Mental Health Provision in Northern Canada: Practitioners’ Views on Negotiations and Opportunities in Remote Practice

O’Neill, Linda; Koehn, Corinne; George, Serena; Shepard, Blythe

doi:10.1007/s10447-016-9261-z

Cited by 7 publications

(11 citation statements)

References 24 publications

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“…In previous research on predictors of intent to leave a nursing (RN) position in rural and remote Canada (Stewart et al, ), three of eleven significant predictors were working in a remote setting, performing advanced decisions in practice and being required to be on‐call. Remote practitioners have described themselves as working on the edge of their competence, with the potential for differences between some practitioners who equate experience with education, while others may feel inferior to those with more formal training (O'Neill, Koehn, George, & Shepard, ). This finding highlights the importance of attending to nurses’ perceptions of their level of competence rather than assuming their competence based on the potential degree of independence in their practice.…”

Section: Discussionmentioning

confidence: 99%

“…Remote practitioners have described themselves as working on the edge of their competence, with the potential for differences between some practitioners who equate experience with education, while others may feel inferior to those with more formal training (O'Neill, Koehn, George, & Shepard, 2016). This finding highlights the importance of attending to nurses' perceptions of their level of competence rather than assuming their competence based on the potential degree of independence in their practice.…”

Section: Discussionmentioning

confidence: 99%

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

Penz

Stewart

Karunanayake

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To empirically test a conceptual model of confidence and competence in rural and remote nursing practice. Background The levels of competence and confidence of nurses practising in rural settings have been highlighted as essential to the quality of health outcomes for rural peoples. However, there is limited research exploring these constructs in the context of rural/remote nursing practice. Design Structural equation modelling was used to verify the conceptual model with data from the cross‐sectional pan‐Canadian Nursing Practice in Rural and Remote Canada II Survey. The STROBE guidelines for cross‐sectional research were followed in the design/reporting of this analysis. The sample consisted of 2,065 registered nurses and nurse practitioners who were working in direct rural/remote nursing practice. Results The maximum likelihood ratio χ2 = 0.0822, df = 2, p = 0.959 indicated model fit, with final model estimates explaining 53% of the variance in work confidence and 17% of the variance in work competence. The model also accounted for 40% of the variance in work engagement, 39% of the variance in burnout and 15% of the variance in perceived stress. The complexity of competence and confidence in rural nursing practice was evident, being influenced by nursing experience in rural settings, rural work environment characteristics, community factors and indicators of professional well‐being. Conclusions The factors influencing nurses’ competence and confidence in rural/remote nursing practice are more complex than previously understood. Our model, created and tested using structural equation modelling, merits further research, to extend our understanding of how nurses can be prepared and supported for practice in rural and remote settings. Relevance to clinical practice This study highlights the importance of supporting new nurses’ exposure to rural nursing experiences, reducing professional isolation and improving decision‐making support for those who are working at a greater distance from colleagues and/or those with fewer opportunities for interprofessional collaboration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Penz

Stewart

Karunanayake

et al. 2019

Journal of Clinical Nursing

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“…Treatments, both medically and behaviourally, have the capacity to enhance the child's long-term outcome and their families' quality of life. Access to services can be costly and limited with issues linked to rurality (O'Neill, Koehn, George & Shepard, 2016). In British Columbia (BC), government funding for interventional services is approved after a child receives an ASD diagnosis (Ministry of Children and Family Development [MCFD], 2017).…”

Section: Asd Medical Managementmentioning

confidence: 99%

Primary care strategies for supporting parents of children with suspected autism spectrum disorder

Salih¹

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ASD is a complex neurobiological disorder requiring early childhood intervention to mitigate effects on overall quality of life. Without early intervention, individuals and families are impacted socially, emotionally and economically. In BC, wait lists for a formal assessment and diagnosis are longer than a year. Parents of children with suspected ASD are often left in an anticipatory waiting phase once ASD is suspected. They require guidance on learning what ASD is, developing knowledge about treatment approaches, and determining what resources and supportive measures are available to them. The mainstay approach to assessment is initially via a primary care provider. As such, the primary care provider (PCP) is the first source of guidance when concerns about a child are raised, and is responsible for referring the child for diagnosis, and providing parents direction on where to obtain interventional therapies. However, there is limited guidance on how to support parents during the anticipatory period of time between suspicion of symptoms and diagnosis. The aim of this project is to explore strategies that enable PCPs when caring for parents of children with suspected ASD. An integrative literature review was conducted, which included ten carefully selected articles. Two major themes were identified, which focused on concepts of knowledge and communication. Knowledge linked to the PCP included the need for up-to-date developmental, clinical, communication understanding and tacit knowledge. Communication is essential during waiting and early diagnosis, and in aspects of PCP availability, multidisciplinary collaboration and supportive decision-making. These key aspects help to prepare families to flourish in their recreation of family life. Attention to parent health and wellbeing is critical, as is the need to discuss difficult topics such as emotional stress and service limitations. Patient and family centred care (PFCC) is reported as a health care model that illuminates the importance of respect, rapport and trust, while affording accord, equity and collaboration. Using the PFCC model as a polestar, the PCP can navigate care focusing on cocreating longer term relationships between primary care, parents, interventions teams and early education partners.

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“…Another type of trauma is secondary trauma which refers to the concept that one can experience symptoms from traumatic events that did not directly happen to them by being exposed to others' horrific, traumatic stories repeatedly (O'Neill, Koehn, & George, 2016).…”

Section: Traumamentioning

confidence: 99%

“…This effect is typically seen in therapists or other workers who have a high case load of clients with trauma. The effects present in the helper or worker appear as feelings of hopelessness, sadness and fear (O'Neill, Koehn, & George, 2016).…”

Section: Traumamentioning

confidence: 99%

Faculty experiences of students in distress on Canadian post-secondary campuses

Giardino¹

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What started as a project to discern faculty members' preferred role in working with students in distress has turned into a discovery of student challenges on post-secondary campuses including but not limited to trauma, Indigenization, barriers affecting non-traditional students and other discussions including faculty self-care. This research was prompted by the Canadian Association of College and University Student Services' (CACUSS) recommendations for faculty involvement in creating healthier campuses with specific reference to mental health. Seven faculty members from a four-year university and two-year college within a northern Canadian community volunteered to participate in semi-structured interviews on their experiences with students in distress. The interviews were coded and analyzed using a thematic analysis. The emergent themes were common humanity, passion, concern and frustration. The author proposes post-secondary institutions look at adopting trauma-informed approaches to building policy, procedures and campus environments to address mental wellness and distress for all campus community members; students, staff and faculty alike.

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Mental Health Provision in Northern Canada: Practitioners’ Views on Negotiations and Opportunities in Remote Practice

Cited by 7 publications

References 24 publications

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

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

Primary care strategies for supporting parents of children with suspected autism spectrum disorder

Faculty experiences of students in distress on Canadian post-secondary campuses

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