Going Rural as a Grad Physio

‘take me home, country roads’

Returning to Rural Victoria to work post graduation

Being a graduate rural health professional involves wearing many hats. 

You have to balance your time between learning the ropes of your profession, managing a diverse caseload of often complex clients, health promotion, covering several clinical services (e.g. acute care wards, community health centre, residential aged care facility, rehabilitation, and home-based settings), and often having to assume some of the duties of other professions not represented in your service!

Whilst at times challenging, becoming a rural healthcare professional can fill you with a real sense of accomplishment.

Across all ages, disciplines and regions, rural practitioners are some of the most widely skilled people around! There are no ‘typical’ days in a country practice.

I recall one day I started my shift on the acute ward working with several patients recovering from pneumonia on their chest clearance exercises. From here I then progressed to fitting a pair of paediatric crutches for a child that had a nasty sprained ankle, and then was advising the urgent care staff on best practice acute soft-tissue injury management. After morning tea was a joint home-visit with the occupational therapist. Her and I got to collaborate on falls prevention and access for a patient returning home from after having to undergo a half hip replacement following a fall at home resulting in a fractured hip.

That afternoon was the aged care facility exercise class which I undertook with the home’s diversional therapist, throwing, catching, quoits, the multi-coloured parachute, and lots of laughter and fun!

After work my dad asked if I could take a look at a friend of his’ horse… There’s never a case of ‘Groundhog Day’ out here in the country!

You know everyone, and everyone knows you. 

Though going rural as a graduate has many, many positives, it would be deceitful not to cover off on some of the harder to deal with aspects of the country life. One big factor is that you really have to balance your role as a healthcare professional, and as a member of the community within which you serve.

Maintaining patient and client confidentiality can be a tricky thing to manage in a smaller town where social and family ties tend to be more complex. Dodging well-meaning questioning about how a member of the public’s relative or friend is going in their rehabilitation, must be delicately handled, as offence at being shut-down for the sake of confidentiality is felt more acutely in a setting where you too are the friend or relative of the person. Professional boundaries can easily blur, and I found myself in the position of being a colleague to, and a patient of my local GP! A lack of alternative healthcare staff can also present rural practitioners with conflicts of interest that would not be an issue in the metropolitan context.

An example from my own life was having to assess the mobility of my own grandfather whilst he was in palliative care at the hospital where I worked. This would never be asked of a staff member in a larger health service.

A Jack of all trades is a master of none… But better than a master of only one!

The second half of this (oft misquoted) idiom, says it all when it comes to the expectations of a rural posting.

Going rural in healthcare gives staff of all levels of experience, the unbridled opportunity to broaden not only their horizons, but also their clinical skill-sets. In larger health services, new graduates and even most junior-level staff will complete several months long in the same ward or department, focusing on a particular aspect of patient care. In the bush, this is not the case. Generalisation is a must from day one. Rather than being afforded the opportunity to hone skills in a particular clinical area prior to rotating through to the next, small health services demand flexibility and versatility to pivot rapidly between clinical streams and specialties in the course of a day or even an hour!

Thank God I’m a country boy.

If like me, a ten minute walking commute, tubing lazily down your local river, and living ‘the quiet life’ are attractive prospects, then I cannot recommend a rural healthcare career more highly.

Mitchell Dunn

Associate Lecturer, Rural Placement Co-ordinator

Going Rural Health Shepparton

Physiotherapist

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