Aims
To examine determinants of intention to leave a nursing position in rural and remote areas within the next year, for Registered Nurses or Nurse Practitioners (RNs/NPs) and Licensed Practical Nurses (LPNs).
Design
A pan‐Canadian cross‐sectional survey.
Methods
The Nursing Practice in Rural and Remote Canada II survey (2014–2015) used stratified, systematic sampling and obtained two samples of questionnaire responses on intent to leave from 1,932 RNs/NPs and 1,133 LPNs. Separate logistic regression analyses were conducted for RNs/NPs and LPNs.
Results
For RNs/NPs, 19.8% of the variance on intent to leave was explained by 11 variables; and for LPNs, 16.9% of the variance was explained by seven variables. Organizational commitment was the only variable associated with intent to leave for both RNs/NPs and LPNs.
Conclusions
Enhancement of organizational commitment is important in reducing intent to leave and turnover. Since most variables associated with intent to leave differ between RNs/NPs and LPNs, the distinction of nurse type is critical for the development of rural‐specific turnover reduction strategies. Comparison of determinants of intent to leave in the current RNs/NPs analysis with the first pan‐Canadian study of rural and remote nurses (2001–2002) showed similarity of issues for RNs/NPs over time, suggesting that some issues addressing turnover remain unresolved.
Impact
The geographic maldistribution of nurses requires focused attention on nurses' intent to leave. This research shows that healthcare organizations would do well to develop policies targeting specific variables associated with intent to leave for each type of nurse in the rural and remote context. Practical strategies could include specific continuing education initiatives, tailored mentoring programs, and the creation of career pathways for nurses in rural and remote settings. They would also include place‐based actions designed to enhance nurses' integration with their communities and which would be planned together with communities and nurses themselves.
A program-centered approach to implementation of an eOSCE management system supports high-quality, efficient assessment of student clinical competencies. [J Nurs Educ. 2018;57(8):502-505.].
With the wide range of clinical skills and responsibilities that home care nurses (HCNs) are expected to perform, it is important they are supported with access to relevant continuing nursing education (CNE) to perform their job safely and effectively. An integrative literature review was conducted to explore the current evidence on CNE for HCNs. Medline and CINAHL were searched and 13 articles that met the criteria were reviewed. The analysis identified three themes: (1) learning strategies (simulation, virtual gaming, elearning, traditional learning); (2) challenges (staffing, time, access, skill) and opportunities (incentive to stay employed, decreased burnout); and (3) learning needs (palliative, patient and family needs, older adults and dementia, acute nursing skills). Nurses who provide care to patients in their homes have very complex roles and responsibilities. In order to keep patients and nurses safe, standards of education for HCNs, beyond their basic education program, must be developed. These educational standards must be designed to address the complex medical needs of patients while making the educational opportunities accessible and value-added. Improving the CNE experience for HCNs has the potential to increase patient safety, improve care outcomes, increase nurse competence, improve retention, and decrease nurse burnout.
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