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

Smith, Stuart F.; Sim, Jenny; Halcomb, Elizabeth

doi:10.1111/jonm.12716

Cited by 31 publications

(27 citation statements)

References 45 publications

(129 reference statements)

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“…The present study's ndings further indicated that the odds ratio of nurses within 1 year work experience were about four fold as likely to indicate intention to stay in their current job as compared to their counterparts with 5~10 years of experience in nursing (Table 4). Such ndings are also in accordance with previously reported studies in the literature [24]. Sociocultural factors associated with the role of experienced workers in society may also play a role in enhancing the job retention of nurses [25].…”

Section: Discussionsupporting

confidence: 93%

Exploring Factors Influencing Retention of Nurses in a Religious Hospital in Taiwan: A Cross-Sectional Quantitative Study

Chiao

Tzeng

et al. 2020

Preprint

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Background: Long-term shortages in the nursing workforce and high turnover rates are common in Taiwan medical industry. Little research has investigated the psychological factors associated with retention of nursing staff. However, in practice, religious hospitals often provide education in medicine or the medical humanities to enhance psychological satisfaction. The objective of this study was to explore factors influencing nursing staff’s retention with their work across different levels of demand. A further objective was to investigate whether medical humanities educations were associated with the retention of nursing staff. Methods: This study used s elf-administrated questionnaires to survey nurses working in northern areas of Taiwan. The questionnaire design was based on the six levels of Maslow's hierarchy of needs. Participation was voluntary and participants signed informed consent documents. Self-administrated questionnaires were administered by contacting a total of 759 participants; 729 questionnaires were returned (response rate 96.04%). A logistic regression analysis was used to estimate the impact of seniority of nursing work on nurses reported intention to stay after adjusting for nurse characteristics (gender and age). Results: In the Pearson correlation analysis, nurses’ willingness to stay was moderately correlated with “physical needs”, “safety needs”, “love and belonging needs”, and “esteem needs” (r=0.559, P<0.001 ; r=0.533, P<0.001 ; r=0.393, P<0.001 ; r=0.476, P<0.001, respectively). Furthermore, nurses’ willingness to stay was highly correlated with “self-actualization needs”, “behind self-actualization needs” and “medical humanities education relevant” (r=0.707, P<0.001 ; r=0.728, P<0.001 ; r=0.678, P<0.001, respectively). We found that the odds ratio (OR) of retention of nursing staff who worked within 1 year (OR=4.511, P=0.002 ) and 1-3 years (OR=3.248, P=0.003 ) was significantly higher referred to those who worked 5-10 years. Conclusions: With regard to medical humanities education, we recommend adjusting the training as the compulsory activities under the official programs are inadequate and adjusting the required hours of medical humanities education. Tailoring different educational programs for different groups (especially for the groups of nurses who have worked 3-5 years and 5-10 years in the case study hospital) might improve acceptance by nursing staff

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Section: Discussionsupporting

confidence: 93%

Exploring Factors Influencing Retention of Nurses in a Religious Hospital in Taiwan: A Cross-Sectional Quantitative Study

Chiao

Tzeng

et al. 2020

Preprint

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“…One of the main incentives used to recruit and retain health workers in remote areas is by offering continued professional development (CPD), sometimes virtually [21,73,105]. CPD is the second reason why recruits choose rural programs in Australia, after financial incentives [106].…”

Section: Non-financial Incentivesmentioning

confidence: 99%

“…The aim of having support systems and group practices is to reduce burdens and isolation. It is one of the highest predictors of job satisfaction and retention in rural areas [105]. Professional support was also one of the main enablers of considering rural practice for dental students in Canada [107].…”

Section: Non-financial Incentivesmentioning

confidence: 99%

Human resources for health interventions in high- and middle-income countries: findings of an evidence review

et al. 2020

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Many high-and middle-income countries face challenges in developing and maintaining a health workforce which can address changing population health needs. They have experimented with interventions which overlap with but have differences to those documented in low-and middle-income countries, where many of the recent literature reviews were undertaken. The aim of this paper is to fill that gap. It examines published and grey evidence on interventions to train, recruit, retain, distribute, and manage an effective health workforce, focusing on physicians, nurses, and allied health professionals in high-and middle-income countries. A search of databases, websites, and relevant references was carried out in March 2019. One hundred thirty-one reports or papers were selected for extraction, using a template which followed a health labor market structure. Many studies were cross-cutting; however, the largest number of country studies was focused on Canada, Australia, and the United States of America. The studies were relatively balanced across occupational groups. The largest number focused on availability, followed by performance and then distribution. Study numbers peaked in 2013-2016. A range of study types was included, with a high number of descriptive studies. Some topics were more deeply documented than others-there is, for example, a large number of studies on human resources for health (HRH) planning, educational interventions, and policies to reduce in-migration, but much less on topics such as HRH financing and task shifting. It is also evident that some policy actions may address more than one area of challenge, but equally that some policy actions may have conflicting results for different challenges. Although some of the interventions have been more used and documented in relation to specific cadres, many of the lessons appear to apply across them, with tailoring required to reflect individuals' characteristics, such as age, location, and preferences. Useful lessons can be learned from these higher-income settings for low-and middle-income settings. Much of the literature is descriptive, rather than evaluative, reflecting the organic way in which many HRH reforms are introduced. A more rigorous approach to testing HRH interventions is recommended to improve the evidence in this area of health systems strengthening.

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“…26 Further to this, nurses asked to work outside their conscience are at risk of burnout and injury through the psychological and negative physical health effects of moral distress. 2 Given the staffing issues in this scenario, consistent with the experience of many rural and remote care settings, 27 risking the health of a nurse through moral injury in an already staffing-challenged unit or area could compromise the care of many other residents.…”

Section: Data and Moral Claimsmentioning

confidence: 97%

Conscientious objection to medical assistance in dying in rural/remote nursing

Panchuk

Thirsk

2021

Nurs Ethics

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In 2016, the Supreme Court of Canada legalized medical assistance in dying in Canada. Similar to jurisdictions where this has been a more long-standing option for end-of-life care, the Supreme Court’s decision in Canada included a caveat that no healthcare provider could be compelled to participate in medical assistance in dying. The Canadian Nurses Association, in alignment with numerous ethical guidelines for healthcare providers around the globe, maintains that nurses may opt out of participation in medical assistance in dying if they conscientiously object to this procedure. The realities of implementing medical assistance in dying are still unfolding. One area that has received little attention in the literature thus far is the ability of nurses who aid with, rather than administer, medical assistance in dying to conscientiously object. This is particularly significant in rural and remote areas of Canada where geographic dispersion and limited numbers of nursing staff create conditions that limit the ability to transfer care or call on a designated team. Exercising conscientious objection to medical assistance in dying in rural and remote areas, by way of policies developed with an urban focus, is one example of how the needs of rural nurses and patients may not be met, leading to issues of patient access to medical assistance in dying and retention of nursing staff. To illustrate the complexities of nurses’ conscientious objection to medical assistance in dying in a rural setting, we apply an ethical decision-making framework to a hypothetical case scenario and discuss the potential consequences and implications for future policy. Realizing that conscientious objection may not be a viable option in a rural or remote context has implications for not only medical assistance in dying, but other ethically sensitive healthcare services as well. These considerations have implications for policy in other jurisdictions allowing or considering medically assisted deaths, as well as other rural and remote areas where nurses may face ethical dilemmas.

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

Abstract: This review highlights some key issues impacting nurses' working in rural hospitals. This understanding can be used by nurse managers to inform strategies for recruitment and retention of nurses in these areas.

Cited by 31 publications

References 45 publications

Exploring Factors Influencing Retention of Nurses in a Religious Hospital in Taiwan: A Cross-Sectional Quantitative Study

Exploring Factors Influencing Retention of Nurses in a Religious Hospital in Taiwan: A Cross-Sectional Quantitative Study

Human resources for health interventions in high- and middle-income countries: findings of an evidence review

Conscientious objection to medical assistance in dying in rural/remote nursing

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