THERE is nothing like a day out of the office to brighten your perspective on life.

Dr Margaret Harris, who teaches nursing at the University of Newcastle, recently had the opportunity to spend a day travelling with the Royal Flying Doctors out of Dubbo with a former student, Christine Minchell.

The experience underlined for Harris the amazing service the Flying Doctors provide in remote areas and the pivotal role Newcastle plays in not only the network of rural care but also the training of health professionals.

Minchell, from Narrabri, came to Newcastle to study her bachelors degree where she met Harris, who lectured in nursing foundations, graduating in 2000 before eventually gaining qualifications in midwifery on a Royal Flying Doctor scholarship.

"I was keen to get back to the country and being a flight nurse with the Flying Doctors was the perfect way," Minchell says.

Lack of funding for public health in remote areas is a problem and many small rural hospitals have closed down and the health system has been centralised. That's why many patients are flown to Newcastle for treatment.

"It was fascinating," Harris says. "The roles were reversed and Christine taught me for the day."

On the day, they picked up a "grey nomad" who'd had a heart attack in Dubbo and flew him to Newcastle.

On the return trip, they transported several patients back to Dubbo.

While on the tarmac they got a call to fly to Cobar and land in the red dirt where they picked up a young person who needed transporting to Dubbo.

"There was extremely strong cross-winds, which made it terrifying and then they ignored the tarmac and took off on some dirt," Harris says.

For Minchell, it was just another day at the office although she didn't realise until afterwards the challenges her former teacher was dealing with.

"It is eye-opening looking at what we do through a new set of eyes," Minchell says.

"Margaret came along for the ride and really, we never know what we'll find when we arrive somewhere, and even though we're in control we are always aware that things can go bad quickly so you can never relax.

"We're always watching for signs and symptoms.

"The key is to show no stress, calmly deal with everything in a systematic way and ensure that the patient feels safe at all times."

Most people who require the service usually haven't flown in a small plane ever, let alone with some form of health trauma.

Throw in the variations of weather, G-forces, temperatures, movements, motions and emotions and it can be confronting.

"A packet of chips will explode at 20,000 feet, so you can imagine what it can do to a bowel blockage," Minchell says.

"Fog, rain, ice on the wings is never good.

"We have to work out all those things on the spot and devise how and where we'll fly accordingly.

"The important thing, particularly for rural people, is to be that friendly face, not only for the patient but also the loved ones.

"The flight is often the first step on a long journey for all, so the better that first step, the better the outcomes."

Minchell often finds herself worrying about the people left on the ground.

"You have to take a holistic approach," she says. "We've airlifted men who've had heart attacks in remote areas, leaving the wife to drive hours with the four-wheel-drive and van to the hospital, all worried too. Same with babies. I've delivered a baby mid-flight, thinking all the time how hubby is going."

In these situations nurse and pilot have to work as a team.

As Minchell says: She can't drive a plane, and her pilot probably can't give a needle.

But as Harris noted, the pilot plays a pivotal role in care. "He helped a lot with the patient comfort and dignity in flight," Harris says. "He was really good at that and keeping them calm.

"A I understand it, he could have had a job in the commercial world but didn't want that. That's pretty common. People in the Flying Doctors tend to want to combine their passion for flying with a strong desire to help people."

The Royal Flying Doctor Service is a non-profit organisation that literally flies by the seat its pants when it comes to funding.

"It relies on donations and so-forth," Harris says.

"One of the funny things is that the old '80s TV shows The Flying Doctors is playing in Germany, so a lot of German doctors come out looking to live the romantic notion, but it's definitely not all romance."

Before embarking on her tag flight, Harris thought on a personal level it was a job she could do.

"But I found myself challenged by all the risks," Harris says.

"Mainly being in a tiny place with an unknown person. Landing in remote places on dirt tracks with diesel cans lit up to show the pilot where to land. It gave me a profound appreciation for the incredible job they are doing and the risks they take to look after rural health."

Minchell was similarly enriched.

"I still see Margaret as my teacher and to hear her praising me and how she might have felt a little out of her depth, well that's how I felt when I first came to Newcastle to study, so it was an amazing experience."