Reducing occupational stress among registered nurses in very remote Australia: A participatory action research approach

Abstract

a b s t r a c tBackground: Nurses in very remote areas of Australia (RANs), work in complex and isolated settings for which they are often inadequately prepared, and stress levels are high. This paper, based on the 'Back from the edge' project, evaluates the development and implementation of an intervention to reduce and prevent the impact of occupational stress in the RAN workforce in the Northern territory. Methods: The methods involved a combined participatory action research/organisational development model, involving seven steps, to develop and implement system changes within the (then) Northern Territory Department of Health and Families (NTDH&F). The development, implementation and evaluation was informed via information from participants collected during workshops and interviews. Pre and post surveys were undertaken to evaluate the study. Results: Occupational stress interventions developed by the workgroups were categorised into four main groups: (1) remote context, (2) workload and scope of practice, (3) poor management, and (4) violence and safety concerns. The main interventions centred on promoting a well educated, stable workforce. There were very few measurable changes as a result of the interventions as many were not able to be implemented in the time period of the study, but implementation is continuing. Conclusion: While the outcome evaluations showed few effects, the study through consensus approaches, provides a blueprint for reducing stress among remote area nurses and evidence which should inform policy and practice with respect to service delivery in remote areas.

Employee voice in a semi‐rural hospital: impact of resourcing, decision‐making and culture

“…Given the high demand and under-resourced environment of the semi-rural hospital, organisational culture may potentially be the key to providing employees the opportunities to have a voice and the organisational support required of healthcare professionals. For example, in their study of occupational stress among nurses working in remote areas, Lenthall et al (2018) suggested that 'system capacity factors' such as the climate for worker psychological health, flexible/adaptable culture, consultation and preparation, and communication systems, could influence demands and resources. Indeed, remote work, social isolation and lack of support were key factors impacting occupational stress of nurses working in remote areas of Australia (Opie et al 2010).…”

More than just numbers! Perceptions of remote area nurse staffing in Northern Territory Government health clinics

“…Significantly, RANs experience high levels of psychological distress and emotional exhaustion . Lenthall et al suggest that RANs have reported a lack of staff, being tired of orienting new staff, being concerned about the capability of in‐coming short‐term staff, being concerned about the continuity of care and feeling that remote communities can be demanding, detract from the RAN role. RANs have also reported being overwhelmed by the work and the after‐hours on‐call duty for emergency care .…”

“…Research, relating to the recruitment and staffing of RANs, has focused primarily on the views of RANs . This paper investigates the perspectives of RAN workforce issues among multiple stakeholders.…”

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

“…There appears to be a relationship between various job demands/resources and nurses’ overall well‐being in their workplaces. With few exceptions (Lenthall et al, ), the majority of these studies involving nurses have been hospital‐based and use a limited set of researcher‐defined indicators of both job demands and resources, with less reliance on psychometrically sound and integrated measures. This article describes the development, pilot testing and psychometric evaluation of two new scales measuring the global (i.e., applicable to a broad range of nursing designations and practice settings) Job Resources in Nursing (JRIN) and Job Demands in Nursing (JDIN) as part of a nationwide cross‐sectional survey involving nurses in a wide range of workplaces in rural and remote communities.…”