When the dust settles: A comparative history of remote area nursing in Queensland in the19th and 20th centuries

A sense of historical perspective is important to balance the historical nature of contemporary research and writing on health care. So many of the major health issues of our time have an important historical dimension that is often overlooked, cursorily treated or ignored. Not all of these outcomes are due to a linear causal effect and the historical comparative research method provides a means of making comparisons about certain times and events.

Remote area nurses have consistently practised in isolated areas since the very beginnings of white settlement (Schultz 1991, Priestley 1992, Strachan 1992, Russell 1995). This isolation was (and in some cases still is) imposed in the first instance by geography. In other instances it has been because these practitioners (who for the most part were prepared as any other general nurse throughout Australia for an urban setting) have been unable to access further education and professional support.

This study aimed to answer the following research questions using an historical comparative approach. 1) Which discourses have prevailed historically in order to ensure that remote area nursing practice is neither legitimised nor endorsed as an area of specialist, independent nursing practice in its own right within Australia? 2) Which specific legal criteria are currently being applied to define the scope of practice of remote area nursing and how appropriate are they given the reality of remote area nursing? Possibly, invisibility of remote area nurses was more a matter of being 'out of sight out of mind' and in many cases this seems to have suited these remote area nurses. This situation began to slowly change for metropolitan registered nurses in the early twentieth century, but until very recently, remote area nurses appear to have been uninvolved in any of the clamour for altered legislations.

In remote Australia, when the dust settles after a wind storm, nothing remains the same-everything becomes coated with the dust that penetrates all crevices and surfaces of life. So it was with remote area nurses -once they began to recognise the value of their own voices and the collective power they generated as a cohesive group, they began to listen to and be listened to by other nurses and legislators. At last the remote area nurses' voices and influence is being felt in political and legislating corridors as well as local practice areas. These voices may now be heard in all avenues of the media, conferences, ministerial task forces and inquiries, as well as at local community levels. This study explored public discourse from nurses, legislators and the media in order to determine why such recognition has taken so long to occur. The study identified that it is not enough to merely blame others -that nurses have not simply been the victims but in fact for many years contributed to their own silence.