this (burned out)
I WELCOME her into my room, we take our seats at my desk and the pleasantries about the weather take but a moment. She looks a little anxious and fidgets. As soon as I ask the first gentle question, the remote schoolteacher starts sobbing, shoulders shaking, holding her face in her hands. The words, once they start, come spilling out. As a GP, I think, ‘‘Oh no, here we go again.’’
My eyes fill as my heart-strings are tugged in empathy. At the same time I feel sad and very angry. My own story being played out yet again. Another sick certificate or period of stress leave. Another professional, whether nurse, teacher or doctor, burned out and distressed by their work in a remote Northern Territory Aboriginal community.
The undermining of self-confidence and self-worth associated with a sense of failure is profound. As a general practitioner I can patch them up and send them back to the front line or I advise some time away from it all to regain perspective and health. My armament includes listening with empathy; reassuring them they are not alone or unique; supportive counselling; referral to psychologists (difficult to access when you live 500km away from an urban centre) and medication. The Bush Crisis Line phone numbers and booklets on surviving stress and avoiding burnout are fantastic resources.
But why should I have to do this time and again? This epidemic is a kept a secret — don’t let the romantic vision of the red earth and deep culture fool you. Yes, it can be an adventure and a life-changing experience, but the costs can be high.
We may start out thinking we may be able to contribute, to be part of the solution for the appalling health status, the low literacy levels, the violence, the alcoholism. The bright, dedicated professional for whom high standards and ethical practice are core values tie themselves in knots trying to provide the best care for their charges.
Challenging the managers and administrators of the system, who often have dubious qualifications and skills, added to the burden of isolation, difficult living conditions and lack of supports, takes it toll. There is a pervasive culture of bullying, lack of accountability and a laissez-faire ‘‘she’ll be right, mate’’ attitude. After all, this is the Northern Territory.
What of the Aboriginal people themselves? They miss out, as always. People come and go too quickly, there is little continuity and quality of care is low. Another ‘‘whitefella’’ on their way through.
I know there is understanding about remote workforce issues building slowly, and I will do my bit to advocate for system changes. At least today I can administer immediate first aid and feel I have done something to help someone’s life improve.