SustainHealth: If you don’t go, you won’t grow & you’ll never know; nursing in Australia’s outback

SustainHealth: If you don’t go, you won’t grow & you’ll never know; nursing in Australia’s outback

As I began composing this article 32,000 feet in the clouds, overlooking the vast barren land of QLD, I reflected on my time at the 2023 CRANA Conference.

In my role as a representative of SustainHealth Recruitment, I had the honor of attending the CRANAplus conference in Cairns 2023. I had the opportunity to engage in meaningful conversations with seasoned nursing professionals, who shared their invaluable insights and experiences into Australia’s remote healthcare landscape. The in-person interactions uncovered the intricate and multifaceted challenges that nurses and midwives grapple with in remote areas across Australia.

As someone who arrived with second-hand knowledge of what nursing in the outback is truly like, I write this article feeling educated, enlightened, and even more curious than when I first arrived.

The Aim

This article aims to unpack the healthcare difficulties that Aboriginal and Torres Strait Islanders face, advocate for CRANAplus and Australia’s Remote Area Nurses (RANS) and reflect on my lessons and learnings from the 2023 CRANAplus conference in Cairns.

For those of you who have been following my posts on LinkedIn, you’ve likely gained some understanding of the unique demands and complexities of nursing in the Australian outback. However, for those who haven’t had the chance to do so, the terms “CRANAplus” and “Remote Area Nursing” might be entirely new to you.

This article is designed to offer an informative, comprehensive, and engaging exploration of CRANAplus, elucidating its significance and relevance within the context of Remote Area Nursing in Australia.

  1. CRANAplus
  2. Remote Area Nursing

By reading further, you will gain a deeper appreciation for the incredible work being done by Remote Area Nurses and how CRANAplus plays an indispensable role in their support and development.

What is CRANA?

“CRANAplus is a grassroots, not-for-profit, membership-based organisation that was founded in 1983”

Council of Remote Area Nursing, more commonly known as “CRANA” is a not for profit, membership-based organisation that advocates for change on issues effecting the workforce and remote populations, including safety, health, inequality and workforce availability.

Already 40 years into their remarkable journey, CRANA provides a wide range of services, support and opportunities to nurses, midwives and other health professionals to ensure the delivery of safe, high-quality prime healthcare to remote and isolated areas of Australia.

But why is CRANA so important?

CRANA and everything that the NFP organisation stands for has never been so important, but why?

Australia is currently experiencing an unprecedented and critical reduction in the number of healthcare workers nationwide. A study taken by Health Work Force Australia shows that the nursing workforce in Australia will face a shortage of up to 1230,000 nurses by 2030. With Australia’s sheer size, breadth and vastness, Australia not only brings with it an amazing picturesque landscape alongside its bucket list destinations; it also comes with demographical and logistical issues that have a knock-on effect when providing healthcare, especially healthcare to remote and isolated communities.

Emphasising the nursing and skill shortage that Australia is currently facing, CRANAplus is important as it safeguards, protects and advocates support for Australia’s nurses.

CRANAplus is a voice for remote and isolated communities and amplifies its presence through education, events and conferences. It signifies the importance of Australia’s nurses and why we should be more vigilant of their efforts and commitment to their work. I could write a piece of text purely devoted to CRANAplus and its origins. However, all of this information can be found through the CRANAplus website and numerous third-party pages.

What I am going to do, however, is offer some context behind remote nursing and share my experience of my time at the CRANAplus conference which I attended last week in Cairns.

Why is this so interesting?

As someone who is from the UK, where a nursing world such as Australia’s is non-existent, I find it fascinating the way in which the nursing model is set up. How is it possible to provide health care from each end of the country when aiming to cover approximately 2.94 million square miles (7.66 million square kilometers)? Let me tell you.

Remote Area Nursing (RANS) & Their challenges

The way in which a country spanning 2.94 million square miles is possible to service is through the deployment of Remote Area Nurses (RANs).

The term “Remote Area Nurse” (RAN) is commonly employed to denote nursing practitioners who provide health care services in rural and remote regions of Australia. RANS more often that not work out in the bush across states such as Queensland, the Northern Territory, and Western Australia. RANs serve a diverse range of communities, including Indigenous groups, as well as supporting the mining, agricultural, and tourism sectors. As a result, their duties and obligations can differ depending on the industry or location in question.

Working so remotely must be tough, right? you have no idea!

Nurses working in remote Aboriginal communities face significant challenges. In these underserved regions, healthcare professionals often work with limited access to essential resources and facilities. According to a 2020 report from the Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander people continue to experience a higher burden of chronic conditions, with approximately 35% having at least one chronic disease, including diabetes and cardiovascular issues. This is compounded by a shortage of healthcare providers, with rural and remote areas in Australia experiencing a deficit of 43% compared to urban regions, as reported by the Australian institute of health and welfare.

Furthermore, cultural and linguistic differences often hinder effective communication and trust-building between nurses and the local community. These challenges underscore the pressing need for increased funding, resources, and culturally sensitive healthcare practices to address the healthcare disparities in remote Aboriginal communities.

The challenges faced in remote communities:

Several severe challenges persist in remote Aboriginal communities. Contemporary research shows that in 2015-2017, the life expectancy for Aboriginal and Torres Strait Islander people in Australia remained considerably lower than that of the non-Indigenous population, at 71.6 years for males and 75.6 years for females. Life expectancy decreases as remoteness increases for Indigenous Australians, but not for non-Indigenous Australians. Indigenous males and females living in Remote or Very remote areas have a life expectancy 6–7 years lower than those in major cities.

One critical issue is the shortage of healthcare professionals in remote and very remote areas, with fewer doctors and nurses per capita compared to urban centres. Chronic health conditions, such as diabetes, cardiovascular diseases, and respiratory issues, continue to burden these communities, exacerbated by limited access to healthcare services and preventive measures. Mental health challenges are also prevalent, with approximately 30% of Indigenous adults reporting high levels of psychological distress. Moreover, substandard housing, overcrowding, and inadequate sanitation facilities contribute to infectious diseases and worsen overall health disparities. It’s important to note that more recent data may provide an updated perspective on these challenges but from reading, this is the latest data that I have drawn upon.

With the context, literature and data in mind, did the CRANAplus conference highlight the aforementioned challenges and nuanced difficulties faced by Aboriginal and Torres Strait communities?

The short answer is YES!

What I learned from my time at CRANA 2023

“Engaging, Enlightening & Exciting”

The CRANAplus conference was nothing short of exhilarating. I choose to encapsulate my time at the conference and in Cairns by three powerful words: engaging, enlightening, and exciting.

From the initial meet-and-greet, where diverse professionals converged, to the exceptional roster of speakers – the CRANAplus conference was eye-opening.

These discussions and talks throughout the week encompassed a wide array of topics, including innovative care models, ingenious techniques to enhance and improve healthcare, and the cutting-edge scientific advancements aimed at reducing issues such as rheumatic heart disease in Aboriginal and Torres Strait Islander communities.

While celebrating the significant strides that have been made in the field of remote healthcare, it is essential to acknowledge that the conference highlighted that more work needs to be down to bridge the existing gaps and unique difficulties that Aboriginal and Torres Strait Islanders face; ones that have been drawn upon in this short article.

The CRANAplus conference further confirmed my commitment to enhancing remote nursing, particularly from a healthcare recruitment perspective. It has illuminated fresh insights and underscored the paramount significance of educational pathways that are needed for healthcare professionals serving in rural and remote communities.

Throughout the week, a few central themes consistently emerged: the emphasis for structural improvements, the necessity to bolster educational pathways, and the demand for more robust support systems for RANs working in remote healthcare settings.

As a healthcare recruitment professional, I see a significant role in connecting skilled healthcare professionals with positions in underserved areas, thereby bridging the healthcare workforce gap and addressing the pressing needs of Australia’s Aboriginal and Torres Strait Islander Communities.

Whilst being unable to provide support clinical from a first-hand perspective, my goal is to support and contribute to a brighter future for healthcare in remote areas by actively participating in discussions, raising awareness, and sharing the stories and innovations encountered at the CRANA conference to nurses when I speak to them.

Closing Comments

I respect, appreciate and acknowledge all of the amazing nurses working in Australia and the work they do. By speaking to nurses from a second-hand perspective and by sharing the lessons that I have learned from events such as CRANAplus, I hope to inspire them to take a leap into the remote area space.

By encouraging more nurses to work remotely, we will be able to significantly bridge the healthcare gap in remote and isolated regions ensuring that the continued focus is to provide equitable healthcare access to all; with great emphasis on Aboriginal and Torres Strait communities.

Written by: Liam Felloni

For more information about working in QLD, please contact Liam at or call 0424 105 072.