They say that the grass is always greener on the other side. It turns out it literally is. I’ve finally made it to a place where I can see the light at the end of the tunnel. It is still a long, long way away, but it is there, glinting at me through the doom and the gloom.

I have spent my last two placements working in health centres in the Top End NT.  What I see here, is community. I see streets and houses free of rubbish. I see mowed lawns and clean washing hanging on the line. I hear the delighted squeals of naked children as they run under the cool water of the garden hose.  I see parents taking their children to school and mums with young babies playing happily at child care. I see children with clean hair, clean faces, white teeth, healthy skin and I see the elders sitting under the shade of a banyan tree, weaving, painting and yarning. The whole community, young and old, black and white gather at the oval for a much loved, much supported game of footy. And as the hot humid heat ebbs away, I see families strolling in the streets, together. In the clinic, people chat to me with confidence, we laugh, we share a joke. Sometimes I think that they care, that they listen.

Perhaps the lush tropical greenness hides a multitude of sins and I am not so blind that I cannot see overcrowded homes decaying into disrepair. I am not so deaf that I cannot hear the pain caused by social injustice, unemployment, domestic violence, drink and poverty. I am not so naive to not know about the silent killers that haunt the health of this community and I am not so foolish to see that there is still a vast chasm of inequality yet to conquer. But it’s a start, right?

I thought that what I needed was to get out of the tunnel, but now that I have seen the light, I can see that I am on the wrong train. I should be heading in a different direction and I’ve decided that this isn’t the journey for me, not now anyway. This is why…..

There seems to be this expectation that once you wear the title “nurse” then you know everything you need to know about, well, literally, everything. I have been nursing now for nearly 10 years and everyday it scares me how much I don’t know and that’s just the stuff I know I don’t know. There is a whole other file marked stuff I don’t know I don’t know. In the last year, I have dived head first into the sea of primary health care and man, is it a big sea. Give me a patient having a heart attack and I’m happy. An MVA? I got this. Deliver a baby? I’ll give it my best shot. But ask me to complete an antenatal check and I’m flapping about like a fish out of water. I’m an emergency nurse, I’ll patch you up and send you off.  Breast feeding and birthing advice is not my forte.

I have worn many hats since I started this job. I’ve looked after men’s health and women’s health, child health and sexual health.  I’ve been responsible for all the patients with chronic diseases such as diabetes, kidney disease, liver disease, heart disease and cancer to name a few. Responsibility. Weighs heavy on my shoulders. These are all specialised roles which require a lot of knowledge and expertise to manage well. Most of my patients are highly complex cases with multiple co-morbidities and advanced stages of disease. Add to this a challenging environment with vast distances, a cultural divide, a lack of resources and an absence of services and you’ve got a hell of a job on your hands. Me? I’ve got four weeks, a to-do list 28 pages long, a book and a telephone.

I think I made a mistake in assuming that I could do this job on a fly-in-fly-out basis. It turns out that you can’t, not in the beginning, not if you really want to make a difference. You need time to make the job your own. You need to draw your own map because you will not find one waiting for you. You need to reach out and build relationships not only with your patients but with the whole of the community. Most of all, you need to become a specialist in your area because you are it. Four weeks and you are nothing more than a list shuffler who barely skims the surface.

These clinics run on a wing and prayer, chaos and fatigue. Some barely run at all. I struggle to cope with the changing roles of nurse, educator, Travel co-ordinator, paramedic, pharmacist, cleaner and driver. Ask anyone for help and advice and you’ll get a weary sigh and the same response “you do whatever you want to do”. The assumption is that everyone is past caring. The reality is that the constant juggling of balls results in burnt out people doing a half -hearted job because that is all they have left in the pot. You are just another nurse on another list who came and then left again.

Here is the crux of the matter. When I do a job, I like to do it well but I can’t. It is impossible and honestly, I wing it every day. It is just not good enough, not to me, not for my patients. I want to go home thinking “you did good today Anna”.  Instead I worry constantly about all the things I missed, all the things I should have done and didn’t do. I have sleepless nights haunted by the forever growing to-do list. I’m drowning in lists. My star sign last week read like this “You’ll probably worry about everything, because that’s how you get sometimes, and anxiety might start to unravel the basic fabric of your security”. Sounds like me? I’m probably way over thinking everything as usual and I’ve learnt to handle the anxiety sometimes, just not all-the-time.

So, put a fork in me, I am done. I am too young, too single, too lonely to commit to this right now. Maybe I’ll come back in my later years when I know all the things that I don’t yet know and I am more willing to dedicate a chapter of my life to one community. But for now, I think it is time for me to face the fear, to commit, to settle and to finally unpack my suitcase. For a short while at least. But that, my friends, is a whole other anxiety driven blog of insecurity you will have to look forward to. I’ll keep you posted.

Its goodbye from Skippy. And it’s goodbye from me. Say Goodbye Skippy. “Goodbye”.