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Meet Dr Lisa Peberdy, nurse turned midwife with a wealth of knowledge in women’s health, public health and midwifery, who describes how her career has taken her from the furthest corners of the Australian outback to international humanitarian work. Lisa has over 25 years of experience as a health care professional specialising in sexual and reproductive health (clinical, education and research). Lisa has extensive experience working in rural and remote Australia and in developing nations such as Timor Leste, Papua New Guinea and Western Samoa.

You will learn about: her PhD and cord blood and tissue banks, the time she nursed in East Timor during the 1999 militia uprising, her upcoming humanitarian trip to Papua New Guinea, learn about her time nursing in rural/remote Australia and check out some amazing pictures from back then she has shared, hear some crazy stories ‘from the road’, her work with the Global Nurses and Midwives Rotary Club and SO MUCH MORE!

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Background

About you

I started my initial nursing training in 1985 at St Andrews War Memorial Hospital in Brisbane in April 1986. So that makes it 36 years – I had to use a calculator to work that out! That makes me sound so old, but I’m not…really, I am not. I was born in Mackay in North Queensland and moved to the Sunshine Coast when I was 6 years old, so I grew up in one of the best locations in Australia.

What are 2 fun facts about yourself?

  • My preferred mode of transport is a bicycle. I cycle almost everywhere, and rarely drive a car. I would fit in well on the set of Call the Midwife.
  • I love rummaging around in Op shops for bargains and quirky clothes that I can wear ‘as is,’ or modify and alter. I used to love shopping at David Jones and designer boutiques, but now I get excited when I see an Op shop!
  • I asked a friend to answer this question and she came up with – “You like all your pegs to match when you hang your clothes on the line, and you are allergic to green dye” (but that is a story for another day).

What has your career path looked like to date?

It’s looked like a ‘dog’s hind leg’. I did not plan my career; it has just organically evolved. I put my hand up for opportunities as they arose that I thought sounded interesting or fun, or just a good idea at the time.

“That is the beauty of nursing and midwifery – it can lead you on the most amazing pathways. There is a saying that ‘no two days of a nurse’s life are the same’ and this is so true.”

Why did you choose nursing initially and what made you retrain in midwifery?

It was for a very flippant reason. It simply seemed like a good idea at the time, and I was following my girlfriends from school into nursing. I really had no idea what I wanted to do when I grew up!

In regard to midwifery, another flippant reason. I was simply following a boy to Sydney, and it was the only choice I had – study midwifery or be unemployed as at the time, there was a glut of nursing positions in Sydney. So, I applied for it and was accepted into the first university based midwifery program in Australia. We attended lectures 2 days and were employed as student midwives 3 days per week in a maternity unit. Sweet! It turned out to be the best ‘accidental’ thing I have ever done.

What’s your educational background?

I started as a pupil nurse and then went on to complete my Bachelor of Nursing. After this, I completed a Graduate Diploma in Midwifery, followed by a Masters of Advanced Clinical Nursing – Child, Family and Community Health, and a Graduate Diploma in Primary Health Care in Developing Nations. I also completed several sexual and reproductive health courses, including cervical screening – an area I specialised in for over 15 years and remain quite passionate about. My PhD Thesis title was ‘Cord blood banking, donation and cord clamp timing: exploring health professionals’ knowledge, attitudes and practices’.

Rural & Remote

Why did you choose Rural/Remote/Overseas nursing?

Well, this wasn’t really planned either – it just seemed like a good idea at the time. When I finished my Graduate Diploma of Midwifery studies in Sydney, I was accepted to do my Graduate Midwifery program at Kalgoorlie maternity unit in rural Western Australia. So a friend and I packed up our worldly belongings and drove across the country to Western Australia in a little Mazda 121 bubble car with a push bike on the back.

When I completed the Graduate Program, we continued on, driving up the west coast of Australia to Darwin where I stayed for another 12 months or so. From there, I worked in Gove in North-East Arnhem Land for a stint, Ingham in North Queensland, Thursday Island in the Torres Strait and the Mt Isa Gulf Country in North West Queensland.  

What’s the most rewarding and challenging aspects of rural and remote nursing?

Where do I start? When you work in rural and remote areas, you really do have to think on your feet. You don’t have a huge team of specialist colleagues around you that you can call upon. You don’t have all the ‘bells and whistles’ to rely upon.

You get to do and experience things professionally that you probably would never experience in larger health care settings. However, the best part about working in rural and remote locations is that you get to know the community you are working with really well and develop long lasting friendships.

“Honestly, rural and remote nursing and midwifery is so rewarding, and I cannot recommend it enough. I think all health care professionals should do a rural and remote stint at some point in their careers.”

You’re featured in the book Australian Midwives which details the challenges of delivering babies in the outback. What are some of these challenges?

Babies arrive when and where they choose to arrive – whether Mum, Dad or midwives are ready! You need to always be prepared – ‘expect the unexpected’ I think is the phrase they say. You can be a long way from any help so you have to trust your ‘gut’ instincts and your own ability, and remain calm and collected. We don’t have all the fancy ‘bells and whistles’ out bush so good assessment skills are a must.

Tell us about your upcoming trip to the PNG. What will you be doing there?

Again, this all happened by accident and came about as a result of a serendipitous situation. I was working 2 days per week at a university as the International Student Coordinator while completing my PhD. I was asked to develop and conduct an Australia Awards Course for a cohort of PNG nurses, midwives and health extension officers in Maternal and Child Health Planning and Administration. As a result of this project, it reignited my interest and passion of working in low-income countries (I have previously worked in Western Samoa and Timor Leste). So I expressed interest with the Australian NGO, Australian Doctors International, in regards to working in PNG.

1994 Samoa Operating Theatre with bare feet

They had just received funding for an Immunisation coordinator in Kavieng, New Ireland Province to scope out and oversee the COVID-19 vaccination program and offered this position to me. New Ireland Province is the most remote, north-eastern Province of PNG, and is made up of a group of islands off the PNG mainland.

However, just prior to departure I was offered a 14 week DFAT Clinical Consultancy position to provide mentoring and upskilling for midwives in the new ANGAU Memorial Hospital Maternity Unit in Lae, PNG. This contract also involved assisting the midwives to develop COVID-19 Management Plans. I will be one of 6 Australian health care professionals in the deployment to Lae. The team consists of 2 midwives, 2 infection control professionals and 2 emergency/ ICU professionals. So, I am taking a slight detour on my way to Kavieng, via Lae.

What are some challenges you’ll face in the PNG, particular during this COVID-19 pandemic? 

Isolation will be a big one. Due to the COVID-19 pandemic outbreak in the PNG, we will be restricted in our movements. We most probably won’t be able to move around the community much to restrict the chance of contracting the virus. We have been fitted with our own PPE so I am assuming we will probably spend our time at the hospital during business hours then transported straight back to our accommodation.

We will also be working with limited resources. Resources are always scarce in PNG, however due to the pandemic, this is amplified. There is also a chance that we will be working with a reduced workforce due to the rising number of health care professionals contracting the virus.

Tell us about your time volunteering in nursing in East Timor during the 1999 militia uprising. What did you learn from this experience?

Oh, this is another story that starts with, ‘it sounded like a good idea at the time!’. I learnt what resilience really is. The East Timorese people endured horrific atrocities during that uprising. I was based in Oecussi Enclave, which is a remote East Timorese enclave separated from the rest of East Timor and surrounding by West Timor on 3 sides. Due to the location, it took a long time for peacekeepers to gain entry and therefore the local people suffered prolonged atrocities and enormous loss of life in comparison to the rest of East Timor. The infrastructure within the enclave was completely destroyed.

“All the buildings were burnt out, there was no electricity or running water and the hospital had no roof – just tarpaulins covering the building. All hospital equipment and supplies were destroyed.”

There were 45,000 people displaced and left homeless. Yet the people were so positive and optimistic for the future despite all they had endured and lost. I also learnt about the wonderful work our Defence Force personnel do every day – they really do an amazing job. There were personnel from all over the world in East Timor at the time as part of the UN peace keeping efforts so I got to see the positive impact that they all have on helping to rebuild communities that have suffered in times of civil unrest and conflict.

What are some of your other interesting stories from the road? 

When I first started in a Mobile Women’s Health position in a rural location, I was provided with a 4-wheel drive as I was expected to travel the health service district providing outreach women’s health services to rural and remote communities within an 800km radius of my base location. The thing was – I could only drive an automatic and not a manual vehicle. As there were no automotive 4-wheel drives available in the fleet vehicles, the choice was drive the manual or…walk. So before I went out on my first outreach trip, I spent a day teaching myself how to drive a manual.

I went around and around the hospital carpark, bunny hop, bunny hop, gear changes, forward park, reverse park, turn on a 50 cent piece manoeuvre – you name it, I practiced it. The next day, I jumped in the car all bright and excited and ready to roll, bunny hopped and stalled it all the way out the gate, and then I was off leaving a cloud of dust in my wake. I felt very sorry for the clutch in that vehicle. I am sure it used to shake and shudder as it heard my footsteps approaching each day!

2003 in the Gulf Country with THAT 4 WD

Another time (different 4-wheel drive yet still a manual), I was driving back to base after a week out on the road. I was only about 50 kms from home so was on the homeward stretch after travelling 400kms from my last clinic location… and I got a flat tyre. My worst nightmare – a flat tyre in the middle of nowhere with a fully loaded 4-wheel drive at the end of the day. I got out, assessed the situation and unloaded all the clinic equipment and eskies of pathology specimens onto the side of the road to access the spare tyre.

I tried jacking the vehicle up as high as I could however could not quite get it high enough to slip the old tyre off and the new one on. Those vehicles are so heavy and the tyres are huge. So I decided to cheat and dig a little trench under the tyre to give myself some room to manoeuvre. The problem was the ground was rock hard and there were no rocks or sticks big enough to dig with.

“So being a good women’s health nurse who always carries spare speculums, I pulled out a couple of metal speculums and started digging. And that is how you change a tyre with a speculum!”

2002 in the Gulf Country_a womens health nurse never packs lightly

My research found that I was not alone in wanting to have access to more evidence-based information on third stage labour options available to new parents. Maternity health professionals’ knowledge of all aspects of cord blood banking and donation was lacking and there was an expressed need for more credible, evidence-based information about these options. However, in relation to cord clamp timing, maternity health professionals were quite knowledgeable about the benefits of this for the infant.

As a result of my research findings, it was recommended that evidence-based information of the benefits, limitations and impact on infant wellbeing of all the third stage labour options be incorporated into health professional education curriculum. This will ensure consistency of knowledge so that parents can be provided with current, unbiased, evidence-based information to allow them to make an informed choice on the options available that best fit with their beliefs, values and family needs. To date, I have published 4 papers from my research outcomes, with a 5th paper accepted for imminent publication.

PhD and Professional Areas of Interest

What are your professional interests?

I have many professional interests. I absolutely love working in women’s health and midwifery, and I have a special interest in cervical cancer screening and prevention, public health and working to support nurses and midwives in low-income countries.

2001 Doomadgee with twins I delivered

My research interest at the moment is centred around care and support for women with an unplanned pregnancy. I am part of a research collaboration of nurse/midwife academics from James Cook University, Central Queensland University, Queensland University of Technology, University of Queensland and the University of New Hampshire (USA). The title of our research project is ‘Unintended pregnancy prevention and care education in nursing and midwifery entry to practice programs in Australian institutions’.

Our research aim is to examine whether, and to what extent, specific content related to unintended pregnancy prevention and care are included in Australian nursing and midwifery entry to practice programs and explore the barriers and enablers to inclusion. Our study is in response to a recent legal reform in Australia that has resulted in the removal of abortion from the criminal code in all jurisdictions other than South Australia. 

Whilst these reforms make abortion lawful, inconsistent jurisdictional requirements and varying provision of service means that service availability information is difficult to source, and access can be unnecessarily complex and confusing for women experiencing unplanned pregnancy.

We have just completed Phase One of our study – an anonymous online survey for academic staff who currently teach nursing and midwifery entry to practice programs at Australian institutions, and final year students in entry to practice nursing and midwifery courses. Shortly we will be commencing Phase Two of our study – interviews with academic study participants. I will be conducting these interviews whilst waiting out my quarantine period on arrival to PNG (more on this trip below). I guess I won’t be bored in quarantine – just a little hoarse maybe? I will certainly be up for a chat anyway!

What are cord blood and tissue banks?

There are two types of cord blood and tissue banks. Firstly, there are public cord blood banks which store cord blood only, for use by anyone, anywhere in the world who is a compatible match and requires it for therapeutic purposes. Parents choose to donate a portion of their infant’s cord blood altruistically following their birth after the umbilical cord has been clamped and cut. Private cord blood banks are another option, and they store both cord blood and cord tissue. Parents pay these banks to collect, process and store their infant’s cord blood for autologous or family use.

Why did you do a PhD in this area and what did you find?

I chose my research question for my PhD thesis on this topic (cord blood banking, donation and cord clamp timing) because at the time I was working as the Queensland State Manager of one of Australia’s private cord blood banks. There was so little information on cord blood banking and donation that was not marketing/promotional information for parents. There was certainly no unbiased evidence-based information for health care professionals to learn about or understand the concept.

The information available on cord blood stem cells and cord blood banking did not provide me the depth of information I wanted to know in regards to the accuracy or value of the stem cells for clinical and therapeutic benefit in regenerative medicine, and the impact cord blood collection may have on the infant. Collection of cord blood for either public donation or private banking purposes requires the umbilical cord to be clamped immediately or within 30 – 60 seconds of birth, therefore the infant may miss out on the benefits deferred cord clamping.

“As health care professionals, our practice must be evidence-based at all times. So, I decided to research third stage labour options to help develop evidence-based on this topic.”

What is the Global Nurses and Midwives Rotary Club? What’s your current role as an Executive? How can other nurses and midwives get involved? 

The Global Nurse and Midwives Rotary Club was officially chartered on the 22nd of December 2020. It coincided with the International Year of the Nurse and Midwife. Our club aims to support, mentor, lead and sponsor our nursing and midwifery colleagues globally in the best Rotarian ways we can. We currently have members in Australia, Africa, Canada, UK and Europe, and meet over Zoom every second Tuesday.

One of the reasons I became a member is because I believe in and identify strongly with the Rotary 4-way test – Is it the TRUTH? Is it FAIR to all concerned? Will it build GOODWILL and BETTER FRIENDSHIPS? Will it be BENEFICIAL to all concerned? It also is a wonderful networking opportunity with like-minded passionate nurses and midwives.

My current portfolio on the Executive committee is Grants Director. There are 4 other people in the Grants team and our role is to evaluate and develop applications for Grants for community-based improvement activities. These activities can be anywhere in the world, mostly in low-income countries. The types of projects our club support are those activities within Rotary’s areas of focus:

  • Humanitarian projects that provide sustainable, measurable outcomes that address real community needs.
  • Vocational training that improves job skills in a community through educational programs, support of professionals to travel abroad to gain knowledge and skills or build the capacity of their community.
  • Scholarships that fund international graduate-level study for people seeking a career within an area of focus.

If anyone wishes to express interest in joining the Global Nurses and Midwives (GNM) Rotary e-Club, simply go to www.gnmrotaryclub.com  and complete the Expression of Interest Application. Applicants are invited to link into a couple of meetings to gain an understanding about what the Club does, and are then are informally ‘interviewed’ by the Membership team. 

What has been your involvement with the National Cervical Screening Program?

I was the national nursing representative on the steering committee for the renewal of the National Cervical Screening Program and Policy 2011 – 2014. This required that I, along with other committee members (Cytologist, Gynaecology Oncologist, Pathologist, Epidemiologist, GP, consumer representative and cancer screening program representative) reviewed the research and evidence regarding HPV and cervical cancer development, to recommend changes to the National cervical screening policy, screening test and screening interval.

The committee recommended the transition from 2-yearly cytology-based screening in women from age 18, to the current 5-yearly primary HPV screening from age 25. As a result, Australia was one of the first countries to make the transition from cytology-based to HPV-based cervical screening in 2017.”

What did your role involve as an A/Nursing Director for Queensland Health Cervical Screening Program?

This was one of the most enjoyable roles I have had the pleasure to hold. Essentially in this position, I was primarily responsible for providing clinical leadership, mentoring and specialist advice to the network of 13 Mobile Women’s Health Nurses who provided outreach women health and cervical screening services to women in rural and remote locations throughout Queensland. The clinical leadership role also extended to all authorised Queensland nurses and midwives who performed cervical screening as part of their role.

I was also required to provide strategic direction for quality improvement in relation to cervical screening and follow-up of screen detected cervical abnormalities, and develop state-wide policies, guidelines and standards relating to cervical screening. This was how I ended up on the steering committee for the National cervical screening policy renewal as I often represented Queensland Health on national committees and advised the Director General, Senior Director Cancer Screening Services Branch and other senior managers of opportunities and implications of national cervical screening initiatives.Reflections and the Future

Reflections and The Future

Why should other nurses consider community nursing/public health?

It is such a rewarding area to work in, and the work is so varied. You can specialise in or work across areas such as women’s health, sexual and reproductive health, men’s health, child health, immunisation and vaccination, and health promotion for example. It is very much about preventative health measures, so promoting good health and healthy lifestyles, and encouraging people to stay well. It is also about looking at the big picture of health from a population and community perspective. Therefore, it is very much a wellness focus as opposed to the illness treatment and management focus of acute care. And…no shift work!

What does a typical day look like for you now?

Gee – like I said earlier, no two days of a nurse’s life are the same. I work part-time, 3 days a week, so I really look forward to those days. Currently I am coordinating a Master of Nursing Studies course, as well as lecturing on Midwifery at the University of Queensland. When I am not teaching over the Zoom platform (thanks to the COVID-19 pandemic), I am researching and preparing lecture and content for the units I teach, and following up and responding to student enquires and questions. I love the student contact and always try my best to answer their questions fully or to point them in the right direction to find the information they are looking for.

“I have had some wonderful lecturers and professional mentors in my career, so I know how important it is to be approachable, supportive and kind to the next generation of nurses and midwives. Kindness really does matter.”

What’s been your top career highlights?

There have been so many amazing opportunities and experiences so far however without any doubt I would say it was developing and conducting the PNG Australia Awards Maternal and Child Health Policy and Planning course. I met the most amazing inspirational participants who continue to inspire me every day through the incredible achievements they are making in their communities in PNG.

What’s your advice to nursing students and early career nurses?

We all have different levels of experience, backgrounds and interests. As nurses and midwives, we are all in this together, helping and guiding people to live their best, healthiest lives.

If you don’t know, ask. A safe practitioner is one who is not afraid to ask questions. We can’t possibly know everything about everything. Rome wasn’t built in a day. Enjoy every moment as you strive to achieve the career you wish for.

“Be kind to each other in the workplace, it is not a competition. Support each other, raise each other up. There is no ‘I’ in ‘Team’”

Grab every opportunity that comes your way. Even if you think you can’t possibly do it for whatever reason, if it is something you really would like to do, apply the Nike principle – Just Do It. Just find a way to do it. An example of this is how I ended up on my latest mission to PNG. I was asked to run the PNG Australia Awards course, while working on completing my PhD.

I had to develop the course from scratch in record time and implement it, teaching 5 days a week, 9am – 5pm. I worked 7 days a week, probably 18 hrs a day for 9 months but I managed to do both things – finish my PhD, conduct the course to the highest satisfaction of the PNG participants and myself, and surprisingly – stay sane. As a result – I have been offered this great opportunity and hopefully the first of many more to follow.



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