S.TRUEMAN PhD THESIS 2016

328

Another example from one of the nurse participants (T3), is where he enlisted a community member to drive the hospital ambulance (when there are no designated paramedics or ambulance officers stationed in the community), to transport the mental health patient out of the community for treatment. In both of these examples the remote nurse is undertaking the recruitment and enlistment of a third party to assist them in delivering the mental healthcare. These innovative and resourceful measures are examples of remote nurses adapting to the local condition of working remotely. Such practices are perceived as simply part of working remotely; in other words, it goes with the territory or is part of their extended practice. Remote nurses ingest such practices into the collegial identification of being a remote area nurse and thereby different to other nurses, especially those who work in metropolitan areas. Mitchell (2000) refers to this difference when she said, ‘problems facing remote nurses, although thankfully dissimilar in many ways [to metropolitan nurses], remain unique. There remains little understanding in the wider nursing fraternity of the complexities of rural and remote nursing and the unique demands placed on bush nurses’ (p. 12). Hence resourcefulness is a trait that remote nurses attach to their differentness to other nurses. This is not to suggest that remote nurses are not cognisant or aware of the lack of resources when delivering mental healthcare. Jelinek et al.’s study (2011) concerned the perceived differences in the management of mental health patients in remote and rural Australia compared to metropolitan hospital presentations. While the study involved both medical and nurse participants, the findings for each cohort were reported separately. In relation to a theme of under resources/environment, both groups noted limited access in rural areas for psychiatric support services, alcohol and other drug services and limited