From nurse to health district leader: Four decades of care

Four decades ago, Marg Martin became a nurse because she wanted to work with people. Now in her new role as chief executive of Illawarra Shoalhaven Local Health District (ISLHD), Marg has the chance to make a difference to the lives of about 400,000 residents of Wollongong, Kiama, Shellharbour and the Shoalhaven.

“I really was attracted to a people-centred profession,” Marg told the Illawarra Flame in an interview last month.

“From a nursing perspective, what I've always valued is that we have the ability to make so much difference in people's lives when they are at their most vulnerable, and I gained a lot of personal satisfaction out of being able to to do that over my clinical career.”

Marg leads a team of 15 executive directors at ISLHD, one of the region’s largest employers, with about 8500 staff working across seven hospitals, dozens of community health services and many specialties, from social work and wellbeing to cancer care and clinical trials. 

“I used to always describe my leadership style as ‘servant leadership’,” she said. “Because I think it's really important that we acknowledge as leaders that we are here not just for our own purposes; that we're here to guide, support and develop others to be the best they possibly can.

"I do believe that I lead with integrity and authenticity, and I love connecting with people. There's nothing more satisfying for me than seeing other leaders develop, and being able to mentor, encourage and guide those people in their professional careers.”

From Adelaide to the Gong

Marg was born and raised in Adelaide, South Australia. “I started my graduate nursing program at Flinders Medical Centre in Adelaide, and I actually spent my entire nursing career there. I did move through different roles, both clinical into management, back to clinical roles over a number of years.”

Before she moved to the Illawarra to take up the job of executive director of clinical operations at ISLHD, Marg worked on a big transformation program – the rollout of electronic patient records across South Australia.

“I think working on the EMR (electronic medical record) project in South Australia was one of the most challenging and probably one of the farthest-reaching things that I have been involved in,” Marg said.

“But there are so many small wins across my career. When I look back at what health was like 40 years ago, there are so many things that have changed, and I have been so fortunate to be part of being on the frontline of some of those really key developments. 

“I remember the first hospital in the home program that we set up, establishing day surgery units. So there are so many things that we now take for granted that I had the pleasure of being in in the very early stages of development involved in."

Marg moved to Wollongong in 2017 and held the role of executive director of clinical operations at ISLHD for almost a decade.

“It was work that brought me here, but it is such a glorious place to live, and I fell in love with it immediately,” she said. “So I have enjoyed every minute of the nine years I've been here.”

That even includes times in the COVID-19 pandemic.

“One didn't have that on the to-do list,” Marg said. “And I think most people working in health would say that was the most challenging time.

“But interestingly – for all its difficulties and for the stress that our staff and community went through – to actually see how people rallied together, the collaboration, the support and the can-do attitude that people showed during that time made really a memorable time, not just for bad reasons, but for all those good reasons, too.”

Building a strong health system

While the media spotlight often falls on emergency measures in public health, Marg supports a balanced approach, taking in everything from preventative measures to crisis management.

“Prevention has always and will always be an important part of a strong health system,” she said. “While hospitals and health services play a critical role in treating illness and injury, there are significant benefits in supporting people to stay healthy and well in the first place.

“This can take many forms, from promoting healthy lifestyles to improving access to screening and immunisation programs.

“As a local health district, we will continue to work closely with our partners across the health sector and community to deliver both prevention and treatment services.”

On the frontline in Illawarra hospitals, however, pressing challenges remain.

Marg has stepped up to be chief executive after Margot Mains, the health district’s leader for the past 12 years, took on a new role at NSW Health as coordinator general in aged care and disability reform.

Delayed hospital discharge, aka bed block, remains a problem in our region, with more than 100 people stuck in hospital on any given day, unable to leave as they are waiting for a residential aged care placement or in-home support services. 

“Aged care patients who are awaiting access to residential aged care remains a challenge for many districts across the state, including ISLHD," Marg said.

Her goal is to build on ISLHD’s strengths, including its people, to deliver a better public service. 

“We have made improvements in our emergency department performance, and also with our planned surgery wait times. So I'd like to see that continue."

She also aims to have a supported and valued workforce: "Because when staff feel valued and appreciated, they can deliver the best care.

"Our other challenge that we really need to continue to work on is within the complex areas of our NDIS and aged care demand. 

“I think that will continue to challenge us for a number of years, but there are some really key strategies that we're looking at trying to alleviate some of that pressure over the next 12 months.”

This includes working with aged care providers to help older people.

“We remain focused on ensuring people receive the right care in the right place. This includes strategies to enhance virtual, community and at-home care and support older people to remain well at home."