S.TRUEMAN PhD THESIS 2016

222

The frequency of mental health nurse visitations to remote areas fluctuates enormously based on three main variables; the number of members in the mental health nurse team, the number of communities assigned to that team and the number or level of mental illness in the assigned district or region (this is without considering other considerations, such as seasonal weather and availability of transport). The first variable in this study was a constant challenge due to the lack of MHNs (see Chapter 1). The teams were often not able to recruit to fill vacancies resulting in the teams attempting to deliver optimal services with reduced staffing levels. Those … [mental health teams] are always working one or two down, cause you can’t fill the positions, people are on holidays, no agency [casual staff], come and go … then can’t get to the communities and we [remote nurses] have to deal with them [mental health patients]. [T29, p. 3] Mental health nurse visitations are rare in response to local mental health issues: [The remote nurse] can call the troops [aero-evacuation/mental health personnel] in, but it’s going to take 24, 38 hours to get them there. [T24, p. 18] The reasons for this are primarily isolation, distance and time, which includes not only the travel time itself, but also the time to make travel arrangements (e.g., book air flights, charter planes). These facts reinforce the isolation of the remote nurse, and at times the delay and limited assistance MHNs can provide. As a nurse participant stated: The mental health nurses is a different story, because … they don’t do after hours call-outs and they don’t work weekends. [T5, p. 17]

They [mental health patients] stay overnight until the chopper comes in the morning, because it is quite dangerous. Flying out at night time. [p. 25].