IN regional and rural Australia, a nurse is never just a nurse.
They're sometimes the sole practitioner, the social worker, the advocate and a shoulder to cry on.
Tamworth Hospital director of nursing Michelle Keir knows the unique challenges faced by those outside metropolitan areas as this week the world celebrates International Day of the Nurse.
"Nurses and midwives are extremely resilient and many work autonomously in the rural setting," she said.
"They may be the sole practitioner, it's their job to manage care and escalate concerns so they have to be very adept in managing complex patients and they do that very well."
Ms Keir leads the team of nurses across Tamworth, Gunnedah, Walcha, Manilla, Quirindi and Werris Creek.
In rural and regional Australia, hospitals don't have the luxury of calling in mass agency nurses when there are staff shortages.
At smaller hospitals, nurses often live in the community and know the patient and their family personally, Ms Keir said.
"You need to be compassionate and caring, you need to be a leader and to be able to advocate for patient care," she said.
"Advocating for patient safety is one of the very important attributes of one of the most respected jobs.
"All the little things matter when you support family and patients through pretty challenging times, you are a leader and you have to have that compassion to think about how you would want your family cared for.
"You have to be a pretty tough cookie to advocate for patient safety and be able to speak up."
The outbreak of COVID-19 has changed the way hospitals are run, and the way nurses conduct themselves on the wards.
Where possible, more patient care is being undertaken through telehealth and virtual clinics to keep the patients and hospital staff safe.
But, it hasn't changed the level of care patients are provided or the dedication to the work, Ms Keir said.
"The work that nurses and midwives do everyday, 24-hours a day has become so typical in the healthcare system but it's important to recognise and celebrate where it has come from," she said.
"People should absolutely thank nurses for their unique contribution, I give a big thanks to nurses and midwives who do an amazing job."