CQ Nurse Founder Kim Estell

According to Kim Estell, founder of nationwide nursing agency CQ Nurse, nursing can be a passport to travel, choice and opportunity.

If you want to know about nursing in the bush, talking to someone who grew up travelling around town in an ambulance would seem a good place to start. Enter Kim Estell, founder and Director of one of Australia’s leading nursing agencies, CQ Nurse.

A second generation nurse, Kim spent her childhood in far-fl ung outposts like the Pilbara in Western Australia and Weipa in North Queensland, where she saw fi rst hand what country nursing was really all about.

“My mother was the nurse in a two-nurse post for a number of years,” Kim explains. “So, while most kids got to go to the swimming pool in the family station wagon, I got to go in the ambulance. You inherently understand how these remote and rural communities work after you have lived in a couple of them and you defi nitely understand how disruptive and adrenalin-pumping it can be to work after hours on call”.

With this background, it was something of a natural progression for Kim, after establishing her own nursing career, to branch out into the area of nursing recruitment.

In 2002 she launched CQ Nurse, a specialist agency placing nurses in rural and remote communities throughout Australia. Her childhood experiences coupled with her own nursing background gave her a unique perspective and business edge. This saw CQ Nurse grow exponentially over the next six years into a thriving and cutting-edge enterprise, placing nursing staff in posts throughout the nation in settings as diverse as resort islands, outback indigenous communities and country towns.

“The problem for the rural and remote health facilities is that they do not have the advantage of calling in casuals if somebody is sick or needs leave,” Kim says. “Their isolation creates a vulnerability that most other services cannot even imagine.”

In just six years, CQ Nurse has grown from a one-woman post to a national company supporting an office staff of 20 with a database encompassing hundreds of nurses. It continues to grow, placing nurses around Australia from Tassie to the Top End and from the West Coast to the Whitsundays. And, in an industry fi rst for Queensland, it was recently awarded a Quality Endorsement from the peak industry body, Recruitment and Consulting Services Association (RCSA).

“I think in part our success comes from the value we place on our staff ,” Kim says. “We like to send the nurses out very well informed about where they are going. For example, it might be that the only internet access available is at the local library or there may be no banks in the town. And then, clinically, they may be the only medical facility for miles, which will require a greater level of nursing experience than a less isolated post.

“We also have dedicated office staff who provide ongoing support for nurses on placements and we are one of the few nursing agencies in Australia to employ a full-time Education Coordinator to assist with our nurses’ professional development. These are both very important aspects of living and working in environments that can be both socially and professionally isolating.

Kim suggests that people planning to make a move to the country or a remote area need to do some research about the community and what it off ers. “And know your own limitations – what sort of setting you would feel comfortable in both socially and from a professional viewpoint,” she adds. “Little things can make a diff erence too. For example, groceries may be very expensive, or if you’re travelling with children with special needs, appropriate services may be harder to find.”

Some nurses see an agency like CQ Nurse as an opportunity for travel and adventure, and Kim says they are happy to suggest places off ering a good opportunity to see the country. But on the other hand, there are nurses who will decide to work in rural and remote areas for the very real and rewarding professional development opportunities this presents. The truth is that both are very valid and rewarding courses to take. A lot of it just comes down to being real about your own expectations.

“Aside from the travel aspects, rural and remote nursing aff ords practitioners a far greater degree of autonomy than exists in larger cities,” she suggests. “This is both challenging and rewarding and does require broad-based nursing skills.

“In some of the areas our nurses go, they are the only medical help available for miles. This means their assessment skills are honed and they really need to work in with the community to provide holistic care. It’s not just about the patient, but the nurse also needs the ability to communicate and network with families, community members, the patient’s broader social network and other health professionals who may be thousands of kilometres away.

“This can be quite an isolating and challenging experience, and yet the paradox is that this very isolation and the stretching of one’s skills is what makes rural and remote nursing so professionally rewarding – the sense of knowing you have really made a diff erence and done something signifi cant with your skills and life.”

And from the community’s perspective, the benefi ts of a long term, stable health professional are endless. Research has repeatedly shown this stability enhances health outcomes, especially in children. This is partly because the practitioner has the opportunity to really attune themselves to the dynamics of the community and the individuals it encompasses, but also because trust is built and anxiety reduced from the community’s perspective. The nurse becomes an integral part of the community in a very meaningful way.

“In addition, with the benefi t of time, nurses can look at community education,” Kim says. “Even something as simple as a program teaching people to wash their hands before meals can lead to a huge reduction in diarrhoea and vomiting cases. And the consistency of follow-up and regular health checks is invaluable to the long-term health outcomes of a community.”

While the caring face of nursing hasn’t really changed over the years, the technology certainly has. And with the rise of Nurse Practitioners (highly qualifi ed nurses who have a greater degree of autonomy in practice, including authorisation to administer some levels of prescription drugs), the future of bush nursing is bright.

“Nurses in remote and rural locations now have access to teleconferencing and videoconferencing which links practitioners and families to specialists in capital cities,” Kim says. “This means patients can receive a comprehensive service without the inconvenience and disruption of excessive travel. For example, in some rural areas an adult with brittle diabetes could begin treatment in his home town under the supervision of the local nurse, overseen by a specialist based in a capital city.”

As populations in the bush decline, opportunities for Nurse Practitioners will increase, due to the shrinking health services off ered. “With the support of the technology available, I believe this will take nursing to a whole new level and is a very rewarding way forward for well-skilled nursing staff ,” Kim adds. “It also paints a positive picture for rural and remote communities who will benefi t with quality health services on their doorstep. Let’s face it, you can’t expect someone to drive four hours after a car accident to have an x-ray examined or for treatment of a convulsing child.

“Overall bush nursing is certainly not without its diffi culties but there are great personal and professional rewards for those willing to accept the challenges and make a diff erence.”

For more about CQ Nurse, visit: www.cqnurse.com.au