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Vicki & Lenny’s QLD, NSW & SA Trip visiting remote health facilities

Well, sitting at Boulia with it’s wide streets and post Camel Cup W/E. Got in just after sunset with those amazing colours of outback Australia of green and orange after sunset to the west then the pink and blue in the eastern horizon that grows across the sky - the coming of the night. Then stars.. beautiful big sky country eh, are we who spend time out here ever so lucky!

Anyway leaving Alice yesterday just as the sun was rising was great to see a big flock of RTBCs which any other birdos out there will know to be the Red-Tailed Black Cockatoo.

To work…(?) up the Sandover Highway stopping at Ampilatwatja then Alpurrulum for the night. Have been up that road three times before when working short term but haven’t been that way for seven years. It’s lovely. The store then was the best I’d ever come across and still seemed to have joy, music and several Indigenous staff which is great to see.

At the mighty Georgina River just east of Alpurrurulum where there is still lots of water there was a big flock of Straw-Necked Ibis and two Brolgas flew over as well.

The track(s) to Uranangie are tricky to work out but got there. Talked with the relatively new publican and her opinion is that there isn’t enough access to health services of this small community of 20-60 folk. She also advised us to take the south road to Dajarra rather then the north road. Lovely drive as she said it was and Dajarra itself has a lovely setting in a range of hills not on the map. Very cute health centre and accommodation there too. It was pointed out that like many others there are serious health issues in this community, which is 95% Indigenous.

Will leave it at that for now. Visiting the health centre staff here before east to Winton. There’s an old stone house here too that I just might check out, some of you may be aware of me doing stonemasonry in ‘06.

There’s already a pattern of issues for remote staff which is not a great surprise to me. You’d like to think there has been some postiive changes to them though!

It’s great having Lenny to share the trip with along with trusted muttley Ness.

Good night.

QLD, NSW & SA Trip visiting remote health facilities - Vicki & Lenny

Well, we’re nearly ready to head off on Monday morn early- well on the work front anyway, on the home front will need to largely happen over the weekend. Plan on being away for two and a half weeks.

First stop Alpurrurulum 700kms to the north east of Alice up the Sandover and Alyawarra country, up close to the Queensland border.

Then it’ll be Dajarra followed by Boulia, then Winton. I’ll have my laptop and mobile with me so if anyone wants to make contact that way please don’t hesitate: vicki@crana.org.au or 0400252602

Will keep you posted over the two and a half weeks or so and Amy is working on the map as I write.

Look forward to meeting up and yarning. Cheers for now Vicki

NT Suicide Action Plan Review

Vicki Gordon
CRANAplus Remote Support Officer

I went to the launching by Malandirri McCarthy the Minister for Children, Families and Child Protection, of the NT Suicide Prevention Action Plan 2009-2011 here in Alice Springs recently, with Mark Millard and Gary McFarlane from Bush Support Services.
As the plan says there are a range of complex and connected factors at play when considering suicide. These include mental health problems, drug and alcohol misuse, inadequate education, lack of meaningful or any employment, cultural or sexual identity issues, poverty, sexual physical or emotional abuse, problems with family and the law, grief loss and trauma.
Many of you of course will be more than aware of this and the numbers of people involved.
Suicide is one of the three leading causes of death for those 14-34. (Bertolote et al 2003). Males were almost four times more likely than females to die this way. There has been a drop however from 2720 in 1997 to 1799 in 2006.
In the Indigenous community the rates are at least 40% higher than the national average. The statistics can be a bit tricky with the influence of under-reporting, differences in reporting methods and with the Coronerís involvement this affects the length of time. The ABS reported that in 2006 suicide accounted for 4.3% of all Indigenous deaths compared with 1.3% in other Australians. Suicide in Indigenous populations was virtually unheard of prior to the 1960s. With the increase since then the distribution has been uneven in both time and place.
In the NT the rate has increased markedly since the mid 1990s with a peak in 2002, which is against the national trends. For the period 2002-2006 the rate was 22.4 per 100,000, which is more than double the national average at 10.4 per 100,000. (ABS 2008). Remote Indigenous males, young urban Indigenous males and non-Indigenous males 25-45 in an urban setting appear to be at higher risk than others. It needs to be remembered too though that these differing rates compared to the national level need to be viewed in the context of the higher proportion of Indigenous people, the higher male to female ratio, a younger population and high rates of known risk factors such as alcohol and drug abuse, crime and domestic violence.
In some Indigenous communities there are increasing rates of cannabis use too, which is of concern.
The NT Strategic Framework for Suicide Prevention (2003) is based on the Australian Governments Living for Everyone (LIFE) Framework (2000). This was reviewed in 2006 and a revised Framework was released in 2007. The NT Action Plan has retained the original key action areas of the NT Strategic Framework for Suicide Prevention and matched these where possible against the revised LIFE Framework for consistency and coordination. There are a range of responses across many different areas. One of the aims is to provide culturally appropriate programs that support community response to the high rates in Indigenous communities.
In each Action Area Enhancing Existing Initiatives and New Initiatives are included looking at various government departments and services/agencies but principally the Dept of Education and Training and Dept of Health and Families
Action Area 1: Promoting wellbeing, resilience and community capacity across the NT
Action Area 2: Enhancing protective factors and reducing risk factors for suicide and self-harm
Action Area 3: Services and support within the community for groups at increased risk
Action Area 4: Services for individuals at high risk
Action Area 5: Partnerships with Indigenous people Enhancing Existing Initiatives
Action Area 6: Progressing the evidence base for suicide prevention and good practice

Some of the themes:
ï The dissemination of information, training and resource development including those that are culturally appropriate
ï Increase of the workforce and expertise
ï Support services for the homeless, bereaved, victims of violence, prisoners and first responders
ï Cross-sectoral collaboration, partnerships, increased co-ordination and whole of govt approach
ï Increased cross-cultural understanding and engagement

Some of the initiatives:
ï Headspace which sounds like a good one stop shop for youth
ï Menís Sheds
ï Wellbeing officers in govt. primary schools
ï Counselors in middle and senior schools
ï Reducing Bullying & Empowering Bystanders package for schools

There is a lot written of programs already in existence many I was unaware of.
Just have to hope this all translates well at the grassroots level.

For more details: www.health.nt.gov.au/Mental_Health

Vicki Gordon
CRANAplus Remote Support Officer
vicki@crana.org.au

E-Health : An Update from CRANA’s Remote Support Officer, Vicki Gordon

I went to the National E-Health Strategy Forum information session in Alice Springs last week and thought Iíd share some of this with you. I certainly learnt a lot about whatís happening in this regard and kinda wondering if much is generally known out there hence me putting this together.
As remote health workers itís well known how quality and continuity of care is compromised without ready up-to-date access to health records.
Peopleís mobility, language and cultural differences affect this of course, and as they say in the information package, this can and does lead to frequent re-admissions, duplication of interventions e.g medications or immunizations and gaps in care. In addition, adverse events related to allergies can only be avoided when they are known about.
If records and information are more easily available clinicians are able to spend more time with the patient and the patient doesnít have to continually retell their story as they know it.
An external evaluation of the trial of eHealth NT in 2004 said that providers, health care managers and consumers unanimously supported the concept. The main three areas of need were identified as being being, Hospital Discharge Summaries, pathology results and Current Health Profile.
Shared Electronic Health Record (SEHR), Electronic Transfer of Prescriptions (ETP) and Secure Electronic Messaging Service (SEMS) are elements with the process being easy fast and secure. No doubt there are some teething problems initially. The SEHR is integrated into local clinical information systems whatever they are and at the end of a consultation there will be a tick box to send the information to the SEHR.
ETPs at this stage are unique to the NT and apart from anything else help get over illegibility problems.
SEMS can include discharge summaries and reports, test results and current medications and notifications such as appointments, referrals and management plans between services.
There is more information available regarding the choice not to send sensitive information to the SEHR if desired by the patient and other matters.
An elibrary and elearning strategy are part of the package.
It was reported that once trained productivity is much the same.

At this stage 80% of rural and remote Territorians are registered with 61 participatory sites involving 2400 health staff integrated into day-today service delivery. The registration process of Aboriginal people was done in a culturally appropriate way it is said.
The Anangu Pitjantjatjarra Lands of northern South Australia are also participating and the Kimberley in WA as well as Queensland are looking to being introduced as well.

The Australian Health Ministers commissioned Deloitte to develop the National Strategy with key stakeholders in early í08 and they endorsed this in December.

After starting off with radio at Walungurru (Kintore) NT in the late ë80s itís amazing!

You can find out more at www.ahmac.gov.au for the National Strategy. This includes provider information and frequently asked questions as well as the Implementation Roadmap. For more details on the NT and cross border areas and an example of a SEHR view go to www.ehealth.nt.gov.au
Hope you find this useful and helpful.

Cheers,

Vicki Gordon

vicki@crana.org.au

From the President

Dear CRANA Members,

Recently the Board, Staff and some stakeholders met for 3 days in Alice Springs. A wonderful opportunity to discuss the big issues for CRANA and make some of the tough decisions that have been needed following the constitutional change and to make the organisation competitive in todayís ìcut throatî environment!

Rest assured there was robust discussion and intense investigation; the outcomes are made in the best interest of CRANA, not any one person or program.

The outcomes of the Board Meeting following the Alice Springs gathering are:

The term ìCRANAî is iconic, yet ìThe Council of Remote Area Nursesî is not inclusive of the entire membership. As such the name is to be changed to ìCRANAplusî or ìCRANA+î.

We will no longer spell out what historically CRANA stands for (similar to QANTAS). The slogan for CRANAplus is ìRemote Health Countsî. There will still be times when we need to describe who we are, therefore: ìThe professional body for remote and isolated health professionalsî can also be used.

The decision was made to also change the logo to something contemporary. The logo and colour theme are currently with graphic designers, so unsure of what the final decisions on that will be as yet.

Along with that it was decided that all CRANAplus program will only use the CRANAplus logo. A planned removal of all existing program logos (REC, MEC, BCL etc) will be undertaken and replaced with the CRANAplus logo. Its essential for such a small organisation to be seen as one entity, and these fantastic programs seen as what they are, CRANAplus programs.

The Bush Crisis Line is undertaking a review of its management structure, and the name is to be changed to ìBush Care Servicesî.

CRANAplus will seize an opportunity to open an office/outlet in Adelaide, and investigate cost neutral spaces in other States.

John Ryan a Medical Lawyer in NSW has been appointed as a co-opted member of the Board to add specific expertise. The Board is also in negotiations with another possible co-opted member. Weíll ask John to provide some details to the CRANA membership about himself in a future email.

A Finance subcommittee of the board was developed to advise the Board on the increasing complexity of this growing dynamic organisation. Likewise the development of the Education subcommittee is progressing, with Dr Trudy Yuginovich agreeing to chair the subcommittee.

We are hoping to officially launch the new CRANAplus at the conference, but a slow roll out will commence prior to then. As your elected directors to run this organisation, weíd all welcome any comments or feedback you may have. Until next time, keep safe.

Christopher
CRANAplus President

Business Activity Update, from Anne-Marie Borchers

Hello FELLOW CRANA Members!

Six months ago I couldn’t have greeted you as such. The Constitutional change in 2008 means the CRANA membership base is broader now. CRANA welcomes health providers working in remote and isolated Australia and her Territories and also those individuals and organisations that support CRANAís objectives. See our website for criteria & more details.
In the newly created role of Business Manager, I know I have come at a significant and exciting time in the history of the organisation. My directive is to expand the profile of CRANA and look at business opportunities that will enable us to offer more to our members.
Response to our special membership offer has proved popular with many members rejoining and new members coming on board, but we need more!

An association is only as strong as itís membership base.

We encourage you to spread the word to your co-workers about your grassroots organisation and the benefits of membership. CRANA offers advocacy, support and professional development to members, and with CRANA representation on more than 20 committees nationally, this means CRANA is well placed to have a significant voice on behalf of remote health.
Are you contemplating a REC or MEC Course or an update this year? If so, please book early as these courses are in hot demand with several courses already heavily booked weeks in advance or FULL!
Donít forget your membership discounts!

Discounts apply to courses and the Annual Conference- October 14-17 in Alice Springs. This yearís theme is ì Remote Health-Unveiling the Mystery.î Regine, (Conference coordinator), and our admin staff work tirelessly to deliver great conferences. It promises to be bigger and better than ever.
If youíve never attended a CRANA Conference before or havenít been to one for a while, then this is the year to do it. Get a friend, family or a co-worker to the conference with you. Submit a paper! Come and be inspired, challenged or invigorated in the wonderful atmosphere of camaraderie that this event generates. Catch up with people you havenít seen for years or make new friends and contacts. Join us to celebrate the extraordinary work of remote health professionals like yourself and network against the backdrop of the spectacular McDonnell Ranges! If past years are any indication we guarantee youíll have a great time.
Watch our website for updates. Conference discounts apply for ëearly birdí bookings!

I think thatís probably it for now but please use the forum and let us know what we can do for you - our members.
Cheers,
Anne-Marie Borchers.

business@crana.org.au
0408 839 723

Welcome to the MEC blog!

Welcome to the new MEC blog! This blog is something that we’ve thought about and talked about for a long time so it is great to finally stop talking and actually get writing!

I am very lucky to do the job that I do (I have to remind myself of that when i get cranky about having to pack my bag yet again and spend hours in airport terminals!). But really what makes me feel so lucky is the people that I get to meet. I have worked as a remote area nurse and midwife so i know how scary it can be to have to deal with a situation that I’ve never had to face before. So I am constantly inspired by the stories I hear from participants about the places they work and how they cope, often under great stress. But I think the underlying theme of all their stories is that attitude of  ’you do what you have to’ and a genuine love of what they do.

When the MEC course started back in 2003 it was in response to a need voiced by nurses working in remote areas where they didn’t have midwives or doctors to provide the care for pregnant women. These days we are seeing an increasing demand for the MEC course in rural areas - particularly in Southern Queensland where we are providing 5 private courses this year and another 7 planned for next year. The participants from these areas are working in small rural hospitals where they may have had maternity services in the past but those have now shut down. As a consequence, there are no longer midwives working there (or the midwives are losing their skills) and the doctors often don’t have obstetric skills. But women are still presenting at these services in labour because that is what they’ve always done! So we talk about the MEC course being aimed at non-midwifery trained health professionals working in isolated practice. But you don’t have to be remote to be isolated! 

I see this blog as a way of giving remote and rural health professionals a voice to tell their stories, about the difficulties they face in managing issues around maternity care and providing safe care to women and their babies; about the programs that are working well in their area; and about the myriad number of challenging, interesting and often strange situations we find ourselves in as health care providers.

Talking about programs that are working well…..during a MEC course in Port Augusta a couple of weekends ago I met 2 wonderful Aboriginal Health Workers who were participants in the course. These women are  AMIC (Aboriginal Maternal and Infant Care) workers working in a partnership program, the Anangu Bibi Family Birthing Program, with the local midwives to provide antenatal, intrapartum and postnatal care to Aboriginal women in the area. The midwives provide the clinical knowledge and and the the AMIC workers provide the cultural knowledge and thus they learn from each other. In the women attending the program, early statistics are showing an increase in antenatal visits; increases in rates of breast feeding; and increases in numbers of babies weighing over 2.5 kg at birth. They are also seeing a drop in smoking rates. For those who are interested, read this report of the first 50 births in this program.

Enough from me for my first blog. Please get involved and feel free to comment on this or add your own story.

 

 

 

 

 

 

 

Carole’s Comments

For an old chick this whole blog thing is quite novel, but I guess I will start the process.
Just a bit of information from the office - we have been really busy post conference with lots to do to start the next one, so keep your eyes on our website for updates!

Over the Christmas period, the office will be closed on Friday 19th December 2008 and will reopen on Monday 5th January 2009. Continue reading ‘Carole’s Comments’