, I have GPS tracking on my vehicle and if I wanted on me. I have to call in at regular intervals and there are written policies for my colleagues to follow if I fail to call in.

The level of collegial support from remote area nurses is outstanding, despite any previous conflicts or personal issues they are a resilient group that will support each other when it comes to the crunch. Maybe it is time to try and harness that group power and change the dynamic that has seen remote area nurses being a scattered group without much political power. Maybe it is time to realise our worth as a group of health care professionals with a unique and special role to play in rural and remote areas. Maybe it is time to demand a safe work environment rather then playing roulette with our lives.

How? I am sure that our professional body CRANA will have a statement and I have signed the petition to go to Safe Work demanding that employers met their obligations to provide a safe work environment.

I sincerely hope that there are improvements to the system and that nurse’s safety is taken seriously for once.