GAYLE RUSHER - PRIMARY HEALTH NP
After working as a nurse in Tasmania, South Australia, Victoria and Western Australia’s remote areas for several years – whilst also pursuing her passion in wine making, Nurse Practitioner (NP) Gayle Rusher settled down for a couple of years in Victoria. She worked in hospital-based and community nursing roles, combined with working as a cellar-hand and winemaker assistant on her days off. Gayle made a decision to concentrate on nursing rather than wine making, which led to a decision to relocate to Cairns and subsequent employment at the Royal Flying Doctor Service (RFDS), which started a new chapter in her nursing journey.
Please share your nursing journey with us.
In 2003, my partner at the time sent my resume to RFDS which led to employment as a retrieval nurse role based in Cairns. I worked for fourteen years in retrieval, child and family health and took on the role of team coordinator, with most of my work based in Aurukun and Doomadgee. The experience working as a nurse in retrieval is resulted in some of the most challenging and satisfying work years of my life. I formed amazing friendships with indigenous and non-indigenous personnel and gained qualifications as a RIPERN, a nurse immuniser as well as gaining experience in child and family health services. I also received a scholarship which enabled me to complete my Master of Public Health and Tropical Health at James Cook University as an external student.
When the ‘Closing the Gap’ Funding and other sources came in line, it became a turning point which informed my practice, particularly in my role as a coordinator of the primary health care nursing team, as we experienced a rapid expansive phase. It was an exciting time!
Over the years, I gained experience as a volunteer in Vietnam; experienced the Kangaroo-care in Bogota Colombia; and became a Director of Nursing at Croydon, Western Queensland. Eventually, I felt the need to move on from RFDS and commenced Master of Nursing (NP).
I got sick shortly after my relocation back to Tasmania and took at least four months off to recover. I had to put my NP studies on hold. After recovery, I was successful in my application for a position as a practice nurse at a general practice at Huon Valley Health Centre in Huonville.
The practice partners at the general practice supported the completion of my last clinical subject as a NP Candidate. I was then supported into creating an NP role which became an integral part of the expanding and busy practice.
Tell us about your current role as a NP.
I practice in the rural and regional settings of Tasmania, particularly in the Huon Valley and surrounds. I also spend time travelling to home visits as far south as Dover and as far north as Kingston. I see patients as part of clinic sessions as well as conducting outreach visits for acute and chronic care. I escalate care, collaborate with the GP team in complex cases, or practice as co-carer for many patients, depending on their individual needs.
My practice is comprehensive and broad. I am available to provide care for many clinical presentations which includes: conducting comprehensive health assessments; providing advise on and administration of immunisations; undertake simple procedures such as suturing, incision and drainage, sample and biopsy skin lesions; provide information on contraception and cervical screening; provide antenatal care; manage acute care presentations; organise referrals; and Diabetes, Endocrinology, and Metabolism (DEM) admissions/referrals. I also manage patients who present for diabetes management in my capacity as a credentialed diabetes educator (CDE). I am involved in an extensive home visit program to manage for at-need patients, patient end of life care, patients with poor access to health care and hard-to-engage patients. As a component of my role, I engage in one session per week as co-team member in a local Aged Care facility, providing health assessments, case conferences and basic supportive care from a nursing perspective.
The most rewarding aspect of being a NP, is my ability to provide patient care using a nursing philosophy, which includes providing education to patients, medical students and interns. It is also rewarding to have a supportive and innovative work environment in which to work and develop an NP role in private practice.
My current area of practice enables me to establish the NP role in a manner which best fits the practice and delivery of optimal patient care. I am hopeful that my work in this role will provide sustainability for future NPs and further role development. The evolution of the NP role is a living dynamic entity!
What Influenced your decision to become an NP? Why the scope of practice?
Many people I have met during my nursing career have been inspirational in encouraging me to take the next steps of my nursing profession. I felt the need to be challenged and was drawn to a position that would allow me to make changes that would result in improved health outcomes.
In terms of my scope of practice – I have felt it necessary to have a wide set of skills to meet the needs of the communities in which I work and have the capacity to make referrals to the specialities in higher levels of care if required.
What are you hoping to achieve in your current role as NP?
I am committed to continuing the development of my healthcare knowledge and to keep an active mind able to better serve the community an provide better health outcomes overall. I would also like to contribute to the design of a sustainable pathway to truly collaborative private practice.
How do you think health consumers benefit from seeing a NP?
NPs are usually more flexible and accessible to patient groups. With a background in nursing, , combined with connection/collaboration with other team members as and when needed,, NPs provide a timely and efficient level of practice.
What advice to anyone wanting to become an NP?
Be prepared for a challenge and some road blocks, it’s all part of the journey. It does not matter how long the journey takes as long as you are always learning! Work in an innovative work culture that allows you to grow into the role and take the time and the further education needed to grow into the role, it’s worth it. Don't ever forget where you come from and the people that helped you on the way.