STUART MOBSBY - REMOTE NP

Stuart lives in Jabiru in the heart of Kakadu National Park and services the region’s primary health care needs through his role as a remote nurse practitioner. Stuart’s role encompasses four health centres across the region of West Arnhem and services the two major centres of Jabiru and Gunbalanya.

As the only NP employed by Top End Health Service that specialises in primary health care, Stuart has worked over the past 11 years in remote health and the last 12 months as an NP to offer a high level of with a focus on chronic disease management including heart disease, renal disease, respiratory disease and diabetes.

Stuart lives with his wife, who is also a part-time nurse, and his three young children; they are expecting their fourth little bundle of joy in November 2018.

Can you share a little about the community you are working in and the nursing you are providing to patients?

My role is in primary health care in remote and Indigenous communities – where there is a rich sense of culture, but delivery of health care is challenged by remoteness, social disadvantage and increased burden of disease.

I work to fill gaps in primary health care and focus on treating the whole person, not just the condition or the symptoms of a disease.

I take the time to focus on the social and emotional side of my patient’s health as well as physical issues. I spend a lot of time with the patient trying to figure out what my clients and their families want to achieve and how they can achieve the best outcomes.

Now that I am a trained NP there is less fragmentation in the care that I can provide which makes the process that little bit more satisfying and useful in the communities that I care for.

What is unique about your role in the community?

In my role I am providing access to people who need a high level of care - whether it is medication, investigation and or other elements of health care provision, through my qualification, I am able to take the traditional RN role to the next level and offer holistic care.

While doctors are available in the area, nursing values speak volumes to the patients I care for and the patient-centred approach is well received and makes for more successful outcomes. By using my skills as a nurse practitioner, I am able to provide a higher level of care and add depth to the primary health care services I provide.

In addition, I provide clinical leadership across the whole health service, with a focus to develop the skills of other health professionals and systems in care.

What is a typical day for you in your NP role?

My days starts by checking pathology results that need following up, then my patients will start coming in, some people make appointments, most people will just walk in and see if I am there.

Usually, my day can involve anything from a full health check right through to re-visiting the health needs of patients from previous visits. I able to provide access to comprehensive clinical assessments, diagnostic investigations, therapeutic interventions, referral to other health providers, whilst working towards patient centred goals. We are focused on the principles of self-management; therefore I am curious about their ideas of health and work to explore and challenge my patients to work out the best health outcomes.

Most people I will spend 30 minutes to an hour in a consult so I can find out what’s going on - I find using motivational interviewing techniques work to provoke a thought of change.

Why did you decide to become a nurse practitioner?

I’ve been a nurse since I was 18 years of age and living in London. To be honest, I never set out to be a nurse, but after doing some work experience with the ambulance service and realising that a nursing degree would allow me to head to university and enjoy some of the university life I switched to nursing and have never looked back.

After training in the UK, I came over to Australia 15 years ago and decided I would stay after finding this amazing world called remote health.

I have a wife, three kids and one on the way and love the life that being a remote nurse has offered us. My wife is a nurse as well, and we’ve worked in community nursing together over the years.

As a bit of a side note, my wife is currently working part time on a project in NT that is working to recognise the Hep B status of all patients in the top end - so far, with another nurse and a part time doctor they have worked through 19,000 patient files to explore blood results and have won awards and accolades for their program and the benefit the project will bring in the management of long term Hepatitis B sufferers across the Northern Territory.

What are you hoping to achieve in your current role as a NP?

In the long term, I want to see that we are providing the most appropriate care for our communities. It about being flexible and adaptable in the delivery of health care and offering primary health care that fits into the community and how they like to do things.

The NP role is important in remote and rural locations, and we are going to achieve great things if we all continue to work as a team and my goal is to provide the best care I can and achieve patient outcomes.

If you weren’t a NP, what would you be doing?

Back in the day when I was leaving school I didn’t know what I wanted to do - I did local work experience as an ambulance worker and after settling into university and exploring the role of a nurse I really found that the uniqueness of the role and the journey that health care could offer me is something I crave.

I really love that every day is different and this really drives me and keeps me loving what I do.

If you were to use a few words to describe a NP what would they be?

Some people will say “You are like a mini doctor”…but really we are a maximum nurse – this means we do have similar skills and roles which we share with our medical colleagues, but do this based within our nursing values and experience.

In terms of the role, it goes beyond the traditional scope of a RN; we provide access to a whole array of services and follow up. We’re focused on a patient-centred approach, and see the person as a whole and work to address everything, not just the ailment, issue or health concern.