Narelle Gleeson, Director of Nursing and Midwifery at Lismore Base Hospital, was recently awarded a Lifetime Achievement Award in recognition of her distinguished 50-year career as a Nurse, Midwife and Director of Nursing and Midwifery. She sat down this week with Darlene Cook to talk about her life, and the many changes she has seen in the nursing profession over those years.

My mother was a nurse, and my father was a coal miner. They were born and lived in Wollongong most of their lives, with my father following in the footsteps of his father and grandfather, who both were coal miners.

I was born in Wollongong Hospital in October 1957, the eldest child in the family. A younger brother and sister came along a few years later.

I attended primary and high school in the suburbs of Wollongong. I don’t remember that I ever wanted to do anything else but be a nurse; my mother influenced my decision to be a nurse, as did the school advisor following an aptitude test. My sister was also a nurse training at Marrickville Hospital in Sydney.

When I think back, in the 1970’s the options for a young woman leaving school were somewhat limited. It’s very different now; there are so many more careers women can choose from. Having said that, if I had my time over, I would still choose nursing and midwifery as my career option. I can’t imagine doing anything else.

I started my nursing career at 17 years of age, just over fifty years ago, on 3rd February 1975. The Hospital where I trained was Sydney Hospital, which is in Macquarie Street and is the oldest hospital in Australia. Sydney Hospital once included what is now Parliament House and the Mint. Sydney Hospital was known as Rum Hospital until 1881, as the convicts who built it were paid with rum.

(Narelle as a young nurse in Sydney

NSW politician, Henry Parkes, was concerned about the state of the hospital and appealed to Florence Nightingale for help to send trained nurses. Subsequently, in March 1868, Lucy Osburn was sent to Sydney as Lady Superintendent of the hospital. She was accompanied by five trained nurses, all with military experience.

Lucy Osborne established the first school of nursing at Sydney Hospital and laid the foundation of modern nursing in Australia. The museum at Sydney Hospital. known as the Lucy Osborne – Nightingale Museum. portrays the history of nursing and medicine in Australia and is well worth a visit.

During my training, I was sent to other hospitals to gain experience in specialised areas that were not provided at Sydney Hospital. These hospitals were Camperdown Children’s Hospital, Gladesville Psychiatric Hospital and Crown Street Women’s Hospital.

The nurses’ home where I lived was in Woolloomooloo, close to Kings Cross and the Garden Island Navy Base. I remember my mother being surprised at how close the nurses’ home was to Kings Cross. There was an immediate warning from her – “don’t you go there.” 

When I got to know some of the other nurses who had similar warnings from their parents, we went to the ‘Cross’, to find out what it was we weren’t supposed to be looking at. The Navy boys were often caught throwing stones at our room windows, hoping to find a nurse to go out with them. Very different from the dating Apps used today.

When I finished my general training, I stayed on at Sydney Hospital for a few months, then went to Adelaide to work. From there, I did as so many of my generation did in the 1980’s, I headed off to the UK for 18 months and worked in several London Hospitals between travelling around the UK and Europe. When it was time to come home, I went back to Wollongong and moved home with my parents. It was then I decided to do my midwifery training.

I wasn’t sure if I wanted to be a midwife; however, once I started my training, I loved it and spent 20 years working as a midwife. During this period, I worked as a clinical midwife in the birthing unit, as a midwifery unit manager, then a senior manager in maternity services.

During that time, I completed a Master’s in Health Policy and Management and then a Master’s in Business Administration at Wollongong University. While initially I felt a bit intimidated going to university at age 40, I soon learned that you are never too old to study, and I thoroughly enjoyed the time I spent completing my degrees.

((Narelle at her graduation at Wollongong University when she completed a Master of Business Administration)

In 2002, I was asked to fill in as the Director of Nursing at Bulli Hospital. This experience reinvigorated my interest in general nursing, and I then went on to work at Port Kembla Hospital in a permanent Director of Nursing position. After 4 years working at Port Kembla Hospital, I decided to take leave without pay and take a Director of Nursing position in Saudi Arabia. I spent 16 months living and working there, it was a wonderful experience and one I will never forget.

I look fondly on the time I spent in Saudi Arabia and how I grew personally and professionally from living in a culture so different from Australia. I was surprised, for example, to learn that women weren’t permitted to drive cars, or travel without permission from a male relative or work. The nurses working in the hospital came from all over the world; it was a huge expat community living in the residential compound.

Saudi Arabia was starting to change some of the strict rules around women and had just begun training Saudi Arabian nurses. This came with some challenges, considering the rules around driving and travel. Thankfully, more changes have occurred since I left Saudi Arabia; today, women can drive, and work and do not need permission to travel from a male relative.

Australia seemed to be such an exotic place for many of the nurses working there, and I was asked lots of questions about our country. Koalas, kangaroos, crocodiles, spiders and snakes sparked most of their interest. I was treated kindly and respectfully and was invited to attend Ramadan celebrations and lucky enough to attend one nurse's wedding. When I went on leave, I had many nurses escort me to the airport, and when I came back, there were nurses there to meet me, often with gifts and streamers. Not something that happens here, of course.

Towards the end of my stay in Saudi Arabia I applied for a position back home as Director of Nursing, at Shellharbour Hospital – I was successful in gaining the position and I worked there for eight years. I moved to Lismore and the Base Hospital in 2013 which is truly one of the best decisions I have made.

I decided to move to the North Coast because at that time my sons were both living in Brisbane. I did not look for a position in Brisbane because I wanted to remain in the NSW hospital system, where most of my hospital experiences had been.

My eldest son is an army veteran, and the younger is a licensed refrigeration and air conditioning mechanic. While they were growing up, most of my work was an easy commute. By the time I went to Saudi Arabia, my sons were both young adults. I am immensely proud of the men they have become and love the time I get to spend with them. My sons have commented at different times that it wasn’t much fun having a mother who is a nurse. They remind me of the times when they tried to get time off school by telling me they were sick and did not get away with it, unlike some of their friends.

(Narelle with her Lifetime Achievement Award)

While working at Shellharbour and Kiama Hospitals (the hospitals were merged), I gained a great deal of experience providing care and services for complex aged care patients and as a result, I am passionate about patient-centred care and preserving the dignity and well-being of elderly patients with complex needs.

Recently, I found an article from a local newspaper that my mother had kept, where the nursing staff at Shellharbour and Kiama Hospital introduced a NSW Health project called Top 5 – it’s a simple tool that allows nurses to collect knowledge about the patient from their family or carer to assist with reducing anxiety of the patient during their hospital stay. We still use the Top 5 tool today.

I have enjoyed every role I have worked in, which is now quite diverse. This is the beauty of the nursing and midwifery profession; there is so much variety in the clinical streams or services to choose from. Nurses and midwives are there at the beginning and end of someone’s life and all the other times in between when people need care and support for their health issues. This is a very privileged position to be in.

Of course, there have been so many changes in the profession in the last 50 years as there have been in other careers. One of the biggest changes to the profession has been the move from hospital-based training to nurses having a tertiary qualification. By the mid-1980s, nursing diplomas were being provided by Colleges of Advanced Education, and by 1993, all registered nursing students in Australia entered the profession via a tertiary education pathway. Australian registered nurses are now required to complete a three-year bachelor’s degree or a postgraduate degree in nursing. Once, only a postgraduate degree, attaining a midwifery qualification could be gained without first completing a general nursing degree. Nurses can also be trained through the TAFE system as an Assistant in Nursing or an Enrolled Nurse.

Many nurses choose this pathway into nursing before going on to complete a degree.

Many of the roles available to nurses and midwives today were not available when I started in my career. The technical equipment that nurses utilise currently to provide care for their patients is extensive including documenting the care they provide to the patient in an electronic medical record rather than paper-based.

So many aspects of the care provided to patients that we once relied on a doctor to do are now done by nurses; we now have clinical nurse/midwifery consultants, clinical nurse/midwifery specialists, and nurse practitioners.

Changes in patient treatment have also been revolutionary. For example, my second rotation during my training was to the Sydney Eye Hospital in Woolloomooloo. Patients would have their cataract surgery and would have to remain in bed with sandbags either side of their head, eye pads on and in a dark room. They would be hospitalised for about 10 days. Today, patients spend only a few hours in hospital after their surgery. 

Many other surgical procedures have improved and have reduced the patient staying in hospital from what was a weeklong stay to day surgery, or a one-night hospital stay. The introduction of Hospital in the Home has also improved the patient experience by the patient being able to receive care in their own home from a professional clinical team.

Similarly with maternity services, it is more relaxed, and women can be discharged if all is well four hours post birth, have the support people they want with them during the birth, and if the services are available, choose water or home births under the care of a trained midwife.

The two greatest challenges I’ve faced in my fifty years of nursing were experienced here at Lismore Base Hospital. The biggest challenge was the COVID-19 pandemic. The courage of the nurses was inspiring during this time. I know other health professionals were involved in caring for patients with COVID as well, but as the Director of Nursing and Midwifery, I am, of course, biased, but the truth is the nursing staff were nothing less than brilliant during this time. They demonstrated compassion and commitment to their patients and their patients’ loved ones while safeguarding themselves.     

Other countries were reporting stories about health workers becoming seriously ill or dying after being infected with the virus after caring for patients with COVID-19. It was a frightening time for us all. NSW Health and the Local Health District kept us all informed about COVID and the strategies being put in place to care for patients and minimise the risk of the transfer of the virus; staff were provided with the appropriate personal protective equipment and educated on how to use it.

While COVID-19 is still with us, it is not as severe, and the number of people with it is reducing. More importantly, people are not getting as sick as they did when it first presented.

The second greatest challenge I experienced were the 2022 floods. I was in awe of the many nurses and midwives who had property damage or were cut off by the water but still came to work. Many of our staff came to work in boats (tinnies) or canoes, or found a way around the flood via country roads to get to work. Most bought with them a change of uniforms as they knew if they got to the hospital, they would be there to stay until the water receded.

Other nurses worked wherever they could get to – if they couldn’t get to the Base Hospital, they went to help at another hospital –e.g. Casino, Kyogle, Ballina and in the evacuation centres. Our staff would work double shifts if needed to care for the patients because there were nurses and midwives who could not get in to work. The Emergency Department was extremely busy during this time and provided patient-centred care for the patients and often their pet. 

I wondered what Florence Nightingale or Lucy Osbourne and her nurses would say about pets in the hospital and sometimes in the bed with the patients. For me, it was truly inspiring to see. I saw compassion in every staff member across the entire health workforce who worked during this time. There are so many wonderful stories to tell about our heroic health staff during the COVID-19 pandemic and the floods, perhaps stories for another day, so this period in our local health service history will not be forgotten.

Outside of my hospital work, I am very involved with ZONTA, which is an international organisation with the mission of building a better world for women and girls in support of sustainable development. We believe in making the world a better place by empowering women, advocating for equality, education and an end to child marriage and gender-based violence.

The Zonta Club of Northern Rivers has furnished a designated, private room at Lismore Base Hospital for women and their families experiencing stillbirth or miscarriage. This room, often referred to as the Zonta Room, provides a sanctuary for families to grieve and acknowledge their loss. Recently, several of the Northern Rivers ZONTA members worked with a local high school to make up birthing kits; these kits provide clean basic equipment for women in developing countries to birth their babies, thus reducing the risk of infection to them and their baby. 

In the past 2 years, 900 birthing kits have been assembled by the Northern Rivers ZONTA members with the assistance of students at a local school.

I love working in my garden while walking and playing with my dog, Molly. I also love entertaining friends and family and travelling to new places and exploring the culture of the town, city or country I am in.

What’s in the future for me? I am not sure. What I do know is that it is hard to think about retirement when I love the work I do and the people I work with.

If I could give one piece of advice, if you are wondering about what to do as a career or thinking about changing your career, consider being a nurse or a midwife. You will have a wonderful, interesting, dynamic career.