“It’s a great feeling knowing that I’m keeping my patients at their prime, at home and independent.”
I am a registered nurse working for Royal District Nursing Service (RDNS).
My story starts when I was a little girl. I always had nursing in me: I used to make Mum get me doctor playsets and pretend to take care of my younger sister. As I went through school, I became interested in biology and how the human body works.
After school I first went to TAFE and I did an enrolled nurse course. This meant I could do most regular nursing tasks, but I was not a Registered Nurse, and had to work under the supervision from one.
For my first job, I worked at an aged care facility for a year. That was challenging. I was in charge of personal care attendants who shower and change the patients, whilst I attended to the more acute care, like stoma bag changes, medicine rounds and wound care.
Everything was new to me.
On some shifts you were just left on your own to manage the staff and residents. But this job opened my eyes to nursing, and gave me a feeling of what I like and don’t like about it.
What I struggled with at the aged care home was not being able to give all the residents in my care sufficient one-on-one time, do proper in-depth assessments. Similar to the larger hospital wards, there were just too many to look after, so there was no time to provide the type of care that I wanted to.
After a while, I decided I wanted to do the full nursing course.
I went back to University and studied for 3 years to get my degree. I continued to work at the aged care facility to make ends meet while I studied, so it was tough going for a while – juggling work, lectures and unpaid placements.
What I noticed in hospital placements is that a lot of nurses were getting burned out at an early age.
The ratio is meant to be 4 patients to one nurse, but often there were 8 to 1, many requiring high levels of care, needing constant attention.
I craved to be able to provide quality care, where I’d get to spend time with the patients and make unhurried judgements on their wellbeing and care needed.
Instead I had to do with quick chats, which could be hard with some people who might not have known the language, or had difficulty communicating verbally, and communicating was done by looking at their body language and the way they moved their bodies.
Also at the hospitals, I felt I wasn’t getting much say over treatments, the doctor’s didn’t really explain what they were giving the patients. Sometimes I’d be administering medication without agreeing that it was necessary, and that didn’t sit comfortably with me.
I loved being a nurse, but I wanted something that would suit my personality and ethics.
So I did some research and found out about the Royal District Nursing Service. Their values aligned with my idea of the service I wanted to give.
RDNS is a private, independent company. It was the first district nursing service in Australia, founded in nineteenth century by a group of dedicated nurses. I even had the privilege of meeting with one of the first district nurses, who was in her 90’s at the time. I got to meet her when I just started, so it was kind of a nice moment – the oldest nurse with the youngest.
I did my graduate year with RDNS. A graduate year means you are basically a fully-fledged nurse, but you do have some further educational and practical support from your organisation. RDNS assigned me a buddy who helped me throughout the year, who I really liked, so that made the first year easier.
As soon as I started the job, I knew it was for me.
I have a list of people I go to see every day. The majority of our clients are 80 and over, some of them have dementia, dexterity or eyesight problems. A lot of the clients are living home alone. Sometimes we have children or palliative clients. Our clients get referred from hospitals and family, sometimes even concerned neighbours. Some refer themselves to us.
You are set in a certain area for the day, within 5-10 minutes’ drive between patients. In the mornings, we usually see diabetics, because they need their insulin with breakfast. We also see people for medication administration, especially those with cognitive decline.
In the afternoons it’s usually wound care – people with ulcers, surgical wounds, catheters and stoma bags.
We also work with other services, like podiatrists, physios, GP’s, pharmacists. A lot of what we do is education: we want people to stay independent, so they don’t have to go into permanent care.
In the graduate year you follow your buddy and learn, taking initiative in researching conditions and medications, being proactive. I did well, because it was something I really enjoyed. I had an amazing manager, who noticed the effort I was putting in, through the feedback I was getting from my clients and peers.
Without my knowledge, he nominated me for the Annual HESTA Nursing Award as the Graduate Nurse of the Year. I got the call telling me that I was one of the five finalists in Australia, and I had no idea what they were talking about!
Still, I was shocked when they announced me the winner at the big awards ceremony in Sydney.
But it meant a lot to me, it meant to me that my hard work was being seen. Knowing that someone appreciates what you do makes you work even harder, up your game.
I had to re-apply for my job after the graduate year, and sit another interview, but I kind of knew I was going to get it, after the award and the reputation I built within RDNS. For the next three years I worked on growing my knowledge and expanding my skills, really enjoying every aspect of the job.
However, after 3 years, I started feeling a bit restless. I felt I needed a bigger challenge, expand my skills. I still wanted to do something in a community setting, but using a different skillset. I thought that since I hadn’t done much work in actual hospitals, my clinical skills were not as advanced as I wanted them to be.
But not wanting to actually work at a hospital, I decided to do something different.
I found a job as a practice nurse in a medical centre, which was part of the MedicalOne franchise.
As a practice nurse, you work with GPs and look after their patients, doing immunisations and wound care for chronic cases. Sometimes we had mini emergencies –people who didn’t want to wait in the hospitals and they’d come in with blood gushing out of their arm. I got a feel of what it’s like to be in a hospital, learnt a lot of new concepts and skills.
I only worked at the medical centre a few months.
Although it was great and I got the challenge I wanted by gaining experience in the fields of nursing I hadn’t yet been exposed to, I realised that I missed my old job and had enjoyed district nursing a lot more.
I didn’t regret trying it, as I knew that if I didn’t, I would’ve continued to wonder if the grass was greener elsewhere. When I told them I was leaving, they tried to keep me, even offering a pay rise, but I was determined to go back.
I called the RDNS manager about coming back. Turned out, they had a role of an assessment nurse.
This is a more senior role, acting as a first point of contact for the clients. You do the admissions, assess the patients’ conditions and needs. There’s a lot more responsibility and patient communication involved. On top of these responsibilities, I still do most of the old nursing tasks I used to do.
I’ve been doing this role for 2 years now, and I’m really loving it. It provides that bit of extra challenge that I was looking for before.
My hours are a lot more flexible than hospital based nurses.
There are no night shifts; the morning shift is 7:30am to 4 pm, and afternoon shifts are 12 to 8:30pm or 1 to 9:30pm; sometimes you have later ones, like 2 to 10pm, but still, that would be the latest time you’d work. I do work weekends, but they’re rotated –one every one or two months. RDNS have part-time options as well, so it works well for nurses with kids.
What I love about my job is seeing the smile on someone’s face.
I love the way you can change a person’s day with the smallest thing, just by giving them a hug, or a bit of reassurance. Some people don’t have a family or social networks, so you coming to visit is a big deal for them.
You know, for someone who has had an ulcer on their leg for 6 months, when you have healed it, it has such a huge impact on their quality of life – they can walk, go out without this unsightly thing on their leg, no bandages.
It’s the best feeling, it makes you feel important and also grateful to be able to bring positive changes to someone’s life.
It’s a great feeling knowing that I’m keeping my patients at their prime, at home and independent.
I wouldn’t say there’s anything I don’t like. The hours can get hard – I’m working full-time, studying, trying to make time for personal life. You always have to juggle and prioritise. You have to remind yourself to take breaks and eat, because if you are sick, you won’t be able to look after someone else.
Another difficult aspect can be looking after palliative clients, that can be emotionally hard.
It’s a skill you have to acquire, to not get too emotionally invested in the patients, but to still retain your empathy.
One of the hardest cases I remember, from when I was starting out, was looking after an eight year old girl who had a very rare genetic condition. Her parents were very young, in their early thirties. I became almost a part of the family in a way, seeing this girl every second day for a year. When she passed away, it affected me a lot. It was even hard to drive by her street.
And it’s not just the palliative cases, for me, just seeing old people who are living alone, who are lonely and unwell, it’s heartbreaking. You worry about them, you almost want to stay at home with them.
So being able to disconnect work from home is definitely a challenge.
You don’t want to come home and be angry, or sad, and take it out on your family, because of work stresses and vice versa.
Before I enter my house after work, I sit in my car for a few minutes, do some deep breathing, make a conscious effort to switch modes. Then I go into the house with a fresh vibe; and the same before work – I put myself into working mode before I front up.
District nursing is a lot of solo work. Previously we used to have local hubs where we could meet up, have team discussions. Recently the company restructured, and now there are no central offices. You start from home and finish at home, and you don’t see your colleagues unless you organise a meetup.
There are definite pluses in that, more time and autonomy.
But some nurses miss having the opportunities to connect with colleagues, debrief. But you can still do that, nurses can organise between each other to catch up to vent and discuss – it’s just that it’s now on us.
RDNS is very big on the employees’ health and safety.
The houses and the people get assessed by the hospitals, if this is how they are referred to us. But the rule is, if you feel uncomfortable, you don’t have to enter the house. You call the manager, there’s always support available, they can even send in a security guard to walk you from the car to the house. I think in all my years with RDNS, I’ve only ever felt unsafe twice, and didn’t go in – and the company fully supported me.
The biggest life lesson I’ve learnt so far, is to stick to your gut instincts. Usually it’s the right choice. If you think the medication order is wrong, just don’t give it, because it probably is. Check to be 100% sure. At the end of the day you have responsibility for your patients.
The smallest mistakes can cause the most dramatic changes, so it’s important to take your time.
I see so many nurses stressing, rushing things – sometimes it is better to be slower, assess the situation and make sure everything is right, than to rush in and mess something up that can lead to really dire consequences for your patient’s health, or even life.
At the moment, I’m also studying nutritional medicine online. I am very interested in alternative medicine, I think our bodies are natural healers, if we provide them with what they need.
Western medicine is great for acute care like surgical procedures and fixing trauma, but when it comes to chronic long-term care, I’m a big believer in natural therapies and prevention.
That is why I chose to study nutrition. People over-complicate things; you can heal a lot of conditions simply with the right diet, the right fuel for your body.
Going forward, I would like to combine my nursing skills with the knowledge of nutritional medicine and natural therapies. I’d like to open up health centres for children to fight obesity and mental health problems, educate people on self-care. Look out for the company name “Wings of Health” – Fly to happiness.
I love the idea of working in the community, helping people stay healthy and avoid hospitalisation.
Hello Zoe. You don’t know me but I have taught both your sisters. I am so
Impressed with your article. I am 70 and I have just learned that I have arthritis all through my neck and back and that has changed my life quite dramatically. I hope that someday there is someone out there like you who has my interests at heart. All the best for your continuing work
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