Posted by: ayrshirehealth | October 7, 2015

Broken Hill by @88kylieh

Broken Hill

During my final year of my undergraduate BSc Nursing degree, there was an option to arrange an elective placement for five weeks. Broken Hill, NSW I chose to go to rural New South Wales, Australia to a small hospital in a mining town called Broken Hill.

I spent two weeks within their six bedded Emergency Department, and three weeks in their 27 bed medical ward.

Broken Hill Base HospitalAlthough I would love to work in Australia as a nurse in the future, my main objective for going overseas was to gain a better understanding of global health issues, experience nursing outside of the NHS system, and develop my confidence by working in a completely unfamiliar culture and environment!

My first impressions of Broken Hill were how far away from any major city we were – 500km to Adelaide, and over 1100km to Sydney – the township just seemed to appear out of nowhere as I flew into the tiny airport.  Broken Hill AirportAround town, there were lots of buildings boarded up, shops closed down, and many houses in a state of disrepair…. and the streets were empty!  People seem to drive wherever they need to go, and I got funny looks on a few occasions for walking around the streets – this may also have been because I was in a t-shirt, enjoying the 20 degree winter’s day, whereas the local residents all thought it was freezing!

Venomous snake

My time spent in the emergency department was fantastic, and I was made to feel so welcome by the small team based there. Since it was winter, it was the wrong time of year for any venomous snake or spider bites, which I was glad of!  Brand name

The biggest differences I noted was that the nurses and doctors call their medications by their brand name, as opposed to their generic name, so it took me a while to get my head around some of them.

I also learned about the Australasian triage scale, the difference between their public and private healthcare systems, and how their rural location can influence their treatment options with patients.

Aboriginal Cultural Awareness

Of most interest to me was attending an Aboriginal Cultural Awareness teaching session which covered areas such as positive communication and specific Aboriginal health needs, as well as the health disparities and stigma faced by Aboriginal clients, and still occurring in today’s modern healthcare delivery.  Aboriginal Health guidelineThe training course was delivered by Aboriginal Health Workers, whose role it is to provide holistic and culturally specific support, advocacy and health promotion services to Aboriginal patients within both the hospital and community setting.

Compulsory for all staff and students, the course was an informative introduction to the cultural norms, and the communication “do’s and don’ts” were an essential component to avoid non-offensive spoken word and body language.

Similar student teaching sessions occurred once weekly, and all disciplines were invited to take part – students of medicine, nursing, speech pathology, dietetics, and physiotherapy. Topics included medication misuse, creative writing in healthcare, chest drain insertion and communicating bad news – a complete variety, and very well attended by all students which helped create the multidisciplinary team approach to problem solving.

Clinical skills into action

Within the Broken Hill medical ward, I came across nurses with 20 years of remote nursing experience, as well as newly graduated nurses in their first year of the job. With such a diverse mix, it was great to be able to work alongside them all as they brought such different ideas and ways of working to the table.

It became clear to me that nursing students in Australia do not get as much practical placement time, working on the wards and putting clinical skills into action as I have been allowed during my university undergraduate degree in Scotland.

Nurses were impressed with my confidence and initiative as well as my communication within the team and to patients and their families. As lovely as it was to hear, I couldn’t help comparing my theoretical knowledge to the Australian students and newly qualified nurses. From reading electrocardiograms and x-rays, to cellular level descriptions of diabetic ketoacidosis, and using stethoscopes to complete respiratory assessments, their in-depth knowledge was impressive.

Ride-along observer

Another highlight was spending the day as a “ride-along” observer with the ambulance service. Broken hill ambulanceWe were called to eight incidents during my eight hour shift (a busy day!)

Call-outs included attending to an elderly patient who was hypothermic as he was unable to afford to put the heater on; a homeless woman who was found unresponsive in an abandoned house; transferring a patient from the intensive care unit at the hospital to the Royal Flying Doctor Service for transport to Adelaide for surgery; and verifying a death, something rural paramedics are able to do due to the lack of medical professionals available. Royal Flying DoctorsI enjoyed the day, learning about the initial treatment given prior to presenting at the emergency department, and being nosey at all the equipment kept in the ambulances! It gave me a full picture of the emergency patient’s journey prior to reaching hospital, further insight into the socio-economic problems facing many of Broken Hill’s population, and a new understanding of the paramedic’s role.

Travel with my nursing qualification 

Overall, my time spent in Australia was incredibly informative and confirmed my desire to travel with my nursing qualification, and to hopefully one day be able to work as a remote nurse in the middle of nowhere!

My elective placement took almost two years to organise and was expensive too, I did choose a country on the other side of the world, afterall.

UADHowever, due to unwavering support from staff at the University of Abertay, as well as receiving a Short-term Mobility Scholarship from the university, the experience has been undeniably worthwhile.

I would recommend all students to seek out experiences such as this; submerge yourself in another culture, get out of your comfort zone, and learn to be resourceful and adaptable to change.

This week’s blog was by @88kylieh (Kylie Hourston), newly qualified staff nurse in Northwick Park Hospital, Harrow, London: at the time of writing the blog Kylie was an undergraduate nurse at the University of Abertay, Dundee.


  1. Great blog @88kylieh .

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