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

Abstract

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.

Development and psychometric evaluation of the Job Demands in Nursing Scale and Job Resources in Nursing Scale: Results from a national study

“…The data used to analyse the factor structure of the JRIN and JDIN scales were from a nationwide cross‐sectional study, the Nature of Nursing Practice in Rural and Remote Canada II involving 3,822 registered nurses (RNs), nurse practitioners (NPs), licensed or registered practical nurses (LPNs) and registered psychiatric nurses (RPNs; MacLeod et al, ). The 27‐page national survey questionnaire included five main sections of individual, community, workplace, nursing practice and personal/professional well‐being and was designed to develop a better understanding of factors influencing the occupational outcomes for nurses in rural/remote communities across Canada (MacLeod et al, ). Descriptive statistics were used to analyse the demographic characteristics of the national level data for the JRIN and the JDIN factor analysis subsamples.…”

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

“…Despite the crucial role nurses play in the delivery of health care in rural hospitals, research and health policy are often focussed on the issues of recruitment and retention of the medical workforce (Kenny & Duckett, ; MacLeod et al, ; Pearson, ). Whilst there is no denying the importance of medical services in rural areas, the recruitment and retention of nurses is crucial to solving the healthcare shortages in rural areas (Pearson, ).…”

“…Despite the crucial role nurses play in the delivery of health care in rural hospitals, research and health policy are often focussed on the issues of recruitment and retention of the medical workforce (Kenny & Duckett, 2003;MacLeod et al, 2017;Pearson, 2008).…”

Competence and confidence in rural and remote nursing practice: A structural equation modelling analysis of national data

“…The data used to test the proposed model were from a pan‐Canadian study “Nursing Practice in Rural and Remote Canada II” (RRNII) (MacLeod et al, ), with results reported according to the STROBE guidelines for cross‐sectional studies. The RRNII national survey questionnaire totalled 27 pages and consisted of five main sections of individual characteristics, work community, workplace, nursing practice and personal/professional well‐being.…”

“…The STROBE guidelines for cross-sectional research were followed in the design/reporting of this study (von Elm et al, 2008) (See Supporting Information File S1). Details on the full survey methodology are available elsewhere (MacLeod et al, 2017). See Table 1 for sample characteristics for the present analysis.…”