The NSW rural allied health workforce is strongly feminised, mature and experienced. Recruitment should target rural high school students and promote positive aspects of rural practice, such as diversity and autonomy. Retention strategies should include flexible employment options and career development opportunities.
Objective Combined, nursing and allied health constitute most of the Australian health workforce; yet, little is known about graduate practice destinations. University Departments of Rural Health have collaborated on the Nursing and Allied Health Graduate Outcomes Tracking to investigate graduate entry into rural practice. Design Data linkage cohort study. Setting Monash University and the University of Newcastle. Participants Graduates who completed their degree in 2017 across seven disciplines. Main outcome measure(s) The outcome variable was Australian Health Practitioner Regulation Agency principal place of practice data. Explanatory variables included discipline, age, gender, location of origin, and number and duration of rural placements. Result Of 1130 graduates, 51% were nurses, 81% females, 62% under 21 years at enrolment, 23% of rural origin, 62% had at least one rural student placement, and 23% had over 40 cumulative rural placement days. At the time of their second Australian Health Practitioner Regulation Agency registration, 18% worked in a ‘Rural principal place of practice.’ Compared to urban, rural origin graduates had 4.45 times higher odds ratio of ‘Rural principal place of practice.’ For graduates who had <20 cumulative rural placement days, compared to zero the odds ratio of ‘Rural principal place of practice’ was the same (odds ratio = 1.10). For those who had 20‐40 rural placement days, the odds ratio was 1.93, and for >40 rural placement days, the odds ratio was 4.54). Conclusion Rural origin and more rural placement days positively influenced graduate rural practice destinations. Outcomes of cumulative placements days may compare to immersive placements.
With increasing interest and research into interprofessional learning, there is scope to more deeply understand what happens when students from different professions live and study in the same location. This study aimed to explore the issue of co-location and its effects on how students learn to work with other professions. The setting for this study was a rural health education facility in Australia with close links to local health care and community services. Philosophical hermeneutics informed the research method. Interviews were undertaken with 29 participants, including students, academic educators and clinical supervisors in diagnostic radiography, medicine, nursing, nutrition and dietetics, pharmacy, physiotherapy, occupational therapy, and speech pathology. Photo-elicitation was used to facilitate participant engagement with the topic. The findings foreground the value of interprofessional rapport building opportunities for students learning to work together. Enabled by the proximity of different professions in shared educational, clinical and social spaces, interprofessional rapport building was contingent on contextual conditions (balance of professions, shared spaces and adequate time) and individual's interpersonal capabilities (being interested, being inclusive, developing interpersonal bonds, giving and receiving respect, bringing a sense of own profession and being patient-centred). In the absence of these conditions and capabilities, negative professional stereotypes may be inadvertently re-enforced. From these findings suggestions are made for nurturing interprofessional rapport building opportunities to enable students of different professions to learn to work together.
We identified four stages: (1) making career choices; (2) being attached to place; (3) taking up rural practice; and (4) remaining in rural practice. This is termed the 'rural pipeline'. However, as some stages of the 'rural pipeline' refer specifically to the medical profession, we propose an extension of the notion of the medical 'rural pipeline' to include other professions such as nursing, midwifery and allied health. CONCLUSIONS. Utilising the 'rural pipeline' as a template for medicine, nursing and allied health would strengthen current approaches to the recruitment and retention of professionals in rural areas and provide a consolidated evidence base that would assist in policy development to improve availability and service provision of the rural health workforce. Future research that utilises a multidisciplinary approach could explore how the role and relationship between place and identity shape needs of career choices and would provide important information to advance the practical aspects supporting rural health career pathways.
Limited research is available on the relationship between objective sleep patterns and pain in children with SCD. Research in other chronic pain populations suggests that the effect of sleep disruption on pain may be stronger than the effect of pain on sleep that night. To examine the bi-directional relationship between objective sleep patterns and daily pain in a pediatric SCD sample. Participants were 30 African American children with SCD 8-18 years (13 ± 2.8 years; 66.7% female) with frequent pain. Children and parents completed questionnaires to assess pain, medications, and depression/anxiety. Over a 14-day period, children completed a pain diary and ambulatory actigraphy monitoring to assess nighttime sleep (duration, efficiency and WASO). Greater pain severity was associated with worse sleep efficiency and greater WASO that night, controlling for age, sex, opioid medication, and depression/anxiety symptoms. Worse sleep efficiency was associated with the occurrence of pain and more severe pain the next day. There was no relationship between WASO and pain. Similarly, sleep duration did not influence pain. Results lend support for a bi-directional relationship between sleep parameters and daily pain in pediatric SCD, and identify sleep as a potential target for future research and intervention.
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