From expert generalists to ambiguity masters: using ambiguity tolerance theory to redefine the practice of rural nurses

Abstract

A greater understanding of rural nurse practice will assist in achieving positive care outcomes in an environment with competing stakeholder needs, and limited resources and options for care.

Rural and Remote Registered Nurses' Perception of Working Beyond Their Legislated Scope of Practice

“…Our findings support Knight et al's (2016) contention that the ways in which rural RNs are embedded within their community and geographical contexts lends additional complexity to rural RNs' scope of practice. These "complex contextual factors … push rural nurses to work outside organisational and professional boundaries and processes" (Knight et al 2016(Knight et al : 1759. This complexity was echoed by open-ended data from an RN in the RRNII study:…”

“…These RNs provided healthcare to the 17% of Canada's population who live in rural locations in the provinces and 52% of those who live in rural locations in the territories (Canadian Institute for Health Information 2017). Rural and remote nurses' practice is generalist and complex (Knight et al 2016) with high levels of autonomy (Birks et al 2016;Kulig et al 2013) and requires well-honed problem-solving skills (Kulig et al 2013). This broad scope of practice is because of geographic isolation, low population density, few resources, limited support and the requirement to address both workplace and community demands (Fowler et al 2018;MacLeod et al 2008;Martin-Misener et al 2008).…”

Nurses’ experiences of working in rural hospitals: An integrative review

“…Nurses employed in rural hospitals are often required to take on additional, unplanned responsibilities, new or expanded roles and work across various clinical areas such as emergency, medical, maternity and mental health (Schlairet, 2017). This diversity and complexity of clinical practice is why rural nurses are often referred to as "expert generalists" and requires nurses to have a strong theoretical and practical knowledge base (Dotson, Dave, Cazier, & McLeod, 2013;Kenny & Duckett, 2003;Knight, Kenny, & Endacott, 2016). Rural nurses often work within a broad scope of practice and often work independently or with limited backup which can contribute to a heavy and potentially stressful workload (Dotson et al, 2013;Hunsberger et al, 2009).…”

Nursing Interfaces in Rural Care: An Integrative Review

“…The studies [28][29][30][31][32][33][34][35] identified that the activities developed by rural nursing range from the care function, such as a home visit, nursing consultation and management activities; to educational activities, such as activities with community groups. For this, the professional needs to have specialized skills and competences on the health inequalities experienced by communities; rural bioethics; political awareness; creativity and assertive communication.…”