this (burned out)


The Weekend Australian - Review - - Lifelines - Ameeta Pa­tel

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.

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