Defining the Role of Primary Health Care Nurse Practitioners in Rural Nova ScotiaDéfinir le rôle des infirmières praticiennes en soins primaires dans les régions rurales de la Nouvelle-Écosse (original) (raw)
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Defining the role of primary health care nurse practitioners in rural Nova Scotia
The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières, 2010
This article reports on a mixed methods study to define the role of nurse practitioners (NPs) in rural Nova Scotia, Canada, by collecting the perceptions of rural health board chairpersons and health-care providers. Qualitative data were collected in telephone interviews with health board chairpersons. Quantitative data were collected in a survey of NPs, family physicians, public health nurses, and family practice nurses.The authors describe participants' perspectives on the health needs of rural communities, the gaps in the current model of primary health care services, the envisaged role of NPs in rural communities, and the facilitators of and barriers to NP role implementation. Optimizing the benefits of the NP role for residents of rural communities requires attention to the barriers that impede deployment and integration of the role.
Canadian rural women’s experiences with rural primary health care nurse practitioners
In Canada, one in five women lives in a rural area. These rural women often experience different health challenges than urban women, including lower life expectancy, higher rates of disability and cancer, fewer available health care resources and greater distances to access health care services. Nurse practitioners [NPs] provide important primary health care [PHC] services to rural women. Research Objective: The purpose of this research study was to explore rural women's experiences with primary health care nurse practitioners [PHCNPs]. Method and Sample: In-depth, face-to-face interviews using interpretive description methodology were conducted with nine rural women, aged 18-80, who used NP services in rural southwest Ontario, Canada. Results: The participants in the study particularly appreciated the nursing knowledge of the NP, the time the NPs spent with them, and the thoroughness of the care provided by NPs. These foundational elements of the participants' experiences with rural NPs created a sense of trust and respect, which lead to a collaborative partnership between the NP and the rural women. Conclusions: Results of this study suggest that these rural women were overwhelmingly satisfied with the care provided by NPs. In particular, they valued the collaborative partnership with the NP. These findings have important implications for rural health care practice, policy, and education.
The Mosaic of Primary Care Nurses in Rural and Remote Canada: Results from a National Survey
Healthcare Policy | Politiques de Santé
Background and objective: Nurses provide essential primary care (PC) in rural and remote Canada. We examined the practice context and responsibilities of this little-known understudied workforce. Method: Data from Nursing Practice in Rural and Remote Canada II, a 2014 to 2015 pan-Canadian survey, were analyzed. Results: Of 3,822 respondents, 192 identified that PC was their only practice focus (PC-Only), and for 111, it was one focus among others (PC-Plus). Proportionally more PC-Only than PC-Plus nurses had graduate education, were employed in larger communities and had experienced higher job resources and lower job demands. Proportionally fewer PC-Only than PC-Plus nurses followed protocols/decision support tools, dispensed medications and provided emergency services. Proportionally more PC-Only than PC-Plus nurses ordered advanced diagnostic tests/imaging, and fewer PC-Only than PC-Plus nurses performed and interpreted laboratory tests and diagnostic imaging on site. Conclusion: Contributions of the rural and remote nursing workforce to PC are rendered invisible by contemporary characterizations of the PC workplace, limiting evaluation and improvement efforts. Résumé Contexte et objectif : Les infirmières fournissent des soins de santé primaires (SSP) essentiels dans les régions rurales et éloignées du Canada. Nous avons examiné le contexte et les responsabilités de la pratique de cette main-d' oeuvre peu connue et mal étudiée. Méthode : Nous avons analysé des données provenant d' une enquête pancanadienne sur la pratique infirmière dans les régions canadiennes rurales et éloignées, de 2014 à 2015 (Nursing Practice in Rural and Remote Canada II). Résultats : Parmi 3 822 répondants, 192 ont indiqué que les SSP formaient l' essentiel de leur pratique (SSP-seul) et 111 ont indiqué que ces soins formaient une partie de leur pratique (SSP-plus). Toute proportion gardée, plus d'infirmières SSP-seul que SSP-plus ont reçu leur diplôme, ont été employées dans des grandes communautés, ont bénéficié de plus de ressources au travail et ont connu moins d' exigences au travail. Toute proportion gardée, moins d'infirmières SSP-seul que SSP-plus ont utilisé les outils d' aide aux protocoles ou à la décision, ont délivré des médicaments et ont fourni des services d' urgence. Toute proportion gardée, plus d'infirmières SSP-seul que SSP-plus ont prescrit une imagerie ou un test diagnostic poussé et moins d'infirmières SSP-seul que SSP-plus ont effectué et interprété des tests en laboratoire et des imageries diagnostiques sur les lieux. Conclusion : La contribution de la main-d' oeuvre infirmière dans les régions canadiennes rurales et éloignées demeure invisible en raison des caractérisations contemporaines du lieu de travail des SSP, ce qui limite les efforts d'évaluation et d' amélioration.
Nurses who work in rural and remote communities in Canada: a national survey
Human resources for health, 2017
In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territo...
BMC Nursing
Background: Pregnant girls/young women and new mothers living in situations of social and economic disadvantage are at increased risk for poor health. Rural living may compound marginalization and create additional challenges for young mothers. Public health nurses (PHNs) delivering the Nurse-Family Partnership (NFP) to mothers living in rural communities may help to improve maternal and child health outcomes. The purpose of this analysis, grounded in data collected as part of a broader process evaluation, was to explore and understand the influence of rural geography on the delivery of NFP in British Columbia, Canada. Methods: For the analysis of this qualitative data, principles of inductive reasoning based on the methodology of interpretive description were applied. A total of 10 PHNs and 11 supervisors providing the NFP program in rural communities were interviewed. Results: The results of this analysis reflect the factors and challenges of providing the NFP program in rural communities. PHNs noted the importance of NFP in the lives of their rural clients, especially in the face of extreme financial and social disparity. Remaining flexible in their approach to rural nursing and protecting time to complete NFP work supported nurses practicing in rural environments. Rural PHNs were often the sole NFP nurse in their office and struggled to remain connected to their supervisors and other NFP colleagues. Challenges were compounded by the realities of rural geography, such as poor weather, reduced accessibility, and long travel distances; however, these were considered normal occurrences of rural practice by nurses. Conclusions: PHNs and NFP supervisors are well-positioned to identify the modifications that are required to support the delivery of NFP in rural geography. NFP nurses need to articulate what classifies as rural in order to effectively determine how to best provide services to these populations. Environmental conditions must be considered when offering NFP in rural communities, particularly if they impact the time required to deliver the program and additional services offered to young mothers. Regular NFP meetings and education opportunities address common problems associated with rural nursing but could be enhanced by better use of technology.
Introducing a nurse practitioner: experiences in a rural Alberta family practice clinic
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2006
To report on the experiences of introducing a nurse practitioner (NP) into a rural physicians' clinic in Taber, Alberta. Case study, grounded theory qualitative approach. A rural community-based family practice in Taber, Alberta. Twenty relevant stakeholders, including physicians, office staff, Regional Health Authority health professionals and community members. Open-ended interviews supplemented with a patient survey, billing and work time records. Successful introduction of the NP in the Taber clinic relied on: 1) flexibility in the first stages of developing the role; 2) strong connections to key individuals outside the clinic to maintain integration with the community; 3) support and guidance provided by a mentor group who assisted in developing positive working relationships; and 4) cost sharing (matched with benefits) by the clinic and provincial health system for sustainability of the position. The NP role in Taber was viewed positively by clinic physicians and other sta...
A profile of registered nurses in rural and remote Canada
The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières, 2005
Research on nursing practice issues in rural and remote areas of Canada is very limited. This report describes the method and initial results of a comprehensive survey of registered nurses (RNs) practising outside the commuting zones of large urban centres, designed to determine: who practises nursing in rural and remote Canada; the nature and scope of their nursing practice; and their satisfaction with their work, community, and practice supports. Using a mailed questionnaire with persistent follow-up, the data-collection frame included a stratified random sample of rural RNs and the full population of RNs who worked in the northern territories and outpost ("remote") settings. The analyses focus on regional comparisons of demographics and primary work settings and on provincial comparisons of satisfaction levels related to work and community. The survey is part of a larger multi-method project intended to inform policy on rural nursing practice in Canada.
Barriers to Practice of Rural and Remote Nursing in Canada
The delivery of rural and remote healthcare has been identified in the literature as a unique and complex working environment for Nursing practice. This Canadian setting integrative review looks at barriers associated with rural and remote nursing. Nine articles were retained after filtering over 200 articles extracted from 4 databases. Critical Appraisal Skills Programme Checklist (CASP) for qualitative research and Quality Assessment Tool for Quantitative Studies (QATQ) were used for assessment of a total sample of N=3402 participants. Four (4) main themes (barriers) were extracted: 1) Professional Isolation, 2) Competing Demands, 3) Lack of Sustainable Continuing Educational Initiatives and 4) Lack of Organizational Support. Following analysis of the demographic data, an emerging theme of an aging workforce was also seen as a potential future barrier to rural nursing practice. Future research is required in order for sufficient and appropriate action to be taken in addressing aforementioned barriers. Recommendations for nursing practice and policy in rural and remote areas revolve around exposing nursing students to rural / remote settings, incentives for new graduate students to practice in these areas, as well as support and educational initiatives encouraging practitioners to work to their full scope of practice.