Voices in the dust

Voices in the dust

A sense of historical perspective is essential to understand and to balance the historical nature of contemporary research and writing on health care. Many of the major health issues of our time have an important historical dimension that is often overlooked, treated cursorily, or ignored. Not all outcomes are the result of a linear causal effect, and the historical comparative research method provides an effective means of making comparisons about certain events over time. Remote area nurses (RANs) have practised in isolated areas of Australia since the very beginning of white settlement (Schultz 1991; Priestley 1992; Strachan 1992; Russell 1995). This isolation was (and, in some cases, still is) imposed in the first instance by geography. In other cases, the isolation has been caused by the fact that these practitioners (who, for the most part, were prepared--as any other general nurse in Australia--for an urban setting) have been unable to access further education and intraprofessional support.

This book aims to answer the following questions using an historical comparative approach: 1) Which discourses have prevailed historically within Australia to ensure that remote area nursing practice is neither legitimised nor endorsed as an area of specialist, independent nursing practice in its own right? and 2) Which specific legal criteria are currently being applied to define the scope of practice of remote area nursing, and how appropriate are these criteria, given the reality of remote area nursing?

Perhaps the invisibility of remote area nurses was more a matter of being “out of sight out of mind” and, indeed, in many cases, this state of affairs seems to have suited remote area nurses. This situation began to slowly change for metropolitan registered nurses in the early twentieth century but, until very recently, remote area nurses appear to have been uninvolved in the clamour for changes in the legislation regarding this. In remote Australia, when the dust settles after a wind storm, nothing remains the same--everything becomes coated with dust that covers all the surfaces and penetrates the crevices. So it was with remote area nurses. Once they began to recognise the value of their voices and the collective power they generated as a cohesive group, they began to listen to and be heard by other nurses and by legislators. At last the remote area nurses’ voices and influence is being felt in political corridors, as well as in local practice areas. These voices may now be heard in all avenues of the media, conferences, ministerial task forces and inquiries, as well as at local community levels. This study explores the public discourse of nurses, legislators, and the media in order to determine why such recognition has taken so long to occur. The study identifies that it is not enough to merely blame others; nurses have not simply been the victims but, in fact for many years, have contributed to the silence regarding their unique position as practitioners in this area of specialist, independent nursing in Australia.

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