Northern nursing practice in a primary health care setting

Abstract

The nurses in this study saw building trust to promote health and well-being in communities as very important, yet very difficult to achieve. The difficulty in part stems from the constraining, structural, administrative, historical, cultural and political contextual realities that have shaped northern community nursing.

Providers’ perceptions of barriers to the management of type 2 diabetes in remote Aboriginal settings

“…Two studies have investigated the barriers to providing care as perceived by health care providers in similar settings to this study (11,12). One study focused on the general experience of nurses working in northern settings (11), while the other examined issues related to continuity of care in Northwestern Ontario (12).…”

Clinical encounters in Canada's northern territories: implications for nurse practitioners working with aboriginal women to promote sexual health

“…In communities where there are high rates of turnover and where it is difficult to recruit NPs for long term employment periods, it is increasingly difficult to maintain practice excellence. According to Vukic and Keddy (2002), in a study of the nature of northern nursing and the day-to-day realities of nursing practice in a primary care setting, the estimated length of employment for nurses is from three to thirty two months with turnover rates of eighty percent. The reasons for the high rates of turnovers were lack of adequate preparation, isolation, and growing employment opportunities in the south.…”

“…A critical examination of the literature reveals that while NPs are identified as main health care professionals in northern communities, there is very little literature regarding how NPs can and do address the broader issues of inequalities and social concerns in clinical practice (Vukic & Keddy, 2002;Tarlier et al, 2003). An article by Browne and Tarlier (2008) speaks to the evidence that suggests that important indicators of health have the potential to be compromised when NPs provide primary care within a relatively narrow model of care, often at the expense of providing care that is contextualized in relation to social determinants.…”

“…An article by Browne and Tarlier (2008) speaks to the evidence that suggests that important indicators of health have the potential to be compromised when NPs provide primary care within a relatively narrow model of care, often at the expense of providing care that is contextualized in relation to social determinants. Other research done by Vukic and Keddy (2002) demonstrates that the skills and competencies needed by NPs to promote social determinants of health and community development are often invisible. The emphasis is on the management of acute care and the focus on health remains narrow and biomedical in nature.…”

“…Unfortunately the discussion in the literature has remained largely theoretical rather than practical (Anderson et al, 2003;Browne, 2005;Browne & Tarlier, 2008;Reimer Kirkham & Browne, 2006;Vukic & Keddy, 2002). One exception found is a study done by Martin Misener et al (2008) in which outpost nurses spoke to the need for nurse who were new to remote nursing to take time to learn the uniqueness of each community, culture and workplace.…”