Hope in their hands

When 2020 was nominated as the International Year of the Nurse, no one knew how apt that would be, as COVID-19 wreaked havoc around the globe. Bronwyn Philips honours our nurses who bring healing, comfort and care.

At the end of a four-month deployment at a US military field hospital in Iraq in 2005, Jenny Lumsden was given a certificate. “It was to acknowledge I’d survived 100 mortar attacks,” the intensive care nurse and Senior Consultant to Air Force Services laughs. Embedded with an Australian team of specialists with the US military, Jenny worked in a tent hospital north of Baghdad preparing patients to evacuate to Germany. “I worked from midday to midnight,” says Jenny, 54. “Sometimes I’d be asleep, the sirens would go off, and the ground shake.”

The team treated American service personnel and civilians caught in the crossfire. “We looked after an Iraqi family whose house had been grenaded by locals, and two children burned,” she says.

Returning to work at The Royal Melbourne Hospital Intensive Care Unit, Jenny missed her colleagues back in Iraq. “You’ve shared that experience. Even though it’s 12-hour shifts, six days a week, I felt like I’d deserted them,” she says. “Being part of the air force is like a second family.”

Nursing in conflict and disaster zones is challenging and exhausting. Some, too traumatised to continue, leave Defence; others, like Jenny, use their expertise to make a difference. In a 30-year career in air force and civilian nursing, Jenny led teams in East Timor and in 2015 was the first nurse and first woman to be appointed Director General Health Reserves – Air Force. In 2005, after a second bombing in Bali left 20 dead and 130 injured, Jenny cared for Australian survivors airlifted to Darwin.

“There were about 12 patients suffering burns and shrapnel wounds,” says Jenny, who arrived in Darwin straight from her shift at Royal Melbourne. “Terrorists use nails and ball bearings in explosives to increase the impact, and because it happened on the beach, sand penetrated through the body. It was nasty.” Many of the injured were from Newcastle,

NSW, and were to be airlifted there the next day with an air force medical team.

In Newcastle, the patients were loaded into ambulances. “Then I flew to Melbourne, and went back to work,” says Jenny. “After my shift, I slept for a long time. In those circumstances you do what you have to.” And her particular patient’s outcome? “He survived.”

In 2013, Jenny was honoured with an Australia Day award for her role in developing an innovative system (Military Critical Care Aeromedical Evacuation Capability) which transforms a cargo plane into an intensive care unit. It’s been used in the Ashmore Reef refugee disaster, and after Cyclone Yasi, the biggest storm in Queensland history. “It gives me a glow to know I had a part of that,” says Jenny, “that I’m leaving behind something worthwhile.”

Jenny still consults for the military and works as an intensive care nurse at Gosford Hospital in NSW.

A typical teenager, Jake loved gaming, Star Wars and Marvel figures, and watching his brother compete in Mixed Martial Arts was the dream of a lifetime. But like the superheroes he collected, Jake was battling a powerful adversary. “He had Duchenne Muscular Dystrophy,” says Ainsley Stock, nurse manager at Hummingbird House in Brisbane. “It’s a progressive condition with no cure.”

Ainsley cared for Jake during the last months of his life, at Hummingbird House, one of only three palliative care hospices for children in Australia. Confined to a wheelchair, Jake only had the use of one hand, but he could still speak. Apart from day-to-day care and managing Jake’s symptoms and pain, Ainsley and the team also made sure he ticked off his most important personal milestones, like going to his brother’s fight and making videos in the Botanical Gardens. And they made sure he could spend as much of his time as he wanted on his favourite hobby – gaming with his siblings.

“He wanted his hair dyed, so we had a hairdresser come,” says 39-year-old Ainsley, who has worked in palliative care for 18 years. Hummingbird House had been open for less than a year when Jake first arrived in 2016, and caring for him during his stays, sometimes for weeks at a time, was a powerful experience for Ainsley. “I was still learning to be a paediatric palliative care nurse,” she says. “He taught me to care for him with patience and humility.”

Six months after his first visit, under the care of his family, in his own bedroom, Jake died. “He was 18,” says Ainsley. Afterwards, Ainsley helped provide special insulated equipment so the family could farewell Jake at home, and removed the medical equipment, drips, tubes and medication from his bedroom. “Jake’s mother wanted it to be like any teenager’s, with Marvel and Star Wars figurines, and a gaming console,”

Ainsley Stock A celebration of life

says Ainsley. Friends and family spent time with him, some even gaming. “His mates came in and he was right there with them,” says Ainsley. “If you can normalise death, it eliminates some of the grief.”

Jake’s funeral at Hummingbird House was a Star Wars-themed send-off, led by a brigade of volunteer Stormtroopers in full regalia. And leading the procession, in a long white dress and her hair braided, was Ainsley, dressed as Princess Leia.

“It was such an honour,” she says. “I didn’t expect to be in the procession.”

The funeral was held on the rooftop of the hospice, which is the backdrop for many goodbyes. “We’ve had Superman funerals, and ceremonies for babies in the garden,” says Ainsley. “On the day of Jake’s funeral, everyone was here gaming. He had an open casket, and he looked so handsome.” In the casket were arranged Jake’s beloved gaming paraphernalia and Star Wars figurines. “It was absolutely a celebration of his life, and very powerful,” says Ainsley. “We gave him back what the disease had taken away from him.”

The breakthrough for Lesley Salem came when an elder at Doomadgee, a remote community in Far North Queensland, made a killing stick for her to bring home lizards when she went for walks. “They gave it to me so I’d be able to feed myself,” the 59-year-old nurse practitioner says. “They’d accepted me.” Soon after, more people gradually began to come in to her clinic.

Lesley’s home is in Newcastle, NSW, but she spends seven months a year in Doomadgee, which was originally established in the 1930s as a mission for Aboriginal children. “It was a place where the church took the stolen generations,” she says.

These days, Doomadgee has a population of around 1400. It’s a troubled community with serious social and health problems. “There are issues: petrol sniffing and sly grog,” says Lesley. “There’s a lot of violence.” And there’s an average life expectancy of just 49.

Doomadgee also has one of the highest rates of rheumatic heart disease (RHD) in the country.

Mostly affecting children, RHD is a complication of rheumatic fever, which can develop when infections like strep throat and skin sores are left untreated. RHD can lead to heart failure and ultimately death.

“It kills young people,” Lesley explains. “By the time they’re 30, they have a chronic disease, and you’re just holding them together.”

Lesley has worked with Aboriginal Medical Services for the past 12 years, establishing two clinics in NSW and one in Queensland. Now, she is working with the Northern Queensland Primary Health Network. There had never been a primary health service at Doomadgee before she arrived two years ago, let alone a nurse specialising in chronic disease.

Lesley Salem Hope for the heartland

Lesley is a proud descendant of the Gringai-Wonnarua Nation, but her Indigenous heritage was no guarantee of acceptance at Doomadgee, where locals were wary of medical treatment.

“Healthcare was associated with the worst conditions,” she explains. “People went to the emergency department when things got really bad. Then the Flying Doctor would arrive, they’d be taken away and never come back.”

These past two years, Lesley has worked hard to build trust and she is starting to see results. She is proudest of her young patients, who have enthusiastically taken up her preventative health message.

“I had one kid say to me, ‘Miss, I’ve got one of them sores, do you want to put a Band-Aid on it?’” says Lesley. “They never wanted to come here before. Now I have a kid with one sore coming in before school for treatment. That gives me hope for the future.”

When Christopher Patterson first met her, Kaylene Booth was anxious, intensely shy and nervous. “Kaylene had experienced extremely challenging and dangerous periods of mental illness,” the 36-year-old registered nurse and University of Wollongong lecturer recalls. Living with undiagnosed bipolar disorder and depression for 30 years, Kaylene was constantly in and out of hospital, and suffered from frequent suicidal thoughts. Then, six years ago, the 63-year-old took part in a unique therapeutic program, Recovery Camp.

“It saved her life,” says Christopher, who co-founded the camp and was named Nurse of the Year at the 2019 Australian Healthcare Excellence Awards.

During the five-day bush recreation camp, nursing students and people experiencing mental illness all take part in activities such as kayaking, rock climbing and archery. There’s a lot of laughter, a few tears, and along the way the students gain a unique insight into the lived experiences of people coping with mental illnesses, who are in turn empowered by the

Recovery Camp activities and the sense of community.

Before he went into nursing 15 years ago, Chris knew very little about mental illness. But during his training, he says, “my eyes were opened to the prevalence of depression, anxiety and drug and alcohol use,” and he decided to become a mental health nurse. “Mental health affects the entire community. I knew this was where I wanted to practise.”

Before Recovery Camp, nursing students would do mental health placement work in hospitals. “What

Christopher Patterson Sharing peace of mind

they see is a specific view of people with mental illness,” says Christopher. “They see them at their most unwell. They don’t see how they live in the community.”

Through his Recovery Camp programs, Chris, who also lectures at the University of Wollongong, has been able to combine his two passions: improving the lives of people experiencing mental illness and building empathy in nursing students.

Since it was established seven years ago, more than 800 students and individuals have taken part in the award-winning camps, which are run in partnership with a number of universities.

“I love knowing nurses can be at the forefront of positive change,” Chris says, “delivering empowering moments for people with mental illness.” He was an old man, in his 80s, badtempered and grumpy. “He’d taken a dislike to every doctor and nurse in the hospital,” Ashleigh Woods recalls. “He was in hospital for a long time.” But where the other staff failed, Ashleigh won him over and he refused to be cared for by anyone else. “I’m known as the happy one, always laughing,” she smiles. “I treated him with kindness and empathy.” He has since passed away, but the 25-year-old registered nurse and midwife will never forget that man. “The connection I had with him had a huge impact on the rest of my nursing career, on the way I treat patients,” she says. “We had a lovely relationship.”

A recent university graduate, Ashleigh specialises in advanced life support in the Emergency Department at The Tweed Hospital in Northern NSW. When she arrived there, she knew she’d be dealing with trauma, such as car accidents and cardiac arrests. “I’d even been ready for a natural disaster or terrorism,” she admits, matter-of-factly. But she’d never imagined being on the frontline of a pandemic in her first year.

One of Ashleigh’s roles is to maintain a patient’s breathing. The first time she assisted a doctor to insert a tube into a patient’s lungs was intense. After it was over, she stepped outside the emergency room and burst into tears. “I was overwhelmed,” she says.

To prepare for the COVID-19 pandemic, new staff have been recruited and existing staff, including Ashleigh, are being upskilled to work in ICU. “We’re all on the spot now. You just become flexible, adapt and do what’s needed,” she says.

Ashleigh is aware that, for many, emergency and ICU departments are all that stand between life and death. “When patients come into Emergency, they’re so vulnerable,” she says. “I can make a difference in that day or that moment, with empathy and compassion, and I really enjoy that.”

“I can make a difference in that day, or that moment.” Ashleigh Woods From graduation to pandemic