Reflections from our 2020 scholarship awardees

Each year ACEN awards eight $1500 scholarships to provide financial support for students undertaking a WIL placement in a regional or remote area of Australia as part of their university studies. Upon completion of the placement recipients are required to provide a reflection of the WIL experience which should

• Identify the personal growth and skill development as a result of the WIL placement
• How the ACEN Scholarship supported the recipient’s career aspirations
• Evidence of the ability to think critically and question biases and assumptions

Medical Imaging WIL

I have undertaken many weeks of placement during my university degree and each one had provided me with many new skills and perspectives. This last placement was in the rural town of Dubbo New South Wales, it was within a private practice that serviced people from many kilometres away. This was a 12-week placement and occurred during the peak of the COVID-19 pandemic, this was a big change in how the health industry functioned. I needed to change my techniques and my approach to patients in order to keep us safe and still get the diagnostic images needed. Radiography requires a lot of communication which can be difficult while wearing masks but allowed to me develop my communication skills. This placement saw me taking a more independent role and growing as a radiographer, student and long-term health provider. It was difficult at times being isolated and not being able to return to my hometown on weekends, but it did help me to focus on study and improving where I could.

Within 2 years I was required to undergo 44 weeks of fulltime placement outside of Canberra, this made it hard financially to save and still be able to afford all placement costs and some outings. This ACEN scholarship helped with the cost of vaccinations needed for healthcare work, helped with accommodation/travel associated with placement and allowed me to explore a part of NSW I had never been to. To ensure that I marked off all competencies needed for the degree I was required to spend a week in Orange during my Dubbo placement, this scholarship helped me to achieve this goal.

I enjoy rural placements, partly because of the change of scenery but also the diversity in patients and peers. I have found that you are able to get more hands-on experience and greater opportunity to control how and what you learn. In bigger areas it can be too busy, and you are not afforded much time to expand your knowledge of the different imaging modalities. During this placement I was able to sit in on mammogram scans, magnetic resonance imaging scans, and change locations within the same company to take images during theatre cases. I had many opportunities to discuss with visiting doctors and my superiors and ask all the questions I needed to.
It is generally assumed that within private practice that the diversity of patient’s is minimal, this rural private practice has many different people coming through the doors. There were days with patient’s with major injuries entering that did not want to go to the hospital because of the long wait times. There were also sad cases of finding cancer and brain tumours, these cases provided me with a lot of growth as a person and helped me to work with patients being as caring as possible. This practice also receives special patients from the Zoo, furry and scaly ones, it helped me to remove my stigma of private practice. A very diverse patient range requires a lot of adaption, along with evidence-based practice and critical thinking to change techniques and radiation dosages to fit what you are imaging. Changing from paediatric to adult or koala means that continuing to learn and adapt is very needed.

I learnt a lot from my rural placement that I will never forget, it is one of my most memorable experiences. I had a great team to surround me and guide me through the hard times of COVID-19, the ACEN scholarship helped me greatly and I very much appreciate it. I am very grateful for the opportunities I have had and the skills I have gained along the way.

Remote Physiotherapist Placement 2020

During my remote placement as a physiotherapist student I was exposed to a variety of indigenous patients including; Aboriginal, TSI and Papua New Guinea patients which taught me sensitive cultural tools for communication in order to build rapport with them. It also exposed me to patients who suffered a variety of comorbidities which challenged me to work with complex patients; having to prioritise treatment. Being in a busy general surgical ward it equipped me with the tools necessary to work efficiently and effectively with a large caseload of patients by prioritising the work day while still showing compassion towards each patient assigned to me.

The scholarship has given me the skills to work at ease with the variety of patients and a demanding patient caseload. This enhanced my flexibility within the workforce as a physiotherapist and I believe has allowed me to increase my chances of employment, though efficient and working with indigenous patients.

I would feel comfortable should I ever need to work within this area again and in fact would embrace the opportunity should it become available again to me.

I was able to use my critical thinking when working with patients that had many comorbidities and prioritise what treatment was more important for the welfare of the patient at the time of assessing and treating them.

I was able to treat patients without discrimination (including a prisoner) in order to benefit the patient, nursing staff and other co-workers.

I was told a PNG patient was difficult to build a rapport with, I approached with an open mind and found a common interest with them in which I could build a strong rapport.

Radiography Placement in Taree, NSW

After five long years, I have just completed my Bachelor’s degree in Medical Radiation Science (Medical Imaging) with Charles Sturt University. I have spent the last nine months of my final placement in Taree, NSW. Taree is known to have one of the highest Indigenous populations in NSW and even though I am Aboriginal, I initially felt like I didn’t belong because it was not my country, it was not what I was used to and I was out of my comfort zone. However, during my time here, I started to build rapport with the local community and eventually I became a part of it. I was the only Indigenous person in my department so I asked if I could enter a NAIDOC door decorating competition. It was a yearly competition where everyone in the hospital could decorate their door however, I did not enter to win, but to educate about the issues that we faced and still experience today. I decorated a door that could be easily seen by all that would walk past the x-ray department. It was the perfect opportunity to show off my culture as I am extremely proud of where I come from and I was so proud of what I shared with everyone. I had heard a lot of positive comments come from people stating that they were unaware that these things were and still are happening. I felt that this small thing that I have done has transformed how some see our culture and some of the issues we face which was such an amazing feeling.

Being placed in a regional area meant that the department was small and that I had a small team. The department was extremely busy at all times and I found this to be a huge advantage as I could get a lot of hands on experience without having to compete with other students. My team were an amazing bunch of people with whom I got along with extremely well. They taught me how to care for the patient whilst I was trying to achieve diagnostic imaging to help get a speedy diagnosis. I learned how to communicate effectively with patients and staff, and I feel that my team have prepared me for my future. To compare, I have had placements in larger centres and in Metropolitan areas and felt that I didn’t really become a part of the team as I was having to work with different people on a daily basis – it was hard to fit in and show what skills I actually had. Whereas here at Taree, I worked with the same people day in and day out for nine months and built relationships with each staff member which made placement so much more pleasant. I am leaving this placement feeling like a competent and independent Radiographer.

The ACEN scholarship has enabled me to exclusively concentrate on my studies. Without the financial support from this amazing scholarship, I could never have made it through comfortably with having to support myself and my three young children with such a lengthy nine months of full-time and unpaid placement. I feel extremely fortunate to have been a recipient of the ACEN scholarship.

I am able to reflect on the differences between what medical care is offered in regional and rural areas when compared to metropolitan areas as I have experienced placement in both. I have seen what services are offered in regional vs metropolitan areas and to say the least, regional areas are far more disadvantaged. This is partly due to the lack of healthcare professionals that are accessible within the region. For example, if there was a major accident in Taree, patients were bypassed from Taree and were transferred to the nearest trauma hospital which was either Port Macquarie or Newcastle as Taree is not considered a trauma centre. This made patients have longer wait times to have access to appropriate healthcare with some of those patients having life-threatening issues with time being of the essence. There are also extremely long wait times for imaging and specialist appointments. For example, in Taree there are two options for medical imaging – the hospital or the private practice whereas in metropolitan areas there is a variety of choices with generally same day appointments. I witnessed a patient’s wait time at the private practice for an ultrasound that was over a month’s wait for a pregnancy dating scan. I found this absurd. People would have to travel outside the region for urgent appointments that cannot wait weeks on end, otherwise present to the hospital emergency department for assessment which also can have lengthy wait times and be stressful for the patient. This was a lot of stress on the hospital as the emergency department was always busy with non-urgent presentations.

I really enjoyed these last nine months at Taree. I love to help vulnerable people and being a part of their journey back to good health is what makes me love my job. Having an amazing and caring team, connecting with the community and feeling a sense of belonging was what I enjoyed the most from my placement. I felt like I was home. No metropolitan area can make you feel like that.

Nursing in Barraba

In the second year of my Master of Nursing Practice study, I completed a placement at Barraba Hospital. Barraba Hospital is a multi-purpose service – inlcuding an Emergency Department, Acute Ward, Community health care and Nursing home. Barraba has a population of 1000 people. In this remote area, only one doctor and three nurses work on every shift. Even through the COVID-19 pandemic period, we were still short for healthcare staff and personal protection equipment.

As Barraba hospital is a multi-purpose service, I gained more experience regarding emergency conditions. For example, I have seen that what interventions and nursing we should give to chest pain, injury and acute stroke patients. Furthermore, I also learnt how to give palliative care to palliative patients. If a patient is diagnosis with palliative care, we cannot do much for the patient but comfort care and personal care. However, bereavement care is also a vital part of nursing for the patient’s family members. We not only nurse patients but also patients’ family members.

Additionally, my time-management skills also improved during the WIL placement. As there is an Emergency Department at Barraba hospital, I had to adjust myself to a fast paced working environment. Sometimes, I had a group of patients sitting in the waiting room, waiting for nurses. Therefore, I had to be organised and find out how urgent their situations are and what I need to do next.

The ACEN Scholarship strengthen my aspiration of working in a remote area in the future. Without the support of ACEN Scholarship, I may not have choosen a hospital in a remote area as my preferences because it is far away from my home and it is difficult to find an accommodation. However, the experience of doing my placement in Barraba made me desire to be a nurse in a remote area. It is a fact that people who are living in remote areas are always short for healthcare staff especially for doctors and nurses. They have to wait for a longer time to receive healthcare than in big cities. They also need experienced nurses to help them. When I graduate from my university, I would like to apply for a job in remote areas because those patients really need my help.

During my placement of Barraba Multi-purpose Service, I found that my critically thinking skills have also improved. Because it was COVID-19 pandemic period, I had to think critically when I met flu-like symptoms patients. For example, I had to think about what kind of PPE I should wear when I have contact with them. I also had to think about how I to deal with the patient’s symptoms before the COVID test result came back. It was a learning process of critical thinking but also reflective thinking.

At the last day of my placement in Barraba, a patient sent the thank you card pictured. I felt very appreciated –  even though I am only a nursing student. What I can do is very limit now, but I hope I can do more for my patients especially in remote areas.

Dentistry in Regional Victoria

What a year 2020 has been. It has been full of ups and downs and lots of confusion – this was much of my experience during my fifth year WIL Dentistry placements in regional Victoria. I started the year in Bendigo in central Victoria, a regional city with a bustling community and finished the year in Wodonga, located at the NSW-Victoria border with the Murray River running through. This year took a lot of getting used to. Despite this, both placements provided me with so much experience and unique learning opportunities I could not have gained elsewhere. I am so grateful for the support provided by ACEN during my placements.

My greatest takeaway this year is the importance of resilience. In the face of a global pandemic, I was not sure how to react. After two and a half months in Bendigo, my placement was cut short in March. It felt like everything came to a standstill. After 4 months, I finally headed back to placement, but this time in Wodonga. Immediately, I realised the atmosphere had changed and everyone was a lot more cautious. Dentistry is inherently a high-risk profession, especially when a global pandemic is spread by droplets (which we produce a lot of). The procedures I would have completed without much concern earlier this year were now considered high-risk because of all the aerosols produced. As a profession, we underwent a massive shift in our approach to dental care. We had to adapt the way dental care was provided while keeping patients and staff safe and I learnt so much about critical dental care during this time. I have incredible respect for the staff in both my placements who worked so effectively to manage the ongoing challenge. They instilled protocols and worked so well as a team to ensure staff and patients were safe. I valued this teamwork and learnt a lot about instilling protocols efficiently.

The value of care we were providing as a clinic also became very apparent to me. Everyone that attended the clinics was so grateful for being able to receive emergency dental treatment during a time when most other treatment was limited. People were arriving with very severe presentations requiring quick interventions. This process of relieving dental pain was immensely rewarding and was a valuable learning opportunity. I realised the extent of discrepancy in dental care in regional areas and the value of the dental in the wider community. The WIL placement has been a great way to experience this firsthand which I am sure I will carry through into my career.

The ACEN scholarship provided support when it was most essentially needed, especially as I had lost the capacity to travel for work and meet family. It allowed me to focus on getting through the uncertain months when COVID was still affecting Victoria to a great deal. Going on placement has allowed me to develop an appreciation for regional healthcare centres for the essential treatment they provide for the community and has allowed me to focus on bettering my knowledge and developing into a capable clinician. The generous support of ACEN has been incredibly valuable during my WIL placement and I am grateful for this opportunity.

Social Work in Katherine

Earlier this year, I was a fortunate recipient of an ACEN scholarship which enabled me to relocate interstate to complete both my social work placements in Katherine, Northern Territory. It is difficult to summarise my learnings as they have been vast, rewarding, at times challenging, but most of all, given me a thirst to further my learning and practice experience. I am really grateful I had the opportunity to complete both my placements in Katherine, Northern Territory. Having lived in an urban city my whole life, the past seven months in remote Katherine has been an eye opening experience and provided an appreciation for the plight of Aboriginal people and the complexities of servicing a remote and disadvantaged population. When resources are limited, it is essential that those on offer are effective in addressing the issues at hand, support the best interests of the people they serve and are adaptable to the changing nature of service provisions and government agendas/funding. This is certainly no easy fate to achieve but it has motivated me in my developing practice to remain purposeful in my work, creative in problem-solving and adaptable to change. These are all characteristics I would like to further develop, particularly the latter two as I feel this will add breadth to my future social work practice.

Working with Aboriginal people has really stressed the importance of advocating for vulnerable people and challenging the wider systems which can oppress and further denigrate vulnerable individuals, communities and minority groups. This was apparent in both my Katherine placements which occurred firstly at a public hospital and secondly in child protection. Specifically, in the statutory setting of child protection, practitioners are often required to obtain informed consent from parents or young people and navigate legal processes or attend Court with clients. Ethically this presented challenges as practice ran the risk of being coercive and the proper use of power and authority became a grey area. I observed, as a result of the legacy of colonisation, Aboriginal people were generally submissive in their interaction with Government agencies (particularly in child protection) and their fear of us had negative consequences on their willingness to speak up or seek help. Furthermore, during my placement, I came to appreciate the difficulties child protection practitioners face in attempting to deliver due care and effective CP practice when case-loads were high, staff turnover was problematic and the complexities attached to cases were significant. I felt empathy toward workers as it is a field where the media, general public and organisations are quick to judge, yet it appears very few have the desire or capability to work in such a field, particularly long-term. This learning for my future practice has reiterated the importance of refraining from judgement and treating clients and professionals, from all avenues, with integrity and respect.

The overarching learning of my placements has been around the importance of culture and improving outcomes for Aboriginal people. Prior to my placements, I was fearful of my own ignorance of Aboriginal culture and challenges faced. As a result, I found myself avoiding the area. I am so pleased I have had this exposure as my fear has been replaced with an eagerness to understand and learn from Aboriginal people and harness the strength which their culture affords. I would like to play my part in addressing the disparities that exist between Aboriginal and non-Indigenous Australians and the attainment of their self-determination. I would like to extend my sincere gratitude to the ACEN for their support. I came to Katherine, wide-eyed and naïve to the vast learning opportunity that was before me. I have since remained in the Northern Territory and hope the course of my future career affords me the opportunity to continue working in remote areas and with Aboriginal people as this is where my passion now lies.

Radiography Placement in Rural QLD

I am not your “typical” university student who is young, just completed high-school and carefree. I ventured back into university studies after having 2 children and going through a separation with their father. This meant moving from CBD Brisbane to a rural QLD town with a new house, new school and no family for support. A decision that at the time made with little insight, however, has turned out to be the best decision I have made.

To become a qualified radiographer, I knew the Bachelor of Medical Imaging course would include 48 weeks of unpaid Work Integrated Learning (WIL) clinical placements. During my 3^rd WIL placement of 11 weeks in the local rural public hospital, I experienced an extremely varied learning environment which included helping the orthopaedic surgeons in theatre to assisting speech therapists with a patient needing imaging and taking the mobile x-ray machines to resus ward on a trauma call.

I saw an x-ray was ordered for a 2-year-old girl. I thought “yeh this will be easy, I’m a mum myself, I know how two-year-old toddlers think, I got this.” Mum and nan bring the girl in and she is already falling asleep in her pram “dang, she’s tired. Not a good start I think to myself.” I introduce myself to both mum and nan and then sit on the ground to introduce myself to the little girl (armed with stickers), I noticed she has little circle band-aids on the crease of her elbows, mum tells me they have just come from having a blood test that didn’t go so well and they gave her two lots of needles to both her arms. I think “uh-oh, this isn’t going to be so easy after all.” After many sticker bribes, cuddles, extra promises of chocolate milk I teamed up with both mum and nan, we place lead gowns on take turns in holding her and I let them know how put her in the position needed. both mum and nan were so thankful they were hugging me and saying “Thank-you so much, you are such a nice lady, I’m so thankful you were patient and so lovely with us.” This taught me through collaboration we can have a safer, happier experience for our patients especially our little ones who are already so vulnerable. While out at the main shopping centre for Thursday late night shopping with my children I was walking through a busy crowd and I faintly heard the words “that’s Abby, I’ve had an x-ray from her, she’s really nice.” – (one of the nicer side-effects of working in a small town), my 8-year-old son said mum those people said your name, my 12-year-old daughter then said ohhh they said you were nice, mum that’s nice of them. Upon reflection of this, I have actually realised how important this was and I am proud that I am remembered even out of my workspace and that I have had a positive impact upon them. I just want to be able to provide the safest, most dignified and respectful care I can towards everyone especially on their worst day. Although it was something small like a passing comment by strangers, it assures me I am on the correct path and I am so thankful for the opportunity to be able to attend WIL placements. I was also asked back for extra practice on the CT scanner after placement ended! An amazing experience I will never forget. As I am not just a uni student, the funds I received from ACEN helped me throughout my 11- week placement as I was able to pay for extra-curricular activities for my children, pay for household bills, and repairs to my car. It meant I was able to complete a time demanding part of the course with one less worry. For this I am forever thank full. From the bottom of my heart thank you very much!! Your funds went towards a very grateful single parent and university student who cant wait to be out in the medical field helping others!!

Podiatry in Toowoomba

The personal growth that I have encountered this year has been similar to the last three years, making choices that affect not only myself but other people as well. Studying away from home when you are married with children may seem like a feminist no-brainer, but when you have developed a close relationship with your children, you do not wish to leave them. Particularly as a mother of tween- and teen-females, some advice can be required of which a male has no experience. Leaving my mother also was not an easy decision, as I am her primary source of conversation and affection. Despite these personal grievances, the border between QLD and NSW was closing and a quick decision was to be made as to whether to leave early and complete my placement in time to qualify with the rest of my classmates or to not go to QLD and graduate sometime in December or January. For once it was an advantage to live approximately 300km west of Sydney. At that time the whole of Sydney was declared a COVID-19 hotspot, but my area was still acceptable to cross the border. So I left early, entrusted my husband with the care of my girls and drove the 14 hours to Rockhampton. One of my lovely class-mates in QLD put me up while I completed the requirements for internal placement at Rockhampton, and then I travelled to Toowoomba to complete external placement.

The placement at Toowoomba hospital was WONDERFUL, on so many levels, and challenging as well. My first day there was a ‘probe to bone’ wound, which was something talked about in class but difficult to explain (without ruining mousse). Every day there was a wound that needed debriding and caring for. I suspected that I would love caring for wounds and I did. I also suspected that QLD, with the combination of warm weather meaning that thongs would be a popular footwear type, and the prevalence of Type 2 Diabetes Mellitus, there would be a plethora of wounds. Sadly, I was correct in this hypothesis. However I was grateful to gain experience in the field of wound care, due to the fact that I live rurally and it could be possible that I would have to care for a wound. I am very happy to report that I now feel confident to care for a wound and also the pathway for referral, should that be necessary. As to wound care itself, my scalpel technique, dressing knowledge and patient education skills all got an upgrade. One of the most delightful aspects of my placement was the podiatry team at Toowoomba hospital. They worked so well with each other. The team supported each other with their knowledge specialities, all very different people and still open to learning and growing as a team. It was an honour to be among them. Their team leader was an inspiration and I was grateful to be in any conversation with her, as her insights were astute, eloquent and deferential.

On a practical level, I noticed that I would stop treating a patient’s wound at about the same time – about three quarters done. I realised that I was afraid of injuring them and I think that my hand, arm (and possibly concentration) was getting a bit tired by this time. Once I realised this was my habit/fear, I pushed through. Then it was a matter of getting faster, which I did in my final week.

Although I loved this placement and enjoyed working with wounds, there was also a sadness present. Where was the diabetic education? Where was the health promotion? Why do these people not check or care for their feet and to prevent getting these wounds and amputations? Why are they showing up to appointments with wounds and amputation consultations half-way through a can of coca-cola? One of my supervisors explained to me the link between diabetes, frontal lobe damage, impulse control and planning inhibition. Also that sometimes people with diabetes just get fatigued by it all the many appointments and the constant monitoring that takes over their lives.

One of the most beautiful experiences at the Toowoomba placement was at Carbal Medical Centre. I have not had the experience of working amongst Indigenous people before, and it was a great honour. It is hard to describe the warmth of these people that was at times engulfing, and the tragedy and loss they had experienced was heartbreaking. I kept my countenance appropriate, but I was deeply touched by these experiences. I wish our ancestors, the invaders, could have been more gentle and respectful, but this would be hard to expect from explorers and convicts (not that they were all like that). At some point, when my children have left home I would be very open to working within indigenous communities, which is something that had not really been on my radar previously.

In the last week of placement I got a call from my husband on Wednesday afternoon – “Don’t freak out”, he said, “I’m in the hospital. I’ve had a stroke”. I spoke to my University and Toowoomba placement supervisors and eventually we decided that I could leave at lunchtime on the Thursday, as I had completed the hours and competencies required for the placement. I got to Westmead Hospital by lunchtime on Friday, and then finally after 15 hours of driving, home to the kids late Friday afternoon. Separation from my children for 6 weeks was a trial – it was nice to have some time on my own but hard when they were injured, or just wanted to chat, it was difficult that I couldn’t be there. Sometimes our schedule didn’t match or I was just tired.

The ACEN scholarship allowed me to relax about the cost of this placement and focus on learning. My husband was on a low wage anyway and then with his not working due to the stroke, the thought of the support of the ACEN scholarship eased our minds considerably. This placement definitely supported my career aspirations. Currently, I am tethered to my location for the next six or seven years, but someday I would love to work in the area of High-Risk Foot or Indigenous community. Thank you for awarding me the ACEN scholarship.