S.TRUEMAN PhD THESIS 2016

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So there’s no other nurses in town, no doctors. It’s just me for my 600 people community so if I [have] … a mental health crisis, I have to try and deal with both of those by myself … I’m stressed for them [mental health patients]. [T4, p. 12] [Resilience] Some nurse participants were of the opinion that mental healthcare was a low priority due to the volume of other types of presentations exacerbated by low staff numbers: Mental health issues rated the lowest of all things. First and foremost, we dealt with daily trauma, and then followed by more chronic illness follow-up. [T3, p. 10] We were patching up people a lot of the time. So, mental health was just left out, or not thought about. [T3, p. 11]. Some commentators and researchers have called for single-post remote primary healthcare centres to be abolished (Cramer, 1995). There was a clear association between increased feelings of confidence in providing mental healthcare and increases in the number of proximal colleagues. Fellow remote nurse colleagues not only logistically reduce each others’ workloads, but in times of a mental healthcare crisis, are able to provide advice, support and assistance, which reduces levels of stress and feelings of isolation. This is particularly the case when de-briefing: We tend to bounce off each other … it’s a way of sort of venting your frustrations or your stress and all nurses do that.’ [T4, p. 15] [Robustness] Another nurse described de-briefing after a mental health crisis thus: Once again it’s our support … and it’s usually fairly straightaway. [T2, p. 12] [Robustness/Responsiveness]