Introducing Dr Mardi Steere
What does a great day at work look like for Dr Mardi Steere? Mardi thrives on the daily pressures of urgent aeromedical retrieval with the Royal Flying Doctor Service. Her fascinating career includes paediatric emergency medicine and eight years in Kenya as a clinical services director of a 350-bed tertiary teaching hospital. From her South Australian base, her passion for aeromedical retrieval involves a constant quest to improve services to save lives. Today, Mardi is the executive general manager of Medical and Retrieval Services, Central Operations for South Australia and Northern Territory.
A great day at work might include…
our team retrieving a multi-trauma from one of our remote clinics. Our skilled remote area nurse stabilises the patient with immobilisation, oxygen, IV access and pain relief. Telemed support is sought to guide stabilisation advice and to determine that an urgent retrieval is needed. The Port Augusta retrieval team arrives and provides on-the-ground ICU care including airway management, ventilation, blood and ultrasound. The team takes flight to get the patient to definitive care as quickly as possible.
It probably sounds a bit dull, but I also enjoy reviewing incidents and issues that have arisen. I investigate the rostering, communication, equipment, or training issues that occur and I’m involved in solving the issues in the system so they don’t recur. I can then get back to streamlining our emergency care procedures so the rhythm of care is automatic and familiar for new and seasoned employees alike. If I can send a “well done” or “thank you” message to a team member who has navigated a complex case, my day would be fulfilled.
My role with the Australian Stroke Alliance involves…
identifying and unravelling problems, engaging with a range of stakeholders and collaborating with our innovation partners to improve stroke outcomes in rural and remote communities.
One of the biggest issues we face in stroke care is time. My team and I are working on identifying the time it takes from a stroke onset in a remote community to receive definitive care. We are working to improve stroke symptom recognition, diagnosis and triaging of stroke patients. To do this, we need to build and strengthen relationships with remote communities and improve communication between remote and urban clinicians and specialists. The RFDS has the added challenge of cross border care. In Central Operations we retrieve people from remote communities in SA, NT and the border communities in Western Australia. The closest or most appropriate treatment centre is often in a different state. I am working to improve interstate collaborations and bring experts from different state systems together to ensure our pathways intersect.
I’m also really enjoying working closely with our innovation collaborators to develop lightweight and portable brain scanners. I am looking forward to trialling the portable brain scanners on an aeromedical retrieval and having non-radiographers sending images from the middle of nowhere, during a storm, and getting a diagnostic response that will help us determine immediate treatment options – and where best to take the patient.
I will always remember…
when I lived in Kenya, we constantly struggled to recruit and retain a workforce in rural East Africa. We worked on defining new models of care such as, training physician extenders in anaesthesia and paediatric critical care. When I began working for the RFDS I realised we had the same recruiting and retention issues in Australia. I remember the lightbulb moment of “We have to be more creative in healthcare pathways here”. Sending doctors for a rural rotation as a trainee and hoping they stay forever is not enough. We need to better tap into the passion of the people who love the land they live on, and explore training and clinical care pathways for nurse practitioners, paramedics, clinicians in remote high dependency care and more. This has deepened my passion for multidisciplinary healthcare, a passion which will not go away.
What will a great day at work look like in 2031?
A respected elder in Pukatja, APY lands has a funny turn at 9am and can’t speak or move his arm, and the Nganampa Health clinic immediately recognises this is a stroke. RFDS/Alice Springs Hospital retrieval team is immediately activated and arrives at his side at 11:40am with their mobile CT scanner. After sending his scans to Alice Springs and taking off, they chat to the neurologist over videoconference in flight, who recommends they start thrombolysis in the air at 12:30pm. By the time they arrive at Alice Springs Hospital, the patient’s paralysis is resolved and he is able to thank them as he walks off the plane. It doesn’t get much better than that!