Most of the flights departing Adelaide Airport are transporting passengers headed on holiday or to a work commitment. But in a pocket of the airfield just behind the Harbour Town shopping centre, there's a team on standby 24/7 ready to transport critically ill and injured patients from across the state and nearby interstate towns and cities to medical help in Adelaide.
We Are.SA spoke with Jacintha Pickles, a member of the SAAS MedSTAR Emergency Medical Retrieval Service that provides emergency transport and care for children from birth to 16 years of age.
What is MedSTAR?
MedSTAR is the retrieval branch of SA Ambulance Service (SAAS), which is split into two speciality areas. The MedSTAR general team looks after adults and pre-hospital patients, and MedSTAR Kids, my team, looks after patients ranging from pre-term babies, all the way up to 16 year olds. Any patient that needs to be transported to special care, a neonatal intensive care unit or a paediatric hospital, will get looked after by the MedSTAR Kids team.
We cover a very large area, retrieving patients from hospitals within South Australia’s borders and places like Broken Hill and Alice Springs, as Adelaide is the closest capital city for them.
We also transport patients from Adelaide to Melbourne and back quite frequently because some babies and kids need specialised cardiac operations.
Well babies really get to know their mothers’ scent in the first few days of life, and this is an important part of bonding and establishing feeding. So the babies we move travel in the cot with a toy that has their mum's scent and then when the mum and baby get back together again, it helps the baby know that that's their mum.
How did you get into this field
I started my career in paediatric intensive care at the Royal Childrens Hospital in Brisbane, which is where my passion for retrieval nursing begun. After my graduate year, I continued to study for a Paediatric Intensive Care Postgraduate Diploma to gain the knowledge and skills needed to become a member of the retrieval team. I enjoyed traveling to rural and remote areas to care for children that were too unwell to stay at the local hospital, then transferring them back to Brisbane for tertiary level care (pictured left).
I then moved to Sydney to work for NETS NSW (Newborn & Paediatric Emergency Transport Service), where my role was the transport care of unwell newborn and premature babies as well as sick and injured children.
After that, I studied midwifery, which is not a required qualification for my current job at MedSTAR, but skills are quite valuable as we often move babies that have just been born. New mums have lots of questions and you’re often assisting with helping start that bond and attachment. If bub is well enough, then I'll try and get them to have their first breastfeed before we move them or at least have some skin-to-skin time with mum, that way mum can start establishing her milk supply for when the baby is well enough to start having milk.
We also have little toys (pictured left) that we will get mum to pop into her shirt while we're
there doing our job stabilising the baby, to collect the mum's scent. We'll then put the toy into the cot with baby for the trip to Adelaide. The small toys are all hand made by a wonderful group of volunteer ladies who also make hats and booties for the babies to wear as they are being transported.
Well babies really get to know their mothers’ scent in the first few days of life, and this is an important part of bonding and establishing feeding. So the babies we move travel in the cot with a toy that has their mum's scent and then when the mum and baby get back together again, it helps the baby know that that's their mum.
What does it take to be a MedSTAR Kids Retrieval Nurse
To work for MedSTAR Kids you need to have a background in paediatric or neonatal critical care, and we sort of say you want to be like the ‘go-to person' in that area and have at least five years of experience and have a wealth of knowledge looking after really sick people and working with a variety of different equipment.
What’s a typical day like
I think the key to retrieval nursing is preparedness as we start off every day by checking our equipment and ensuring its ready to go. We collect our communications equipment, our phones, radios and pagers, and let our communications team know that we're ready to respond.
Once we've done that preparation phase, there's some admin that needs to be done, it’s the less glamorous side of our job. We also follow up our patients, which I think is a nice aspect of what we do.
For example, if I did a retrieval yesterday and dropped a patient off at the Women's and Children's Hospital, today I would complete my paperwork and call the unit to get an update about how that patient is going. It helps us work out whether the care we've provided was accurate and exactly what they needed.
We pick up our patients from hospitals in one of three different modes of transport. We will travel via ambulance for places like Gawler, Murray Bridge and down to Victor Harbor. Then we have the helicopter (pictured left) to go to places like Clare and Wallaroo. If we're going even further again, we will fly with the team from the Royal Flying Doctor Service (RFDS) on a fixed wing aircraft and for super long distances we use a jet charter.
A call for our services will go through to our coordination centre where a nurse will get all the vital information for us and then another team member will jump on the call to get an understanding of what's happening and potentially what’s wrong with the patient. From there, our team will be dispatched with either a priority two, which is lights and sirens, or priority four, standard driving, for when we use the kids ambulance. The time between the end of that call and us on the way to the patient is usually between four and 10 minutes.
A career where you’re always learning
There are always cases that challenge you, regardless of how much experience you have. We continuously review our work to identify areas we could improve, both personally and as a service. I’m also always learning from the people around me, from the doctor I’m on shift with or the team out in the country. Our patients and their families also teach us a lot.
Support for those who support us
Sometimes it's not all sunshine and roses and, when we are facing those difficulties, we can access Peer Support . There are systems in place to flag really challenging jobs and a Peer Support Officer will contact us to talk about what happened.
We can also access the Employee Assistance Program where we can speak with a clinical psychologist that has expertise in supporting people in my field. For me personally, I know my emotional response isn’t always immediate after a difficult case. Sometimes it’s a build-up of emotions that gets triggered by something relatively minor and that when I know it's time for me to talk to someone.
I went to Samoa a couple of years ago as part of the Australian Medical Assistance Team when there was a big measles outbreak. There were lots of unwell children and unfortunately a lot a lot of those children died. We don’t see major outbreaks of diseases here, especially vaccine preventable diseases, and we just don't see such large volumes of children dying at a time.
It was a tough time while I was there, I cried every single day for two weeks and I didn't really realise how much it would affect me in the long term. About a month after that, I went and spoke to a psychologist. We can get support for anything we are going through, not just experiences we have had through MedSTAR, as they can sometimes be triggered by other past experiences.
What working for MedSTAR Kids means
So many people ask me if you wasn’t a nurse, what would you be? I have no answer because I've got my dream job and it's such a meaningful job, and I’ve hit the career jackpot
I feel like every day when I come to work, there's an opportunity to make a big difference in someone's life. Knowing that you can positively contribute on someone’s worst day and make a meaningful difference is such a heartwarming feeling.
Especially when we get to meet our patient twice, specifically the babies that we take to Melbourne for surgery. They are usually really unwell on the way over and sometimes it just lines up that you're the nurse who also gets to bring them back. You walk into that room and the mum gives you a big hug and is so grateful.
Sometimes they don't even look like the same baby because they have improved so drastically. It’s simply a great and rewarding job.
