AAARRRGGHH! Can't do Primary Health Care

Social Justice demands all people have a health service they can trust, provided in the best possible manner by the health team. In remote communities it is no secret that it is difficult to maintain a stable, qualified workforce. Nurses in these areas are so overworked and under-supported that they are unable to provide the level of primary health care required by people dwelling in these isolated communities. This study has identified major concerns of RANs endeavouring to provide such care with limited ability due to their location in single nurse clinics in remote Australia. RANs identified that they provide acute care in response to need without time for recall, follow up or initiating any primary health or preventative care in their communities which are surely the most disadvantaged. Reasons impacting on lack of ability to provide adequate/any primary health care included lack of management support, lack of staff, lack of support, lack of time and lack of safety. This study has identified continuance of two levels of exclusion, the remote communities from equity in health care provision and RANs exclusion from the support of their own profession-despite National Health Strategies and Specific Indigenous Health Strategies. Within health services the tension remains between ideology (the dominant view about how things should be done) and the way things are done in reality. Design: A descriptive study involving a two stage process of data collection with typical case sampling within a constructivist framework was utilized for the study including; i) a mail-out to all CRANA nurses, ii) in depth interviews with RANs Participants: Remote area nurses throughout Australia (nurses working in small isolated (often Indigenous) communities throughout Australia. Results: respondents indicated that in single nurse clinics they are unable to provide the level of care that is required. Conclusions: Staffing current single nurse clinics with two or more nurses will improve RAN’s ability to provide appropriate Primary Health Care. What this study adds; Provides documentary evidence that social justice is not being served in remote communities of Australia. Adds to the paucity of formal literature about the reality of RANs’ ability to meet to expectations of Governments and consumers in relation to primary health care provision