Cape York Nightingale

Meet our first Indigenous nurse practitioner*

Pormpuraaw-based Nicole Ramsamy is the first Indigenous Queenslander to earn Australia’s highest clinical nursing qualification.

She’s now a nurse practitioner but says it’s just a means to an end. For Nicole, the qualification is simply a way to bring better health care to Cape York’s communities.

“Becoming a nurse practitioner is really exciting,” she said. “It means I can do things for people they previously had to wait to see a doctor about.”

And that’s very important in a doctorless, remote community that’s 640 road kilometres from Cairns.

Tiny Pormpuraaw has a population of about 700. Doctors fly in two days each week but, for the rest of the time, the town’s medical care is in the hands of four registered nurses and five health care workers.

Nicole’s team provides antenatal care, immunisations, mental and women’s health services, emergency care and even community education programs for children and teenagers.

“They’re some of the things but, really, we do absolutely everything,” she said. “We’re even the undertakers.” Nicole loves the location – she’s spent 10 years there – and loves making a difference to the lives of the area’s Aboriginal families. But she understands its remoteness presents its own set of problems.

“I find (its) primary care has gaps in it,” she said. This is one of the main reasons she took on her nurse practitioner studies – going some way to filling the gap that exists between the doctors’ visits.

As a nurse practitioner, Nicole is now qualified to prescribe medicine, refer patients to specialists and request X-rays, blood tests and other diagnostic tests – duties once handled exclusively by doctors.

Nicole’s path to becoming a nurse practitioner goes back to her childhood. Her mother, Anne Gray, is a senior health worker and has worked for Queensland Health in Cairns for 30 years.

Nicole was born in Mackay, raised in Cairns and knew she wanted to work with people. It might have been as cabin crew with an airline but they wouldn’t accept her until she turned 21. That decided Nicole to make nursing her career.

“I was inspired by my mum and the work she did,” she said. “And also just being in Cairns you see a lot of Indigenous people. I’d never been to the Cape before but I wanted to work with Indigenous people.”

Nicole completed her Bachelor of Nursing in 1997 in Newcastle, NSW, and was the first Indigenous person to graduate with a Masters of Midwifery from the University of Southern Queensland in Toowoomba in 2003. She began nursing at Mackay Base Hospital, did a stint in England and has spent most of her time working with Indigenous communities in Cairns, Yarrabah, Torres Strait and Cape York.

Although she was fully qualified, Nicole decided to return to the books in 2009. The nurse practitioner course represented more masters-level study, which Nicole completed in two years rather than the usual 30 months.

Her experience in remote communities gave her some credits and people from the Royal Flying Doctor Service provided mentoring support.

But studying remotely and without resources was no walk in the park. She had to go to Cairns Base Hospital for textbooks and fitted her studies around a workload that included weekend shifts and being on-call. And she’s a mother of two.

“If you’re determined to do it, you find ways to make it happen,” she explained. Through guts and determination, Nicole now has her nurse practitioner qualification and is looking forward to using it to good effect in remote Cape York.

* The nurse practitioner role was first established in Queensland in 2005. There are now more than 90 endorsed nurse practitioners in public and private health facilities. They can often treat people sooner and also free up doctors for more specialist work. For further information, visit: www.health.qld.gov.au/nursing/pracproject.asp