Two Careers One Pathway2 2010

Two Careers One Pathway

Sir Eric, Lady Neal and honoured guests, I would like to express my appreciation to

Bronte for asking me to speak to you this evening. It is a privilege to address this forum

and ask you to take a journey with me of reflection.

The title “Two Careers One Pathway” reflects the interrelationship of my role as a

member of St John and as a Registered Nurse and is a personal analogue of

achievements and failures. The early years as a member of the St John Ambulance

Brigade provided the foundation for experience, drive and catalyst for the desire to

achieve.

In September 1962, when I joined St John as a Cadet with Thebarton Division, I had no

intention of having a career in nursing. Having a trade (fitter and turner) or pursuing a

career in the police force were early considerations. As a fifteen year old cadet with

Motor Cycle Combined, I was fortunate for the opportunity to be rostered on weekends

to ambulance duty at Unley Ambulance Division. There is no doubt that this influence

was an enduring one that would guide not only my professional life but my personal and

family life.

Having progressed through Cadets with both Thebarton and Motor Cycle Combined

Divisions, I settled for a short time with Motor Cycle Adult Division. During this particular

time I was unhappy with career choices that I had made. A member of Motor Cycle

Division, who was a male nurse at Glenside Hospital, convinced me that I should apply

within the mental health sector for a position. In April 1967, I commenced a three year

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nursing programme at Hillcrest Hospital to achieve the qualification of a Registered

Psychiatric Nurse.

Later that year in September 1967, I transferred St John membership to Prospect

Combined Division. The years at Prospect were all encompassing and life was directed

at fulfilling work and St John commitments. Minimal time was spent at home. I can only

image that my parents believed that I was in a safe environment and no concerns were

expressed by them as to my excess period of time away from the family home. There

were examples when at Hillcrest Hospital, I would complete a twelve hour night duty shift

only to commence duty at Prospect or visa versa.

On reflection, considerable immaturity was displayed by myself, had surmountable

energy and was completely over auld by the excitement and adrenaline surge with the

role of an ambulance officer. Adult members of the Division fulfilled the role of surrogate

parents although there were considerable extremes in ability of individuals to act as role

models. However, the friendship, support and comradeship of members played a pivotal

role in the cohesiveness of the Division as well providing an environment for listening

following extremes in tasking and patient outcomes.

In 1968, considerable changes were occurring in nursing that enabled males, provided

they had successfully completed and were registered as a Psychiatric Nurse, to

undertake General Nurse training at the Royal Adelaide Hospital. Prior to this time,

males had no ability, except to travel overseas, to undertake General Nursing in an

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acute hospital. These changes also influenced my career direction and enabled me to

plan to undertake General Nurse training at the Royal Adelaide Hospital.

In the latter period of 1969, at the Angaston Cadet Camp, I met Janet who was a

member of Adelaide Nursing Cadet Division. The relationship flourished between St

John commitments and we were married in September 1971. After a short period of

time, I resumed St John duties exceeding hours of what would have been considered

appropriate for someone who had recently committed themselves to married life. There

was no doubt that the marriage was under stress in the first twelve months compounded

later by the birth of my daughter, Michelle. The circumstances surrounding my

daughter’s birth clearly reflected priorities at the time and would be considered as

being less than ideal and warrant criticism when compared with current expectations.

Support consisted of me on ambulance standby at the hospital and prior to the

delivery in early hours of the morning my crew partner walked the corridors of the

hospital while I slept on the stretcher in back of the ambulance.

I commenced General Nurse training at the Royal Adelaide Hospital in 1970. With shift

changes to eight hours and a variable roster considerable effort was required to balance

my personal life, St John and work commitments. General Nursing was also full of

challenges predominantly focusing on gender, stereotypes and discriminatory practices

to trainee male nursing students. Considerable growth in knowledge and clinical skills

occurred during this period of time enhanced by the ability to remain in “casualty

departments” of hospitals on “sleep-on” where I undertook numerous duties that included

assisting in the resuscitation process and suturing of patients. There was also a devious

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strategy behind this need and it was to source as many ambulance taskings as possible.

Sleep overnight would be a secondary need to fulfilling transport commitments.

My long term career direction at this time was focusing on employment with the

ambulance service, although there were changes evolving in midwifery nursing with the

acceptance of male nurses. Following completion of training at the Royal Adelaide

Hospital in September, 1972, I commenced full time employment as an Ambulance

Officer. At the same time, I applied to commence training as a Midwife at the Queen

Elizabeth Hospital. During my role as ambulance officer the long term career prospects

appeared limited and the appeal of commencing Midwifery was preferred as it involved a

significant change process, challenge, dynamic work environment and opportunities in

the longer term.

Three males, including myself, out of a group of twenty three participants, commenced

Midwifery Training at the Queen Elizabeth Hospital in 1973. The Queen Elizabeth

Hospital was the first in Australia to offer males the option of Midwifery training. In

retrospect, the acceptance of males by both medical and nursing staff was

unprecedented. During training, males were given preference and autonomy over some

duties that included assessment of labouring women. This enabled me to excel in my

role as an ambulance officer in the assessment and delivery of newborn babies to the

degree that I almost equalled my required delivery rate required for registration as a

Midwife.

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During the latter period of my Midwifery training, an informal approach was made to me

to fulfil the role of Matron at Lameroo Hospital. There were a number of considerations at

the time including a small baby, no experience in the rural environment, leaving family

and friends and a change of St John dynamics.

I commenced as Matron of Lameroo Hospital in January 1974 and due to personal

reasons at the time resigned in March. On my return, I commenced employment at

Modbury Hospital as Night Senior and re-established my ties with Prospect Combined

Division, fulfilling duties, at times, in excess of forty eight hours per week.

In December 1974, I transferred from Prospect Combined to Campbelltown Division

where I forged life-long friendships and further consolidated skills as an ambulance

officer. I continued to exceed what was considered reasonable hours of duty, which at

times, further compromised my relationship with Janet and missed opportunities with

daughter, Michelle.

In 1976, The Institute of Ambulance Officers, Australia, had established itself as a

professional organisation for both volunteer and career ambulance officers. All members

of the Institute at this time were Associate Members and a once only examination, over a

full day, was held throughout Australia to enable elevation to the status of Member. In

South Australia, a small group of both volunteer and career ambulance officers sat the

examination with the outcome that five were successful, including me, in achieving the

status of Member.

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After twelve months, I transferred to the Royal Adelaide Hospital to undertake the

Intensive and Coronary Care Nursing course. Clinical assessment and resuscitation

skills were further enhanced during this period of time and there were situations when I

would transport patients to the Royal Adelaide Hospital and then provide nursing care to

them on the next shift. Family members of patients expressed no real concern but were

often surprised at the time. There is no doubt that with these enhanced skills patient

outcomes, through my ambulance work, dramatically improved. Even in those days, prior

to both the Echo and Advanced Patient Management Programmes, I had an ability to

positively influence outcomes in a number of patients. In January 1977, I transferred

back to Modbury Hospital and fulfilled my previous position as Night Senior.

During my early nursing career at Modbury, I made my intentions known that I wanted to

pursue career advancement in nursing. In 1978, I was fortunate to be successful in

applying to the Hospitals Department for a full time, twelve months, scholarship at the

Lincoln Institute of Health Sciences, Melbourne. Following successful completion and

attaining a Diploma in Applied Science, Hospital Nursing and Unit Management, I was

appointed Charge Nurse of a surgical ward at Modbury Hospital. In January 1980, I was

appointed Nursing Supervisor and was responsible for developing a Hospital disaster

plan, commissioning the Psychiatric Unit, Woodleigh House, and assisted in the

redevelopment of the Emergency Department.

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In April 1980, I was appointed Divisional Nursing Officer, Campbelltown Nursing Cadet

Division, resulting in a varied commitment. I was fortunate to have a Superintendent

who was tolerant as both ambulance and personal commitments were given priority over

this role.

In March 1985, I was approached to undertake the role of Superintendent, Unley

Ambulance, with the knowledge that both the lack of membership and commitment to

duties were problematic. Prior to this appointment, through nursing, I had acquired

considerable managerial experience which I applied conscientiously in this role. I found

the role to be both challenging and rewarding and achieved positive outcomes

particularly in morale, recruitment, retention and duty commitment.

My nursing career progressed with my appointment as Assistant Director of Nursing,

Queen Victoria Hospital, followed by Deputy and later Assistant Director of Nursing

(Management) at Modbury Hospital. Academic achievement also paralleled progress in

my nursing career that included Bachelor in Applied Science, Nursing, South Australian

College of Advanced Education, and commencement of studies for the award of Master

of Health Administration, University of New South Wales.

During the late nineties, with the increase in the number of nurses in St John, a concern

was expressed by Ms K. Zeitz, Divisional Nursing Officer and I of the need for a nurse

reference group. With the permission of the then District Nursing Officer a forum for

nurses was established with the following broad objectives:

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Promote nurses and nursing

Act as a resource group

Delivery of a high standard of first aid

Communication forum for nurses

The Professional Officers Group continues to meet on a monthly basis and consists of

medical officers, nurses and ambulance members.

Over this period of time, I was asked to mentor officers of the newly formed University

Division, University of South Australia, City Campus. This involved attending divisional

meetings, overseeing administrative responsibilities and acting as a resource person to

the leadership group. Membership of the University Division consisted initially of nursing

students and later evolved to incorporate both staff and students from a variety of

disciplines.

In January 1990, I transferred to the Lyell Mc Ewin Health Service to fulfil the role of

Director of Nursing, a position held for three years, approximately. During this particular

time considerable change was ensuring with completion of Stage One Redevelopment

Programme, commissioning of the Birthing Centre and planning for the development of

an in-patient Psychiatric Unit. Prior to returning to Modbury Hospital, I had also instigated

discussions to restructure the Nursing Division to improve overall management in light of

foreseen challenges associated with a developing and expanding health service.

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The decision to return to the clinical environment was one of the hardest decisions I

have made in my nursing career. Up to this particular point in time, I had spent 17 years,

approximately, in management with minimal experience in the clinical environment. I

questioned my ability to cope with a busy clinical area, whether I would be able to deliver

safe and reasonable nursing care to patients and implications of returning to shift work.

There is no doubt, and it cannot be underestimated, that my experience and knowledge

base through my commitment with St John facilitated the transition from management to

clinical nursing.

After returning to Modbury and having attained the status of District Staff Officer, Grade

4, through St John, processes were in place to privatise the Hospital and a decision was

made to transfer to the Intensive Care Unit, Royal Adelaide Hospital. After twelve

months in the Intensive Care Unit, I resumed retrieval duties incorporating the

knowledge and clinical skills gained through experience in St John and nursing.

In the latter period of 1996, I was asked by the District Nursing Officer to develop a brief

document on Infection Control that could be utilised and adapted across the state. At the

same time, I gained the position of Clinical Nurse Consultant responsible for the delivery

and standard of nursing care in the Intensive Care Unit. A major component of this role

was to implement strategies to minimise transmission of infection in critically ill patients.

After extensive literature searches and consultation with experts the document soon

exceeded twenty pages and I was concerned that I had missed the point. I contacted

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both the District Nursing Officer and the District Medical Officer for guidance. I was

advised to continue, with the final document comprising forty one pages covering all

facets of Infection Control from delivery of first aid services to cleaning and

immunisation. The document was not only accepted as policy within South Australia but

nationally. Infection Control principles and practices were incorporated in all aspects of

first aid as demonstrated by policies (Occupational Health, Safety and Welfare),

processes and published texts.

In October 1997, forest fires were raging in Bandar Lampung, Indonesia, as a result of

villagers harvesting timber. Through Aus-Aid, the Country Fire Service (CFS) was asked

to provide personnel to support two fire fighting aircraft. The role of the aircraft was to

drop foam and water onto the fires. An approach was made by the CFS to St John to

provide first aid support for two teams and as a result Ms K. Zeitz supported the first

team and me the second team. The length of the secondment for each team was two

weeks. There is no doubt that in retrospect this role should have been fulfilled by a

medical officer given the potential for an aircraft crash, fuel fire, personnel injury or

illness.

Although my role was “First Aid Officer”, I fulfilled responsibilities that included

Occupational Health, Safety and Welfare Officer, resourcing the midday meal from the

local store, reinforcing to team members the importance of hydration (temperatures were

extreme with high humidity) and personal hygiene that predominantly focused on

frequent and thorough hand-washing. As the result of a team member becoming ill

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during the early period of the secondment, I assisted in aircraft support operations. The

overall experience was outstanding including the “near death experience” as the driver of

the bus weaved through peak hour traffic each morning on the way to the airport and the

personal experience of riding on an elephant.

Through my nursing endeavours in 1999, I was nominated for Nurse of the Year Award

through the Nurses’ Memorial Foundation of SA Incorporated. In June 1999, I was

appointed Chief Nursing Officer, a position that enabled me to promote the role of nurses

in St John. The position was influential in changing first aid practice through the Skills

Maintenance Programme and published texts that included Cadet Handbooks,

Australian First Aid Manual and Carers Handbook and related directly to infection

control, trauma management and contemporary nursing practice. I was also able to

establish a communication forum and supportive network for state nursing officers

ensuring their input in policy and practice changes.

The position further consolidated learned leadership skills gained both within the nursing

and St John environments. My personal goal was to demonstrate a strong nursing

presence in all facets of the St John Community, act as a change agent, team member

and ensure the contribution of nurses in decision making processes relating to the

delivery of first aid services. In 2005, I received a Commendation from the Chief

Commissioner for my commitment to the role.

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In October 2002, I was a member of one of two retrieval teams that were flown to Darwin

to assist in the evacuation of Australians as the result of the Bali bombings. On arrival

into Darwin we were advised that two Hercules Aircraft would be arriving during the

morning hours. Both teams were activated at Darwin Airport for the second Hercules

which carried multiple patients with varying degrees of injury including extensive burns.

The patients were triaged from the Hercules and it was decided that two female patients

(sisters) with extensive burns should be evacuated immediately to the Royal Adelaide

Hospital. Other patients were transported to Darwin Hospital by a fleet of ambulances

from the wider Northern Territory.

Both sisters were conscious and had extensive burns requiring large volumes of

intravenous fluid and close observations. During the flight one of the sisters overviewed

an incident when taken into a hospital in Bali. As she could not view her sister in the

immediate surrounds she asked a staff member where her sister was only to be told that

she was lying on a barouche next to her. The extent of burns and swelling around the

face made her sister unrecognisable.

For my commitment as the result of the Bali Bombing, I was both honoured and humbled

to receive an Order of Australia Medal in October 2003. Through the Department of

Health in 2004, I was also privileged to be a Finalist South Australian Nursing

Excellence Awards, Nursing Clinical Practice, Metropolitan Acute Care Registered

Nurse/Midwife. I view both these awards as a culmination of personal achievements and

opportunities that have been the result of endeavours both in St John and in nursing.

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In my role at the Royal Adelaide Hospital, through the Department of Health, I was a

member of the Government Radio Network Steering Committee. The Committee was

responsible for the implementation of a common radio system in all hospitals across the

state, determining the number and allocation of Talkgroups (Channels) and technological

resources required to support the Network. Previous experience in radio through St John

and the needs of hospitals supported my expertise as a member of this group. The

Government Radio Network within hospitals is the primary communication resource for

SAAS, retrieval teams, intra-hospital communication and state-wide emergencies or

disasters.

In my role as State Staff Officer, I was one of a number of members, in response to the

bushfires, who were sent to Victoria from the 12 th – 15th February 2009. Roles were

varied depending on the need and ranged from supporting first aid posts and incident

command centres to attending local duties.

I was allocated to the role of Liaison Officer, Kangaroo Ground, Incident Control Centre,

responsible for areas that included Whittlesea, Kinglake, St Andrews and Arthurs Creek.

All of which were affected by the bushfires.

As the St John Liaison person I was responsible for interfacing with other services and

was involved in incidents that included:

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Community incidence of Gastroenteritis

Kinglake West – Incident – Farmer wearing knee high boots working on fence

post – sank in soft ground – hot ash filled his boots – lost balance – sustained

further serious burns to both hands – Medivac flight to Alfred Hospital.

In May 2009, I was successful in applying for the position of Nurse Retrieval Coordinator

with MedSTAR Emergency Retrieval Service. The role involves the coordination and

activation of retrieval teams through the use of road ambulances, fixed and rotary wing

aircraft. Although retrieval teams for neonates, paediatrics and adult patients are based

at Adelaide Airport, the Coordination group is based with SAAS, Eastwood. At

Eastwood, I have had the opportunity to reflect on my voluntary role as a radio operator

within St John and to re-establish friendships with a number of career ambulance

officers. In July of last year MedSTAR was incorporated within the clinical governance of

SAAS, resulting in a change in the structure of reporting and a personal journey that has

gone full circle.

In Summary:

From my personal perspective, the role of first aider and that of a Registered

Nurse are inseparable and inextricably linked. All my actions whether as a

member of St John or nurse practitioner, regardless of the position held were

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based on knowledge and experience from both disciplines reinforcing the analogy

of Two Careers One Pathway.

As you can appreciate, there have been a significant number of highlights and

achievements, all of which would not have occurred if it was not for the support of others.

The support and love by my family during this amazing journey has been unequivocal,

unconditional and all encompassing.

Theodore Roosevelt:

"It is not the critic who counts: not the man who points

out how the strong man stumbles or where the doer of

deeds could have done better. The credit belongs to the

man who is actually in the arena, whose face is marred

by dust and sweat and blood, who strives valiantly, who

errs and comes up short again and again, because there

is no effort without error or shortcoming, but who

knows the great enthusiasms, the great devotions, who

spends himself for a worthy cause; who, at the best,

knows, in the end, the triumph of high achievement, and

who, at the worst, if he fails, at least he fails while

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daring greatly, so that his place shall never be with

those cold and timid souls who knew neither victory nor

defeat."

Thank you

3rd August 2010

© Revised 22nd April 2011.

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Documents

Two Careers One Pathway2 2010