Introduction: Recent literature has explored the health and social implications of industrial workers who are involved in a variety of long-distance commute (LDC) work arrangements including fly-in, fly-out; bus-in, bus-out; and drive-in, drive-out. However, the role of an industrial health worker in caring for this special population of workers is poorly understood and documented in current literature. In Australia, the health role has existed primarily to meet minimum standards of safety legislation and carry out compliance activities. The combination of low social risk tolerance, increasingly remote locations and changing health and safety legislation are driving changes to accountability for the health as well as the safety of remote industrial workers. Health staff are recruited from the ranks of registered nurses, paramedics and diploma-qualified medics. Often, they work in autonomous transdisciplinary roles with little connection to other health workers. The lack of a clear professional identity contributes to increased tension between the regulatory requirements of the role and organisations who don't always value input from a specialist health role. The aim of this study was to understand the experience of isolation for health workers in industrial settings to better inform industry and education providers. Methods: A phenomenological methodology was chosen for this study owing to the paucity of qualitative literature that explored this role. This study utilised face-to-face or telephone interviews with nurses and paramedics working in remote offshore and onshore industrial health roles seeking to understand their experience of working in this context of health practice.Results: Three thematically significant experiences of the role related to role dissonance, isolation, and gaining and maintaining skills. The second theme, isolation, will be presented to provide context for nurses' and paramedics' experiences of geographical, personal and professional isolation. Conclusions: Nurses and paramedics working in remote industrial roles are not prepared for the broad scope of practice of the role, and the physical and profession isolation presents barriers to obtaining skills and confidence necessary to meet the needs of the role. Limited resources in rural and remote areas combined with the isolation of many industrial sites pose challenges for industrial staff in accessing primary healthcare services, yet industrial organisations are resisting attempts to make them responsible for the health as well as the safety of their onsite workers, particularly in off-duty hours. Health workers in remote locations have to cope with their own experience of isolation but also have to treat and counsel other industrial workers experiencing chronic illness complications, separation from family and other consequences of the fly-in, fly-out 'workstyle'. In addition to the tyranny presented by distance and the emotional isolation common to all remote industrial workers, health workers are isolated from professional networks,...
Rural and remote communities are challenged by an incongruous combination of poorer health and deficits of health workers. Health professionals working in rural and remote practice contexts are largely educated with standardised curriculum content designed for urban-dominant systems, even though non-urban populations account for approximately half of the global population. Education is one strategy considered pivotal to recruitment and retention of health care workers in rural areas, yet has received less research attention than strategies such as rural background, incentive schemes and clinical placements. Peer reviewed literature published in English between 2011-2021 were obtained, guided by PRISMA-P guidelines (Shamseer, 2015). The aim of this review was to examine how health professionals are currently being prepared for rural practice. Following key health database searches 189 relevant articles were retrieved, of which 26 articles met the inclusion criteria for final analysis. This review identified a heavy reliance upon standardised curricula delivered via clinical and interprofessional placements with little attention to specific rural curriculum content or pedagogic strategies tailored to rural and remote practice. Three themes were developed from the literature: Context (‘learning to think differently’, ‘relationships’, and ‘health leadership’), Curriculum and Pedagogy (‘rural clinical placements’ and ‘interprofessional education’). There is a paucity of educational design and evaluation research to assess the value of education strategies that prepare health professionals to work in rural places. Identifying key rural pedagogic strategies can support curriculum content, experiences and assessment that provide health professionals with the competence, confidence and skills to sustain careers in rural and remote practice.
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