Norma J. Stewart

Registered nurses working alone in rural and remote Canada.

This paper describes the demographics of Registered Nurses (RNs) who work alone in rural and remote Canada, their workplaces, and the benefits and challenges of this unique nursing employment situation. Data presented are from a national survey, one of 4 principal approaches used in conducting the project The Nature of Nursing Practice in Rural and Remote Canada. Of the total survey sample, 412 nurses (11.5%) were employed as the only RN in their work setting. Variables of interest included level of education, employment setting, and regional distribution of workplaces. An exploration of predictors of work satisfaction confirmed previous research findings with respect to the importance of continuing education and face-to-face contact with colleagues. Findings from this analysis may inform policy decisions regarding the employment of RNs in rural and remote Canada.

Work Setting, Community Attachment, and Satisfaction Among Rural and Remote Nurses

OBJECTIVES To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada. DESIGN AND SAMPLE Cross-sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample. MEASURES The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions. RESULTS Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment. CONCLUSIONS Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.

More alike than different: a comparison of male and female RNs in rural and remote Canada.

AIM To explore gender differences and similarities on personal, employment and work-life factors and predictors of job satisfaction among registered nurses in rural and remote Canada. BACKGROUND Research suggests that men and women are attracted to nursing for different reasons, with job security, range of employment opportunities and wages being important for male nurses. METHODS Using data from a large national survey of registered nurses in rural and remote Canada, descriptive and multiple linear regression analyses were used to identify gender differences and similarities. RESULTS A larger proportion of male nurses reported experiencing aggression in the workplace. Age, annual gross income and colleague support in medicine were not found to be predictors of work satisfaction for the male nurses, although they were for women. CONCLUSION There are more similarities than differences between male and female registered nurses in factors that affect job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT Nursing management needs to increase their awareness of the potential for workplace aggression towards male registered nurses and to explore the perceptions of interpersonal interactions that affect satisfaction in the workplace.

Nurses who work in rural and remote communities in Canada: a national survey

BackgroundIn 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.MethodsA 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 territories, living outside of the commuting zones of large urban centers and in the north of Canada.ResultsRural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses’ levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region.ConclusionsThe proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

Exploratory factor analysis and reliability of the Primary Health Care Engagement (PHCE) Scale in rural and remote nurses: findings from a national survey

Aim The study purpose was to provide evidence of validity for the Primary Health Care Engagement (PHCE) Scale, based on exploratory factor analysis and reliability findings from a large national survey of regulated nurses residing and working in rural and remote Canadian communities. BACKGROUND There are currently no published provider-level instruments to adequately assess delivery of community-based primary health care, relevant to ongoing primary health care (PHC) reform strategies across Canada and elsewhere. The PHCE Scale reflects a contemporary approach that emphasizes community-oriented and community-based elements of PHC delivery. METHODS Data from the pan-Canadian Nursing Practice in Rural and Remote Canada II (RRNII) survey were used to conduct an exploratory factor analysis and evaluate the internal consistency reliability of the final PHCE Scale. Findings The RRNII survey sample included 1587 registered nurses, nurse practitioners, licensed practical nurses, and registered psychiatric nurses residing and working in rural and remote Canada. Exploratory factor analysis identified an eight-factor structure across 28 items overall, and good internal consistency reliability was indicated by an α estimate of 0.89 for the final scale. The final 28-item PHCE Scale includes three of four elements in a contemporary approach to PHC (accessibility/availability, community participation, and intersectoral team) and most community-oriented/based elements of PHC (interdisciplinary collaboration, person-centred, continuity, population orientation, and quality improvement). We recommend additional psychometric testing in a range of health care providers and settings, as the PHCE Scale shows promise as a tool for health care planners and researchers to test interventions and track progress in primary health care reform.