There is insufficient theory development within community health nursing that addresses the community as a collective and not simply as groupings of aggregates. Conceptual clarification of nursing's domains is needed, however, before theory development can take place. In an attempt to rectify this situation, this article discusses the environment domain. Community resiliency, or the ability of a community to deal with adversity and in so doing reach a higher level of functioning, is presented as a useful framework to gain greater understanding of this particular domain. Findings from research that have resulted in a community resiliency model for describing the environment domain, within which rural-based community health nurses (CHNs) work, are presented. The relevance for community health nursing theory is included with recommendations for future research and subsequent theory development.
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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-017-0209-0) contains supplementary material, which is available to authorized users.
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