Nurse Staffing and Workload Drivers in Small Rural Hospitals: An imperative for Evidence

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

“…The lowest job resources mean subscale score found in our analysis was for "Staffing and Time," indicating that nurse participants had a lower level of agreement about having an appropriate mix of support staff, or adequate time to provide comprehensive care, an area of concern commonly identified across the nursing literature, both rural and urban (Shamian, Kerr, Laschinger, & Thomas, 2002;Twigg, Cramer, & Pugh, 2016). When exploring demands in our analysis, "Safety" demonstrated the highest level of agreement for the participants, indicating that their greatest demand was related to their safety being at risk both in their workplace and when off-duty.…”

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

“…Workplace stressors were found to be an important factor that was mentioned in all included studies (Jondhale & Anap, ; Kidd et al, ; LeSergent & Haney, ; Medves et al, ; Molinari & Monserud, ; Penz et al, ). Patient census and acuity levels rise and fall rapidly in rural hospitals and as such there are difficulties in predicting staff requirements (Hunsberger et al, ; Twigg et al, ). Staff are often required to work across several areas of practice and must be flexible in the hours they work.…”

“…Rural nurses often work with limited resources, variable staffing patterns and with unpredictable patient census and acuity levels (Hunsberger, Baumann, Blythe, & Crea, 2009;Twigg, Cramer, & Pugh, 2016). Nurses employed in rural hospitals are often required to take on additional, unplanned responsibilities, new or expanded roles and work across various clinical areas such as emergency, medical, maternity and mental health (Schlairet, 2017).…”

Nursing care left undone, practice environment and perceived quality of care in small rural hospitals

“…Hospitals are an integral part of Australian rural communities. Not only are they often the largest employer in the area, but also they are usually the sole provider of health care to rural communities (Twigg, Cramer, & Pugh, 2016). Health care in rural hospitals is provided largely by nurses who need to have a broad skill set and the ability to work autonomously with limited medical and allied health support (Baernholdt & Mark, 2009).…”