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It Takes Heart
It Takes Heart is an unmissable podcast where healthcare workers share their honest and unique experiences from Australia’s frontline.
Discover real-life stories of passion and purpose, insight and inspiration from people on the inside and tales that are equal parts heart-warming, heart-wrenching and hilarious. It Takes Heart is co-hosted by cmr | Cornerstone Medical Recruitment CEO Samantha Miklos and Head of Talent and Employer Branding Kate Coomber.
It Takes Heart
Beyond the Clinic: The Power of Cultural Connection in Remote Nursing
Listen in to this episode as dedicated remote and emergency nurse, David Maxwell shares the power of cultural understanding in remote nursing. He shares poignant stories about patient vulnerability, emphasising support and clear communication as well as empathy in the role of male healthcare professionals in community.
Since 2018, David has been on an inspiring journey serving rural and remote communities, focusing on primary health care and chronic disease management. His path to nursing is as unique as it is motivating, having transitioned from the world of hospitality in England to healthcare in Australia, all sparked by a life-altering conversation with a rugby teammate.
David demonstrates that nursing isn't just about clinical skills in communities like Wilcannia and Bamaga but about empathy and cultural sensitivity. Hear his practical insights on building trust with patients by respecting their cultural norms and giving them choices in their care.
Additionally, we delve into his personal initiative, Planet Prostate, and the significance of open conversations about men’s health. This episode is packed with heartwarming stories, practical advice, and inspiring initiatives that highlight the power of compassion and community in healthcare.
This episode of It Takes Heart has CEO of cmr Sam Miklos hosting alongside Head of Talent and Employer Branding, Kate Coomber.
We Care; Music by Waveney Yasso
More about David's Charity of Choice:
COUCH (Cairns Organisation United for Cancer Health)
COUCH is a community focused charity with a mission to improve health care services for Cairns and Far North Queensland residents diagnosed with cancer.
Established as an action group in September 2006 by founders Charles and Pip Woodward, COUCH was inspired by Cairns resident Liz Plummer and her inspiring fight for better oncology services in Far North Queensland.
The COUCH board and volunteers have been dedicated to that original vision of addressing the imbalance of services and support for people with cancer - and their families - in Far North Queensland compared to those in larger, metropolitan cities.
The lack of oncology and cancer support services has caused unnecessary pain and suffering, with Far North Queensland residents often forced to travel to Townsville or Brisbane for treatment.
Visit https://www.mbansw.org.auhttps://couch.org.au/charity/donations for more information.
Get to know cmr better!
Follow @ittakesheartpodcast on Instagram, @cmr | Cornerstone Medical Recruitment on Linked In, @cornerstonemedrec on TikTok and @CornerstoneMedicalRecruitment on Facebook.
We care for the land and sea. We care for the energy. We care for our community. We care. Welcome to it Takes Heart. I'm Sam Miklos and I'm Kate Coomba. We hope you enjoy these incredible stories of healthcare professionals making a difference in communities across Australia and beyond. Through our conversations, we look to celebrate the spirit of community and care. We acknowledge the traditional custodians of the land who have long practised and shared ancient methods of healing, providing care and support for their communities with wisdom passed down through generations.
Kate Coomber:Join us as we explore what it truly means to take heart.
Sam Miklos:Today we get to speak to remote and emergency nurse David Maxwell. David's been working with our team on and off since 2018 on a variety of rural and remote contract roles. In 2023, prostate cancer survivor, david launched a local initiative in Cairns called Planet Prostate to help raise vital funds and awareness for the disease that impacts one in five men in their lifetime. Our team described David as a dedicated nurse who makes it his mission to fully understand the culture of every community that he supports, and he's always straight to the point. Welcome, david, to the it Takes Heart podcast. Hello, thank you for having me. Fantastic, thank you for coming David.
Sam Miklos:I guess I'd love to know go on what was that I'd like to say.
David Maxwell:First, I'd like to pay respect to the elders, past and present, on the land on which I am and where you are. I'm in Gimli, on your dingy country, and, yeah, very happy to be home briefly.
Sam Miklos:I love that. Thank you, so home for you is Cairns at the minute.
Kate Coomber:Yeah, it's Cairns or Gimli.
Sam Miklos:Yes and you've just come back, so tell us about where you've been in the last few months.
David Maxwell:At present I'm working in Bamaga, which is in the northern peninsula area, which is basically from above Mossman, sort of Hopevale, all the way up to the tip of Australia on Queensland side, and I'm working at the moment for Queensland Health in their relief pool in a primary health care centre.
Kate Coomber:Yeah, and can you maybe paint a bit of a picture of what that's like and see that it's very, very far north. What's?
Sam Miklos:a day. Look like you know what's a day in the life of that role.
David Maxwell:Oh, it's mostly standard sort of health checks, primary health care. We do have a hospital. We're one of the two facilities in the Northern Peninsula area that are lucky to have a hospital. Ours is the closest. It's literally, you know, two minutes down the road drive. So in my present role I don't see an awful lot of emergencies.
David Maxwell:Yeah, because we have a. We have a Queensland ambulance service that's attached to the hospital there and that sort of thing, but it's basically basically dealing with the day-to-day. I'm now moved into a role where I'm still learning about chronic disease, so I'm managing portfolios around sort of the renal, the cardiovascular and the RHD rheumatic heart disease. That is in which I'm responsible, not solely but as one of the nurses. I was there for the last three months. I was pretty much on my own, so doing sort of stepping across two roles, and was the only nurse really responsible for giving the bisulin injections in that facility and then had to enlist the help of others either the hospital or other nurses in different fields, like the diabetes educator, to help me when people didn't want to come and see me.
Sam Miklos:Yeah, yeah, and what's Bamaga like for people who've never been?
David Maxwell:there.
Sam Miklos:Which is probably many.
David Maxwell:It's like nowhere I've ever been. It's beautiful. The NPA, where I am, consists of five communities, so Bamaga is the biggest, which I just thought was another lovely name. But since being there I've learned it's actually a person's name and it was created with permission of the local Aboriginal people when 76 years ago the start of the sinking of side by basically started to sink yeah, I mean, it probably didn't start 76 years ago, but at that time it was a critical point and um, a group of people from side by left in canoes and came to Bamaga and the gentleman who led that was named Bamaga and it was. Then they gave him this part of land and it was named after him and his grandson is still alive today. He's 78. I saw him before I left and he's the last survivor that I know of that came in that canoe 76 years ago.
Kate Coomber:How incredible, how incredible. I love that. You obviously have a real thirst for knowledge and really want to understand where you're working and understand everything you possibly can about the place, the people and the community. I think that that's something that the team have really commented on. In your work that you do, I guess, take us back to earlier in your career, I guess did you always want to be a nurse. How did that start out? Where was home and you know where you finally are today.
Sam Miklos:Home originally as you might be able to tell is england, yeah, um, I was born there.
David Maxwell:Um, I came to australia in 95. It's one of those uh, sad and sad, but um productive because I'm still here love stories that didn't quite turn out yeah um, so I I didn't come here as a nurse. I had no intention of coming here as a nurse in 95 were you qualified as a nurse?
David Maxwell:though I qualified as a nurse in australia right and so I actually studied in between 2006 and 2011 in lismore, new south wales, yeah, at summer, plus uni, right. So that came about by. I say, my previous career was hospitality events and that sort of stuff and I was, um, itching for a break. Shall we say yeah, yeah, um. And it actually came about, uh, through an associate professor I was playing rugby with by the name of Professor John Stevens and we got talking about you know what else I could do, and he suggested nursing and we were playing rugby together and I actually broke my neck. Oh, wow.
David Maxwell:And was flown up to Brisbane and in those days they had the hard collars and they put on the hard collar and I was getting increasing pain down my right shoulder and they padded it. They'd given me a lot of morphine and I wasn't really working and I was still awake. And they were quite surprised, really working, and I was still awake and they were quite surprised. And so when I got to Royal Brisbane that was a Saturday afternoon, that happened Sunday morning the consultant came and saw me and said you know, you've got a stable spiral fracture in and out. It was a c6 fracture, no deficit, and still had the hard collar on. And I I said to him I've got this pain and tingling down my right arm and he said, oh, it's probably, you know, just the injury. And I said, okay, he said he'd wait and see if it dissipated and I just had this feeling it was the collar. But everyone back then was really reluctant. We're not. So it's changed the management of neck injuries now.
David Maxwell:but then it was put the collar on and don't touch it until we absolutely have to. And the male nurse, funny enough, came in and I said look, this collar's really giving me a problem. And he'd been there and heard that I had a stable fracture so there was really no danger. He said I'll go and see if I can find a soft collar.
David Maxwell:And so he went away and came back and, funnily enough, I don't know if I knew his name, to be honest, because he was in and out and he went down and he found a soft collar and I said, look, I'll take responsibility, but if it's stable it should be fine. And he took off the hard collar and slipped this one on, and as soon as he did that, all the feeling came back to my arm and it would be pressing on a note.
David Maxwell:Yeah, um, and just after that, with the conversations I'd had with um John Stevens, I thought you know this is this is probably what I want to do. You know, I made that little bit of a difference. Um, I'd been sort of on the other side of the schedule with applying people with alcohol or doing them not to behave in pubs and things like that, yeah, yeah.
:And.
David Maxwell:I felt it was enjoyable. I did that on both sides of the planet, if you like, england, and here for about 10, 15 years, and then I just decided you know it's time to do something different, and I felt something that would make a difference, really. So I ended up studying. I started in 2006 and my mum was ill then, so I got interrupted. I went over to be with her briefly, which extended it a year, and I came back. Then I decided to go to Norway as part of my course.
David Maxwell:So I went to Stavanger in Norway and that, uh, when I went, I was told don't worry, it'll all still align up and it'll, it'll be fine. Yeah, um, unfortunately it didn't when I came back, so that extended that by a year and then I failed. A couple of things as you do when you're at uni and having fun.
David Maxwell:So it ended up five years to fully complete the degree and then I, pretty much from then, went rural and back then in 2011, you know people were like, oh, don't go rural, it'll wreck your career. You know you want to go to a big hospital and get all the experience, but it was actually a really eye-opening experience, both you know for for my psyche and seeing parts of australia that I I never imagined, and my first point of call was broken hill and will canyaanya in New South Wales, and you know it was amazing. Uh, the welcome was amazing, um, the learning was steep um, but you know it was. It was really rewarding and learning how to interact differently. I I quickly learned, uh, very earlier on, being in that sort of you're 200 kilometres away from your nearest hospital.
David Maxwell:So we were also the ambulance as well. We had other people driving, but we were actually trained up to use the ambulance and do all that sort of thing, and Royal Flying Doctors used to fly in when they could or we'd do 100 kilometre each way. You know mid-road transfers halfway. We'd meet a Broken Hill ambulance halfway down transfer and it's lay-by. And you know mid-road transfers halfway. We'd meet a Broken Hill ambulance halfway down transfer and it's lay-by and you know do those sorts of things.
Sam Miklos:So it was yeah, it was really, you know, really turned your perspective on your head if you like, Because that's I was just going to say, because that's very early to go remote.
Kate Coomber:Yeah, like a lot of people. What prompted you to want that's very early to go remote, like a lot of people prompted? What prompted you to yeah?
David Maxwell:to actually do that uh well, for me it was how far could I go? You know, it's like if originally, I guess in my head in an idyllic way, I was like, oh, I could be a nurse and then, you know, when I get trained later on, I can go and help in disasters and do all this sort of thing, um, and so I thought, oh well, if I'm gonna be a nurse, how far can I go with with my placement? So I actually went um in 2008, while I was still at uni, was the first placement um in broken hill and wilcannia, and I had a very supportive boss. So when I graduated in 2011, I asked you know, would they have me back applied? And they said, yes, I went back.
David Maxwell:And so as a new grad in Wilcannia, I was very well supported. I wasn't left out on my own. Yes, there were ups and downs, but there was the support there and because it was close by you generally had you know a doctor who stayed around back then and you had senior nurses in the community you could call if something really went wrong. But I was quite lucky there. We didn't get too much trauma and that sort of thing, despite the fact we were on a major road highway. Well, kenya used to be known as the Paris of the West.
Sam Miklos:Oh, wow, I've not heard it be known as the Paris of the West.
David Maxwell:Oh wow, I've not heard it referred to as the Paris of the West. Yeah, it used to have paddle steamers going up and down all the way down the Darling Yep and the old bridge at Wilcannia used to have a drawbridge sort of thing that lifted up.
Sam Miklos:Oh wow.
David Maxwell:It would lift up in the middle and the paddle steamers would go along. That was when the water was flowing, which doesn't happen quite as regularly now.
Sam Miklos:Like Tower Bridge in London. Yeah, yeah, yeah, sort of.
David Maxwell:But it was a straight sort of up like that in the middle.
Kate Coomber:I read I think it's Sarah Donnelly's book where she was a teacher who went to Wilcannia and she talked a lot about the water when it flows and didn't. Yeah, you know the community and oh, very different yeah.
David Maxwell:When the water's flowing, it's a very different, vibrant community as to when you know the water's dried up. And yeah, there's some amazing pictures of people, just you know, walking in the riverbank with just puddles and stuff like that.
Sam Miklos:Yeah, it's uh, yeah, it's very different aspect. You've, um, you've really landed on your feet in in rural and remote, like straight up from the outset, which it often takes other people, you know, a good couple of years to get there. What would, I guess, in terms of tell us about some of the communities that you've had the biggest impact on, and probably those really memorable ones that have really stayed with you?
David Maxwell:I think pretty much all of them I've had. I've been to in different places. I've worked as a RAN Well, kenya. I was a registered nurse there obviously not quite a. Ran at sort of two years out. I then went from there to a place called Bell Reynolds, where it was like a doctor on call um and you had to always explain to people why you had a Victorian um dialing code even though you were still in New South Wales, and why you wanted to send people to Swan.
David Maxwell:Hill and not somewhere else, you know. So that was quite funny. But yeah, I think I think the thing about it is each one's taught me something different, I say in Wilcannia, first up was the perspective of you know, you come out of uni, you're all very keen. I was lucky enough, like I had good mentors and I was able to relate with the community and learn very quickly that what you've learned and what you're capable of isn't the most important thing. Yes, you have to be safe. Yes, you have to have the skills, but it's actually more about understanding people and where they're coming from and what it is they want, rather than you know they, they I think they always say that you know, some of the nurses that go remote are like we're going to save you, the saviours or whatever, and it really is just letting all that go.
David Maxwell:I mean, it's a practice. It's a practice ongoing, because we kind of go oh, I've given you this information and this could help you and do this, but at the end of the day, you don't want to or it's not your priority. You know somebody's obligation to their family or the caring responsibilities is more important than their own health, um, and it's. It's sometimes difficult to grasp that. But it's about trying to understand that and letting it go and and just every every time's a fresh time, and now, sort of 11 years down the road or 12 years down the road, I just say to people okay, this is, I, explain who I am, how long I'm there, for I think that's always important you're saying about you know what could I say to other people?
David Maxwell:I think it's very important when you go into the communities to a give people choice. Sometimes you don't have that if you're the only nurse. I've tended to stay away from the single nurse post because I think for me, I wanted that support. I wanted that um knowledge and and um ability to be mentored, whether it's by health workers or other nurses, so that you're not fatiguing. Yeah, um, which is important, but it's, it's that um, it's that thing of okay, here I am, I'm here. My name's david, I'm here, I'm a nurse. This is my history so when I was in the nt sorry, I'm jumping around- love it it was.
David Maxwell:It was the four f's, and I always forget one. So they thought that footy, family, friends and fishing, there we go, I got it this time.
David Maxwell:There you go you got it in one hit. So that's your point of contact. So where you start as a nurse is introducing yourself to that person, telling them where you're from, because you're on their country and what your heritage is. This is my personal thing. I'm not saying that everybody should do this, but I've found it works for me and so they get a sense of where you're from. You tell them how long you're going to be in their community and you give them that choice, because a lot of time people don't want to see a stranger. They don't want to go over that story over and over again. Yeah, um, necessarily, um. So if you give them that choice and then they go, no, it's all right, I'll see you.
David Maxwell:Yeah, and that's a, that's a real privilege when you really know nothing in that sense of where you are, how the dynamic is and and the ins and outs of the protocols or even that sort of thing. It's just trying to learn. The other thing now I've developed in saying is you know, please, I'm here to learn, so I don't know your culture, I know little bits, but please educate me. Let me know if I say something wrong or ask you a question that may be deemed inappropriate, so that I can learn and better my practice. Um, and a little thing about that is is one thing that came out of that is especially somewhere in the territories. It's not so much where I'm now, but there are places where, even when you've got a couple in, you can't ask them about providing a sample in front of their partner.
David Maxwell:Yeah, yeah. So I, I got told luckily, I was told that by a very lovely man and he said look, you can't say that. Yeah, so you literally just go and get the pot, put it in the brown bag everybody knows what it's for and you hand it there and say can you do that for me? Yeah, you don't actually talk about what it is, because in certain places that's not acceptable, yeah, yeah. So it's just things that rejigging and, I guess, self-reflection in those terms of what we think is day-to-day, which in all these different cultures cultures, because there are many around this country- that's what I was going to add yeah, just completely, you just wouldn't even think of it.
Kate Coomber:Yeah, you can't assume, can you you've, you've got to kind of go in with an open mindset of of almost I know nothing, tell me everything, and we were talking earlier about that cultural awareness piece and it's challenging. I think some people have talked about certain courses that you can do and some upskilling in that regard, but it really sounds like you need to lean into each and every community and actually ask questions and be open and authentic so that you can really have the best impact you possibly can while there.
David Maxwell:Yeah, no, absolutely, and I think, unfortunately, because of the system, we're going into places that are short of nurses.
:let's face it.
David Maxwell:You know we're filling a gap, a need, because people don't want to necessarily be there, that local community, the local health workers, even the driver. You know it doesn't really matter to ask those questions. You know it's very strange to me in the territory. You know, in certain places when somebody dies, depending on their standing in the community, they shut the shop. Yeah, you know, and it was like what the shop shut.
David Maxwell:Yeah, yeah, no, so-and-so's passed and we're shut in the shop and you know the clinic's going to be shut, or you know a lot of times now. They'll allow the clinic to keep going, but all the Indigenous staff will go home as a sign of respect. So it's okay for the outsiders to keep working, but the Indigenous staff will go home in certain places.
:And it's just like, like you know, when you landed there and you don't really know something, you're like I'll pop up to the shop and get something and they go no, it's shut.
David Maxwell:Yeah, you know, um, or or for other reasons, you know the way where things happen culturally and they close the shop, yeah, and it's like okay, if you haven't got food, you just, you know, I've got a big enough belly that I can manage for a day or two.
Kate Coomber:Yeah, you can survive.
David Maxwell:Yeah, it is those sorts of things and it's really, it's a privilege to be allowed into those communities, I think, being mindful of the fact that we are guests. Also, you know, taking into account, you know places where I've worked, where overcrowding is rife, which we know in communities, and we step in and step off a plane and you get the use of a car and you get a two-bedroom house to yourself or a single-bedroom unit. I was in a three-bedroom house living next to people who had 20 people in a two-bedroom house in the Territory, and so, being conscious of that and understanding that, oh yeah, the environs are challenging, but we're blessed.
David Maxwell:We really are blessed you know, and I hear a lot of people complaining about oh, it's not enough money, all the conditions are this or the dogs are barking all night and this, and that you know someone's partying down the road. And I get that because you know we do have to get up and we have to go to work. But what you have to understand is the rest of the people have to deal with this when we've gone when you're gone. This isn't something that they've cooked up to upset us.
Kate Coomber:This is the way the communities live, you know.
David Maxwell:A lot of places when it gets really hot, no one gets up in the day and they get up at night and they basically live their life back to front because it's too hot.
Sam Miklos:Yeah, you've also been. I mean, you've been so involved in the communities you've worked in and is it true that in one of the communities you were offered was it a permanent role or a longer term role and you actually went and spoke to the elders in the community to see if you had their blessing? Is that correct?
David Maxwell:That is actually correct.
Sam Miklos:Tell us about that.
David Maxwell:So that was in Nooka. You guys had sent me there as a ran and the possibility came up to have, you know, a full-time role. Yeah, and we had. I can't remember how it came about, but there was a. I think it was just people said search about the Arts Centre and look about something you know. It was an off-the-cuff comment and they said, oh, go and look at this video about the Arts Centre and in that there was a lady from Nooka who was I better not say her name, just in case she's no longer with us.
David Maxwell:Yes, but she was talking about the structure and the cultural structure and she described, you know, the proper way of doing things and the fact that there's this sort of three-tier system, if you like, of elders that you had to go and talk to if you wanted to do something in the community. You needed to get these people's permissions and at the time I hadn't I'd met some of those people but didn't know I'd met them because I wasn't introduced to them Anyway. So I did some research when this came up and the opportunity I think when I was working with Janine to be there, and so now I knew these people, I went and asked and I went and saw the different levels and said, look, there's a possibility, I'm going to apply for a job here and want to stay, Is it okay?
David Maxwell:One of them I treated like the day before and the other people and they was like you know, we're happy to have you in your community and I said you know I'll be applying, but I wanted to talk to you first and and generally when I go to places anyway, I try to seek out either the you know, local land council, if you like, or someone an elder in the community and introduce myself.
David Maxwell:Sometimes that's done for you, but generally I think it's important to just go out and say hello, whether it's a council office, and say I'm your new nurse. You know I might only be here for two weeks, they'll know you're there, but it's just making that difference and reaching out to them office and say I'm your new nurse. Yeah, you know I might only be here for two weeks, that they'll know you're there, but it's just making that difference and reaching out to them. I found really good and and the welcome was great and I stayed, I think ended up there 15 months and in working there and it was a hectic place, five hours drive from Catherine, I think, yeah, um, so you know.
David Maxwell:but it was, it was it was enjoyable and I tend to measure my, my contributions. I think going back to leading back to that question about the impact is less about what I do but how community relates to me. So I'd be lucky enough that, say, you work in the Territory, you go to Darwin or you go to Catherine. If you're working in, you know, Mount Isa, I think, another place you sent me you go to the shop and stuff. It's how the people you've treated react to you when you're out on the street or when they see you in somewhere else. And for me I always say to people I have a saying that says you know, if they're not throwing stones at me, then I think I've done it right, I guess with that notion are there places?
Kate Coomber:and sometimes you go on contract when maybe it just isn't right and it's not the right fit.
David Maxwell:Yeah, I think it is. There are, I mean, and it's about being aware, you know, and I think part of that is that connection and talking to people about what it is they want. I think a lot of us, you know, we've gone to university, we've spent all that time, we've got all this knowledge and we know what's what, but really we don't in that respect. So I think I've been to places where certain say visiting specialists will get no one in their clinic, you know, and certain other professionals will find it hard to get people in, you know, for certain things.
Sam Miklos:Why is that?
David Maxwell:Well, it's, you know it's about, like I say, it's about the connection. If you're approaching stuff from a point of view of you know I've got the knowledge, you know you need to listen to me. It's not going to work. When I was leaving uni to give an analogy of this story, one of, after I left uni and had been to wilcannia um and this was in my first year which impacted this um quite a lot one of the lecturers who I didn't know had done a survey in the indigenous college in Southern Cross in Lismore about the understanding of diabetics, about their illness.
David Maxwell:Because there was this perception in the medical profession oh they don't know, you know that we've got to chop off a toe, then we've got to chop off a foot, then we've got to chop off a leg, so they mustn't know. You know, understand, and what he found in his research? That they understood very well that they'd seen it all, that they'd had relatives from doing that and all this sort of thing. But they were looking at what pleasures can I get out of life and making choices like the rest of us. Because, let's face it, antibiotic resistance didn't start with the indigenous community.
David Maxwell:I know I'm still doing that you know, I feel that I don't think I'll finish the course, or I left them at home and you know, so it was that, that understanding that people actually knew more about their illnesses probably than their own health professionals, but the way we talked to them about it made it seem that they didn't. And so once you start to actually listen, it made it seem that they didn't. And so once you start to actually listen to people and understand that for them it's less about what you're telling them Sometimes it's a health literacy thing, but sometimes it's. I've got more important things to deal with. This isn't, this isn't my priority. You know, and certainly just recently where I have, I've seen that with um people, a couple of people with um coming home to pass away you know, that that is a major priority.
David Maxwell:Everything centers around that and stops for that, and you know everything else. You know I don't have an appointment. You know I've got an appointment for my heart. No, I've got to cook a meal for my uncle who's 90. Yeah, you know. And you go off and you see someone and they're like no, no, I'm not coming to that appointment.
David Maxwell:You go okay, that's all right, I'm not going to give you a hard time, just let us know when you're ready and when you're back, and I think that's that's the hardest thing for us as health professionals because even the ones like myself, with the best intentions not that I always have the best intentions I say but you know it's that, but I, but I know this will help yes.
David Maxwell:I know this this could make a difference and it's like, yeah, but that's not the thing. What's going to make a difference for this person now is kind of saying I'm here when you're ready to come back.
Kate Coomber:Yeah.
David Maxwell:You know, or even giving little kids who've been brought in for their jab and have no choice about having the jab, letting them say which arm do you want it in? You get little kids go what you know. And I look at their parents and they say which arm do you want it in? You get little kids go what? And I look at their parents and they yeah, which arm? You know you're going to have the injection because mum says so.
Sam Miklos:Yeah yeah, but where do you want it? That's the right. A little bit of control over the outcome too.
David Maxwell:And it's those things. It's about giving people options when they have none, and that leads into what you're talking about with the male female.
Kate Coomber:I was just going to say you know and we know that men's health I guess is, you know, important to you. You came and spoke to the team last year and we mentioned in the intro you launched the initiative, Planet Prostate. I guess I'd love to hear a little bit about that initiative and what you hope to achieve, but potentially also the impact that you can have being a male nurse in some of these communities. You talked earlier about the, maybe the, the men's business, the women's business and and obviously having that, that different person there who can add to the community yeah, I mean it is.
David Maxwell:It's. It's a case of sometimes you've got to use the facilities you have. So let's face it there's very few male rams. There's probably even fewer male midwives but they do exist. I listened to a great podcast from a guy who's in Arnhem Land somewhere and you know it took him two or three years, he says, but you know he worked at it and now they're kind of no, we want him.
David Maxwell:Yeah, yeah, I bet I bet, and you know I've had instances where I've been, shall we say, caught off guard by the willingness to sort of show their injury or something, without kind of warning.
Sam Miklos:You know it's like well, all right babe, all right, we're here, you could have sat down first and described something you know.
David Maxwell:Hello, I'm David. You know that's surprising at times but generally I've found, to be honest, the best. I guess the best way of approaching it is again going back to that. Are you happy to see me? You know, there's been times where I've got. You know, obviously, being an older man, I didn't always have the beard, so I could get away with looking a bit younger.
:Now they're going. Oh, you're an older man.
David Maxwell:Which is kind of good because they don't feel like I'm a lot younger than I am. So it's getting. You know, you get, say, a 25, 30-year-old woman in and you say, are you happy to see me? And they go, yeah, yeah, yeah. And you go in and you start to do their obs and you just notice that they're not connecting. They're feeling like you know, there's body language. Not that I'm a great believer in body language of its own, but it is very important in communities. In fact, they express that body language is more important than talking in a lot of ways. And so you just go. You know, are you really happy to see me? You know I've got there's a lady down the hall, I can get her to see you. And they go oh, no, it's right.
:And I go yeah, I know it's right.
David Maxwell:And I go yeah, I know it's right, but you have the choice and then they might go okay, I'll see the lady, but in certain places I've been told you can't do that you know you're the nurse just tell them you're their nurse.
David Maxwell:Yeah, and I think that's part of the problem that happens with with health is we're vulnerable, all of us. When we go in, we're looking to our health professional to provide answers, to provide support, but the dynamic is skewed. You know you're unwell or you're feeling off thing. You know you're vulnerable. Someone could say like you could have done this better. Or you know why didn't you take your tablets?
David Maxwell:it's like what's gone before is gone. You know, okay, you didn't you take your tablets. It's like what's gone before is gone. You know, okay, you didn't take your tablets. Okay, this is what we need to do with it. We need to explain to you.
David Maxwell:Maybe you know, if you'd finished the course, we wouldn't have this. You know we do this a lot with the sores and the bisulin, Is it? The choices for that treatment are either a bisulin injection or a course of syrup for kids. And so I try to say to the parents are you sure they're going to take five or seven days of syrup? If they're not, I know it's painful and I know it's traumatic for the child, but give them a bisulin because it's done, it's over with, it should do its job and, more importantly, it's quicker to protect against something like rheumatic heart. So it's those kind of choices and dealing with those sorts of things where the difference is made in increments. There's going to be people who may not like you for being there, but let's face it. As RANS and primary healthcare care nurses, our job is to do our job so well that we're not needed.
David Maxwell:We're always going to be needed. But the primary health care principles is that that all goes back eventually to community and becomes community controlled and organized and whatever.
David Maxwell:But that has its problems and I've been in places where people say we're glad you're here because so-and-so won't talk to so-and-so, so if you're not here then that person doesn't get treatment in extreme cases. But on the other hand, you know there's places where there are those cultural barriers but people understand that if there's no one else you've got to kind of deal with that. You know I I will say I won't do an ecg on you unless it's a life-threatening yeah thing. It's not life-threatening, you just need a routine ecg. I'll get you a lady, yeah. But if you drop on the floor and you need, you need um, you know, advanced life support we're gonna do it, but it's then also how you do that if there's somebody there, you can get them.
David Maxwell:You know advanced life support, you know I'm going to do it, but it's then also how you do that If there's somebody there, you can get them. You know, literally speaking, to lift up their relative's breast and you can put the dots on, and you can do all that without actually being too invasive. Make sure they're covered. You don't just rip things off and you know it's just a different way, where you know you'd see in a normal hospital. Oh, it's an emergency, we'll cut the clothes off.
Sam Miklos:Yeah, yeah.
David Maxwell:You don't kind of do that and I've had people say you're not cutting this shirt off. It's my best shirt.
Sam Miklos:Yes, yes. Okay, this is going to hurt because I've got to get it off. Yeah, yeah.
David Maxwell:So it's those things. It's just vastly different.
Kate Coomber:So many stories. I think if other healthcare professionals were listening and really enjoying hearing the differences between different communities, but also just the different line of work that you can have, what sort of advice would you give to people who are considering is that the line of work for them?
David Maxwell:You have to be flexible, which doesn't always work, but you have to try. You know, open to change it's. You know little things are different, like the way, small things, like going rural, it's kind of like going into a religious community in certain ways, and I'll make that clear in dress. You know we come and we're from beach suburbs and do this, and you know we're runners and this and that we go in in these tight little shorts and little vests and we're running around and it's like you don't do that.
David Maxwell:You know people do, but you know people do, but you know they go. Why is everyone staring at me? You know, and you go um, and and this happened when I was, uh, when I was um going to broken hill, I had a friend actually we went. We both went out to broken hill in different places well, canyon, broken hill. And I said to her you know, I've been out there before, you need to. You know, when you go to the swimming pool you need a rashie on, you know, and she was like oh no, and she's a surfer chick and we're still friends today. And she went to the pool without all that. And she came back she said everyone's staring at us. I said I told you you've got to put a shirt on. You might have a bikini on, but you put a shirt on. If you haven't got a raffia, you put it on.
David Maxwell:Yeah, now, nowadays, you know 12, 15 years later you go to broken hill woolies and people are wandering around in in bikinis now, but back then in 2008, it was a bit different.
Kate Coomber:I still find it weird because broken hill's miles from the sea but anyway, I was thinking, why are they in bikinis in broken Hill?
David Maxwell:It's the tourists, though they come through and you know it's hot, yeah, and you know I've got my bikini on and. I'm going shopping. It's like it's not Byron Day, yeah, yeah, you can get away from it.
Sam Miklos:No it totally isn't David? Can I ask a little bit more about Planet Prostate? You know that's um for you to have launched that initiative yourself. Like what tell us about that? Like what do you hope to achieve with that?
David Maxwell:um well it's going to be a slow uphill climb I know that so the idea of planet prostate was to raise money and awareness. Um, I must say that, um, I think even when I spoke to you guys it was. It became less about the money and more about the awareness.
David Maxwell:Prostate cancer is a widespread diagnosed cancer for men. It's also a double-edged sword, because it's one of those cancers that people say you don't die from it. In general, you die with it, which is true in a lot of cases. But there's those small amount of cases where, um, you know it, it has a major effect and obviously, like breast cancer, it's a family-wide effect. You know, um, and the thing about that is the. The guidelines in general in the greater population are like don't test because we only find one or two people, that's fine, but when you're in a rural area, one or two people is a big impact compared to, like, a city. So for me, going through it as a health professional, I found bewildering, challenging at times and with someone who has that health literacy, I also began to realize that, comparatively, and two gene, which is a, a potential cause for breast cancer, it's also a potential cause for some prostate cancers. Wow, and we, we do all this breast screening and we find people with breast cancer. And that didn't seem.
David Maxwell:I couldn't seem to find any way that we were then saying you need to talk to your brother or your son because you've had breast cancer, so that he gets checked earlier than the guidelines, because there's a potential and vice versa that if someone's got prostate cancer like myself, you know, then I need to talk to a sister. If I had, or even my niece, you know.
David Maxwell:So for me, my dad had it and that's what he passed from. If I get it, you know, I think I'm twice as likely to get it if I'm right with the figures If I've had a relative, close relative, get it, because myself and my dad have got it. My brother is three times as likely to get it, but he's had a different type of cancer, so I'm actually the last in the family of four to get the cancers.
Sam Miklos:But anyway, that's another story.
David Maxwell:Must have been all the hospitality days?
Sam Miklos:I think it is, it is and it's a lot of.
David Maxwell:To be honest, as a for me I I also believe in the sort of psychosocial of of health as well. You know there's more to it than social, emotional and psychosocial causes and holding things in. You know um resentments, all these sorts of things. You know I I do read a bit of louise hay, if you're aware.
Sam Miklos:Yes, I am aware of her writing on the mirror the affirmations and all of the affirmations and stuff you know it's.
David Maxwell:it's not about being a be all and end all, but it's. It's about taking a multitude of things and picking what works for you out of little things. But coming back toate, it was that speaking to my cancer nurse, I think they said at the time there were maybe 12 or 14 prostate cancer nurses dotted around and in Cairns there's two nurses that job share and they have possibly 300 clients in the far north Queensland and so the idea of Planet Prostate was to raise awareness, get people talking, hopefully raise funds as well. It hit a bit of a snag because I got the blessing of the Prostate Cancer Foundation of Australia and I was also working with a small charity here. But there's all these rules about doing raffles and things like that and as a small charity you're unable to do a nationwide raffle because you have to have financial footprints in the states that you're doing it right, or at least be with like a commonwealth bank or you know, and
David Maxwell:a bank.
David Maxwell:So these are all things that I learned, but the whole thing is about raising awareness and getting people talking about it in the same way that we talk about breast cancer and eventually, hopefully, although it could take a while if I, if I keep going getting a sort of p test thing going on.
David Maxwell:Yeah, you know, but my, my, my idea is is, uh, I've been playing with ideas and this this year I'm trying I haven't started yet which I should have done um, coming up with do a dad for for prostate, which is going to be hopefully donate a dollar. Yeah, so do a dad for prostate. And then the plan with the peep sort of test thing was eventually to make connections with both the nrl and the afl, because their seasons finish roughly at the same time, not not the, not the final stuff where it's really important to people there, but generally the last game, when they've had the Pride round, they've had the Indigenous round, nobody has a round at the bottom end. Yeah, that's so true, it's like you know, it's hopefully the bottom end for prostate, you know and that would be our idea.
David Maxwell:That's a good like marketing um tagline there right there and then just to get people because cost of living as well, you know I I've had this discussion with the prostate cancer foundation and other charities. You know we tend to sort of put up these things and you go on and you get a link and it's like give 50 or less, you know, and so people go oh, you know, because we're not paying our mortgages and stuff like that. So my idea was to say, give a dollar or two and to get 10,000 people giving a dollar or two, rather than 50 people giving $50.
Sam Miklos:Yeah, that's fantastic, and people won't miss that.
David Maxwell:So that's the idea that I'm trying to develop and hopefully, if we can get those codes together and other codes. I did try and get in touch with the Wallabies, actually because they had the Rugby World Cup in September and I was trying desperately to make contact with them because one of the stand commentators, justin Harrison, was an alumni of my university. Oh, there I am. That didn't really work, but you know you can't expect to do it all in the first year. That's it.
Kate Coomber:I have to think who do we know? How can we connect? Yeah, I mean, it's just about connecting.
David Maxwell:But you see, it's also difficult because what I'm learning as well is a lot of charity fundraising is dependent on individuals, so they will give you a letter to say you can raise money for us, but I've got to be very clear that I don't work for them.
Kate Coomber:Yeah.
David Maxwell:And also they have ambassadors which I'd love to approach but are kind of off limits. Yeah, okay, you know and all that sort of thing.
Kate Coomber:So yeah, so I guess today, David, when we talk about Cornerstone bringing $500 to a charity of choice today for your participation on the podcast, where is that money going today?
David Maxwell:So my choice is the local charity that helps cancer survivors of all sorts. It's called wellness and it has a long history in cairns and I believe it's on land that was donated by a family who campaigned long and hard and were instrumental in eventually getting a cancer center that we now have in in cairns and the liz plumber cancer center. They operate separately on a block of land not far from where I live and they basically um have services. So they've got, you know, physio, massage, um all these sorts of different things. They've got, um, what do you call them?
David Maxwell:uh god, my brain's gone sorry, therapists, yeah, you know, psychologists you can access. They run a little cafe. It's in a very lovely little um courtyard area. You can hire the buildings to support the charity. Um, you know, they do regular fundraising around Cairns and because of the family links they've got, you know, got a great sort of grassroots thing with various companies around Cairns that will do, you know, have not tip jars but have donation jars for two or three charities and local charities and you put your bottle tops in or whatever, and now they count them up and give to that charity. So for me they've been very helpful. Um, they were very um supportive with the planet prostate thing and that's a small charity in in in a big, small town in far north queensland I think five hundred dollars would go a long way to to them.
David Maxwell:Um, so that's where I choose to send the $500. He's gratefully, uh, donating on my behalf.
Sam Miklos:Thank you so much, David um, we have just so enjoyed our time with you. You know you are such a genuine respectful man. You know the the work that you do and just the effort that you put into your community. It just shines through so much. And you know, at Cornerstone we're so very grateful that we've been able to be affiliated with you over the years and certainly I've always loved that. You've always given us feedback and told us that we need to lift the game of what we're doing well.
Sam Miklos:And I love that about you, because you're just always looking to leave where you've been a better place. So thank you so much for your time today.
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