Driving Change Through Diversity: How new staff can make a difference

Miss Laura Wright1, Mr John Wright1

1Tennant Creek Hospital, Tennant Creek, Australia


Being a new staff member can be challenging and confronting, but can also provide an avenue to initiate and drive change. Good communication is crucial and recognition of shared responsibility is key to sustainable change.

We will share our experiences from the perspectives of a new nurse and a manager and mentor of new staff. We all know generally that diversity is important. Diversity of experience is vital in developing innovative healthcare teams, and it provides an avenue for newly qualified staff to enter and thrive in those teams.

New staff bring fresh perspectives for identifying areas for improvement and suggesting alternative approaches to ‘the way it has always been done’. However, fantastic ideas don’t work alone, as effective change requires the whole team. Unilateral decisions are unsustainable, whether made by anyone from the student to the manager. Success depends on balancing eagerness for change with respect for history and experience. Managers and leaders must unequivocally support the exploration of new ideas. Whether or not they turn out to be workable is not the point, a culture of continuous improvement is the goal.

Finally, we offer practice tips for both new staff and managers, to help them navigate the communication minefield of change.


Laura Wright RN, BN, MACN, Emergency Nurse, Tennant Creek Hospital. Laura is in her third year as an RN, graduating from CDU in early 2017. Having grown up in the bush, she is passionate about remote health and making a difference wherever she can.


John Wright RN, BN, MRHP (NP), MRHM, GCCE, MACN, Fellow CRANAplus, Fellow CENA, Nursing Education and Research Coordinator, Tennant Creek Hospital. John has 25 years of experience in emergency nursing, remote area nursing, management, and education. He has a strong focus on supporting change and building effective teams.


Connecting and Empowering Aboriginal and Torres Strait Islander Maternal, Child and Youth Health Workforce To Drive Cultural Change And Improve Health Outcomes

Mrs Heidi Atkins1

1Qld Child & Youth Clinical Network


Introduction: Aboriginal and Torres Strait Islander (A&TSI) Maternal, Child & Youth Health Workers face significant unique workforce challenges which hinder efforts to improve health for their communities. Feedback through workshops with A&TSI Health Workers indicated they felt isolated, undervalued, had limited networking and training opportunities. As workforce and service delivery run in parallel, improvements in workforce will have a positive and direct impact on child and youth health outcomes.


The QCYCN undertook Indigenous-led statewide consultation to understand local and shared issues, map service structures and identify needs, including a forum with key stakeholders to identify solutions within the context of their roles and responsibilities.  An outcome was to establish a statewide governance model to foster collaboration, drive workforce culture change and ultimately lead to better health outcomes for A&TSI children, young people and their families.


A statewide governance model was established consisting of a Steering Committee (SC) and 5 local cluster network groups. Leveraging off the QCYCN has provided SC members with the platform to lead change from the ground up. The local cluster groups create a statewide collaborative and support the SC by acting as local cultural expert groups. QCYCN has received extremely positive feedback from Health Workers.


The SC is the driving force within Queensland charged with creating a positive, cohesive and productive workforce culture statewide. Through their leadership, an integrated and equitable statewide governance model has been established. This will produce better health outcomes for Aboriginal and Torres Strait Islander children and young people, their families and communities and will have a positive contribution to Closing the Gap.

This work will produce a proof of concept for a collaborative, sustainable approach to workforce governance that is transferable to other specialties, service areas, organisations and jurisdictions.


Heidi Atkins is a passionate project manager with over 13 years experience in the health industry (Queensland Health and the UK) and has completed a Masters in Health Services Management. Heidi has leadership experience in coordinating and facilitating implementation of statewide strategic initiatives aiming to improve health outcomes for children, young people and their families and is the Principal Policy Officer for the Qld Child & Youth Clinical Network, leading the Aboriginal and Torres Strait Islander Maternal, Child & Youth Health Workers project.


Agricultural Health and Medicine education-engaging rural professionals to make a difference to farmers’ lives

Ms Jessie Adams1,2, Dr Jacquie Cotton1,3, Professor Susan Brumby1,2,3

1National Centre For Farmer Health, Hamilton, Australia,

2Western District Health Service, Hamilton, Australia,

3Deakin University, Hamilton, Australia


Populations in agricultural communities experience poorer health outcomes than their metropolitan counterparts. Despite continued higher rates of workplace injuries, earlier morbidity and mortality in farming populations globally; few formal programs focus on agricultural health, wellbeing and safety. Agricultural Health and Medicine (HMF701) was developed in 2010 by Deakin University and the National Centre for Farmer Health, aiming to increase cultural competencies and empower rural professionals to improve the health outcomes of rural and remote Australians.

This research used a mixed method approach to identify the extent to which past students (2010 to 2018) utilise the Agricultural Health and Medicine unit content in their current occupations, and identify barriers faced in implementing their learnings. Students were invited via email to complete an online survey. Following the survey, consenting students participated in a one-on-one phone interview.

Forty-one students completed the survey; a response rate of 31%. Additionally, interviews were conducted (n=11). Results were analysed using descriptive statistics, frequencies, chi-square tests and open-ended questions were themed. Nursing and farming were the most represented occupations. Of responders, 81% felt confident discussing agricultural health and medicine topics with their peers and community. Upon completion, over 75% agreed their ability to diagnose, treat or prevent agricultural occupational illnesses or injuries had improved, with 42% reporting that they use the course content professionally at least weekly. However, minimal evidence suggested career development resulting from course completion.

This research informs the continuous curriculum development and innovation within Agricultural Health and Medicine, and highlights the importance of an integrated and collaborative approach to at risk populations. Despite engaged graduates and the continued high mortality and morbidity rates within the agricultural industry, the importance placed in farmer health within organisations is inadequate and under recognised, with structural barriers a factor restricting career development post completion of this highly valued course.


Jessie Adams completed her Bachelor of Public Health and Health Promotion (Hons)/Bachelor of Commerce at Deakin University in 2017.  Currently, Jessie is working as a Research Assistant at the National Centre for Farmer Health in Hamilton working on a variety of projects focused on improving the health, wellbeing and safety of farmers in Australia. This opportunity has allowed Jessie to combine her interests of health and agriculture.

BCom, BPubHealth & HealthProm (Hons)

Email address: jessie.adams@wdhs.net

A framework and approach to assess; access, quality and sustainability of the primary health nursing and midwifery workforce in rural, remote and regional NSW

Bernadette Gotch1

1NSW Rural Doctors Network


The purpose of the presentation is to present an approach and framework NSW Rural Doctors Network (RDN) has embedded to assess; access, quality and sustainability of the primary health nursing and midwifery workforce.  RDN is the designated Rural Workforce Agency for health in NSW whose aim is to ensure the highest possible standard of healthcare is provided to rural and remote communities through the provision of a highly skilled health workforce. The Department of Health funds RDN to undertake Rural Health Workforce Support Activities.  A primary objective is to contribute to addressing health workforce shortages and maldistribution in rural and remote NSW.  Underpinning this activity is an evidence-based Health Workforce Needs Assessment methodology. In its third year, Primary health nursing and midwifery workforce is to be integrated into the general practitioner and allied health workforce needs assessments.  The expected outcomes of this work is to meet current and future community primary health workforce requirements through workforce planning by identification of needs and undertaking initiatives in three priority areas;

  • Access – improving access and continuity of access to essential primary health care
  • Quality of access – building health workforce capability and
  • Future Planning – growing the sustainability of the health workforce.

RDN has embedded a framework and regionally facilitated engagement approach; encompassing latest evidence, policy, initiatives and drivers to enable both quantitative and qualitative capture of the current workforce distribution and to identify issues, gaps, solutions and opportunities for the nursing and midwifery sector to meet the health needs of rural and remote communities.  RDN welcomes feedback from the sector on the proposed approach and utility of the framework for the nursing and midwifery sector in rural and remote communities.


Bernadette Gotch is the Director of Service Delivery for NSW Rural Doctors Network (RDN). Her passion for the delivery of health care began more than 25 years ago and since then she has undertaken many key senior executive roles across private, public and  government organisations. Before working at RDN, Bernadette was the General Manager of Customer Operations at the NRMA. Prior to this role, she was responsible for Assistance Services across Australasia at International SOS, the world’s largest medical and security assistance company.  Bernadette holds a Bachelor of Nursing, and a Grad Certificate in Intensive Care. After which she has studied Psychology/Law and is currently completing her Masters of Law at the University of NSW. After receiving the International SOS future leaders award in 2013, she was offered a scholarship to attend Harvard University, Executive Leadership Course on two separate occasions. Bernadette is an effective, high energy leader who enables an inclusive and collaborative work environment that leads to positive outcomes for those she supports.


Ms Katie Pennington1

1Puntukurnu Aborignal Medical Service, Pilbara, Australia,

2Edith Cowan University, Joondalup, Australia,

3Tasmanian Health Service, St Helens, Australia


Introduction:  Registered Nurses in very remote Australia, medicines and the law is a mixed methods research project utilising an explanatory sequential design that commenced in early 2018.  Early results from the project highlighted that a significant proportion of participants, RNs who had worked in very remote Australia within the previous two years, were likely the have worked outside the law with regards to medications.  Respondents from WA were more likely to have worked outside the law with regards to medications than any other state/territory.

What is happening in the Project:  Results from the project have been utilised alongside strategic lobbying by the WA Aboriginal Community Controlled Sector to successfully bring about legislative reform that better enables some aspects of remote nursing practice with regards to medications.  This presentation will discuss the approaches used to obtain the reform, the risks that still exist for nurses and patients in rural and remote areas nationally due to asynchronous medicines and poisons legislation and the ongoing work to #ChangeTheLaw

Conclusion: Collaboration and research-based evidence can be powerful drivers of both local and systemic change.  #ChangeTheLaw is an example of a grassroots, nursing driven quest for change in order to improve legal access to medications for remote populations and address the uncertainty and confusion remote area nurses face in aspects of their work with medications.


Katie is a Registered Nurse working with both the Tasmanian Health Service at St Helens District Hospital and in a Continuous Quality Improvement and Clinical Systems role with Puntukurnu Aboriginal Health Service in the Pilbara.

Her experience in rural, remote and isolated health spans 18 years.

Katie holds a Bachelor of Nursing from the University of Tasmania, a Graduate Diploma in Remote Health Practice and a Graduate Certificate in Child and Family Health Nursing from Flinders University. She is currently undertaking her Masters in Public Health (Research) through Edith Cowan University.