The Limerick Declaration on Rural Health Care 2022.

The 19th World Rural Health Conference, hosted in rural Ireland and the University of Limerick, with over 650 participants coming from 40 countries and an additional 1600 engaging online, has carefully considered how best rural communities can be empowered to improve their own health and the health of those around them. The conference also considered the role of national health systems and all stakeholders, in keeping with the commitments made through the Sustainable Development Goals and the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being. This conference declaration, the Limerick Declaration on Rural Healthcare, is designed to inform rural communities, academics and policymakers about how to achieve the goal of delivering high quality health care in rural and remote areas most effectively, with a particular focus on the Irish healthcare system. Congruent with current evidence and best international practice, the participants of the conference endorsed a series of recommendations for the creation of high quality, sustainable and cost-effective healthcare delivery for rural communities in Ireland and globally. The recommendations focused on four major themes: rural healthcare needs and delivery, rural workforce, advocacy and policy, and research for rural health care. Equal access to health care is a crucial marker of democracy. Hence, we call on all governments, policymakers, academic institutions and communities globally to commit to providing their rural dwellers with equitable access to health care that is properly resourced and fundamentally patient-centred in its design.

The NURSING-Positive Recruitment Arabic Model (NURS-P.R.A.M.): A mixed methods study.

AIM: To identify factors influencing high school students' choice of nursing and explore strategic interventions to promote nursing as a career in the Arab region. BACKGROUND: This study forms part of a PhD thesis, conducted in Bahrain, in a healthcare environment with a high dependence on expatriate nurses to maintain nursing services. However, in attracting local candidates to study nursing, the public image of nursing in the Middle East must be improved by implementing strategies that are sensitive to the Arabic culture. DESIGN: A mixed methods approach incorporating quantitative and qualitative dimensions. METHODS: Data were collected between 2012 - 2015 using self-administered questionnaires, semi-structured interviews, focus groups, and written narratives. The study sample included high school students, parents, career guidance counsellors, and nursing students. A one-group pre-test posttest design was used to introduce a nursing recruitment intervention to high school students. spss was used to analyse quantitative data. Colaizzi's () and Krueger's () frameworks were applied to analyse the qualitative data. FINDINGS: It is proposed that the public perceptions of Arab people about nursing may be grounded in strong cultural influences and any efforts to improve the enrolment and retention of local nurses should consider enhancing the social values of the nursing profession. The NURSING-Positive Recruitment Arabic Model incorporates essential elements which will guide nursing recruitment in the Arabic cultures. CONCLUSION: The study findings reflect certain issues similar to the core international literature on nursing recruitment, however there are fundamental issues particular to the Arab region, which must be included in the development of a nursing recruitment strategy for Arabic nursing.

Factors deterring dentistry, medical, pharmacy, and social science undergraduates from pursuing nursing as a healthcare career: a cross-sectional study in an Asian university.

BACKGROUND: Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career choice. This study aims to identify the deterrents to choosing nursing among healthcare undergraduates by examining the differences in the factors influencing healthcare career choices and nursing as a career choice. METHODS: A cross sectional study was conducted using a 35-parallel items instrument known as Healthcare Career Choice and Nursing Career Choice scale. Six hundred and four (n = 604) first year medical, pharmacy, dentistry and social science students from a university in Singapore completed the survey. RESULTS: Nursing as a career was perceived by healthcare students to be more likely influenced by prior healthcare exposure, the nature of the work, job prospects, and social influences. Lack of autonomous decision making, perceived lower ability to make diagnosis, having to attend to patients' hygiene needs, engendered stigma, and lack of parental support were identified as deterring factors to choosing nursing as a career. CONCLUSION: An understanding of the deterrents to choosing nursing as career allows policy makers and educational leaders to focus on recruitment strategies. These include providing more exposure to nurses' roles in early school years, helping young people to overcome the fear of providing personal hygiene care, promoting nurses' autonomous nursing practice, addressing gender stigma, and overcoming parental objection.

Experiences of service users involved in recruitment for nursing courses: A phenomenological research study.

The aim of this study was to gain insight into service users' experiences of participating in recruitment for Adult, Mental Health and Child nursing studies at the authors' university; to establish potential motivations behind such participation; and to make suggestions for improved future practice. The involvement of service users in nurse education and recruitment has for some years been required by the Nursing and Midwifery Council, but there is a dearth of publications on the meaning of that involvement to participating service users. It is hoped that this study will contribute to this body of knowledge. A phenomenological approach was selected, field-specific focus groups of service users being facilitated using a semi-structured interview format; these were audio recorded and transcribed. The data was analysed using thematic analysis. Participation was subject to the service users having been involved in recruitment to nursing studies at the authors' university and the focus groups took place either at the university or at the child participants' school. Themes identified demonstrated largely positive experiences and a sense of meaningful involvement for all concerned. Findings indicated a close link between the values of the participants and those of the wider NHS, benefits to a sense of wellbeing and achievement, as well as the need for greater ownership of the recruitment process by service users. Potential lessons for academics wishing to promote greater service user involvement in student recruitment are articulated.

Development and psychometric testing of an instrument to compare career choice influences and perceptions of nursing among healthcare students.

BACKGROUND: With the availability of more healthcare courses and an increased intake of nursing students, education institutions are facing challenges to attract school leavers to enter nursing courses. The comparison of career choice influences and perception of nursing among healthcare students can provide information for recruitment strategies. An instrument to compare the influences of healthcare career choice is lacking. The purpose of this study is to develop and evaluate the psychometric properties of an instrument to compare the influences of healthcare career choice with perceptions of nursing as a career choice. METHODS: The study was conducted in two phases. In phase one, two sets of scales with parallel items that measure the influences of healthcare career choice and perceptions of nursing as a career choice were developed through an earlier qualitative study, literature review, and expert validation. Phase two involved testing the construct validity, concurrent validity and reliability with a convenience sample of 283 first year healthcare students who were recruited at two education institutions in Singapore. RESULTS: An exploratory factor analysis revealed 35-parallel items in a six-factor solution (personal interest, prior healthcare exposure, self-efficacy, perceived nature of work, job prospects, and social influences) that explained 59 and 64% of the variance for healthcare career choice and nursing as a career choice respectively. A high correlation (r = 0.76, p < 0.001) was obtained with an existing tool, confirming the concurrent validity. The internal consistency was sufficient with Cronbach's alpha of 0.93 for healthcare career choice and 0.94 for nursing as a career choice. The test-retest reliability was acceptable with an Intraclass Correlation Coefficient of 0.63 for healthcare career choice and 0.60 for nursing as a career choice. CONCLUSIONS: The instrument provides opportunities for understanding the differences between influences of healthcare career choice and perceptions of nursing as a career choice. This comparative understanding of career choice influences can guide educator and policy-makers on nursing recruitment.

Career choice and perceptions of nursing among healthcare students in higher educational institutions.

BACKGROUND: Due to the ageing population and competition from other healthcare courses, a greater demand in the healthcare workforce has made it challenging for educational institutions to attract school leavers to enter nursing courses. Understanding the considerations of students who have chosen non-nursing healthcare courses and their perceptions of nursing can help identify specific strategies to enhance the attractiveness of nursing course. This study aims to examine the differences between healthcare career choices and perceptions of nursing as a career choice among first-year non-nursing healthcare students. METHOD: A descriptive survey design was conducted at the beginning of the healthcare courses of seven healthcare groups and from four higher educational institutions in Singapore. A total of 451 students responded, yielding an overall response rate of 52.7%. The online survey was administered using a valid and reliable 35-item parallel scale, known as the Healthcare Career Choice and Nursing Career Choice. RESULTS: The participants perceived prior healthcare exposure as the most influential factor and self-efficacy as the least influential factor when choosing nursing as a career. In comparison to their own healthcare career choices, nursing was perceived to have greater gender stigma and, as nurses, they would be less likely to achieve higher qualifications and career advancements, and they would be less likely to enjoy fulfilling careers. They also perceived that they would be less likely to gain their parents' support to pursue nursing and to make their parents proud. CONCLUSIONS: This study provides educators and policy-makers with vital information to develop key strategies to improve nursing enrolment in educational institutions. These strategies include early exposure to nursing as a rewarding career during school years, addressing the issue of gender stigma, and promoting information on the career and educational advancement of a registered nurse to parents of school leavers.

Identifying applicants suitable to a career in nursing: a value-based approach to undergraduate selection.

AIMS: The aim of this study was to complement existing evidence on the suitability of Multiple Mini Interviews as a potential tool for the selection of nursing candidates on to a BSc (Hons) nursing programme. BACKGROUND: This study aimed to trial the Multiple Mini Interview approach to recruitment with a group of first year nursing students (already selected using traditional interviews). DESIGN: Cross-sectional validation study. This paper reports on the evaluation of the participants' detailed scores from the Multiple Mini Interview stations; their original interview scores and their end of year results. METHODS: This study took place in March 2015. Scores from the seven Multiple Mini Interview stations were analysed to show the internal structure, reliability and generalizability of the stations. Original selection scores from interviews and in-course assessment were correlated with the MMI scores and variation by students' age, gender and disability status was explored. RESULTS: Reliability of the Multiple Mini Interview score was moderate (G = 0·52). The Multiple Mini Interview score provided better differentiation between more able students than did the original interview score but neither score was correlated with the module results. Multiple Mini Interview scores were positively associated with students' age but not their gender or disability status. CONCLUSION: The Multiple Mini Interview reported in this study offers a selection process that is based on the values and personal attributes regarded as desirable for a career in nursing and does not necessarily predict academic success. Its moderate reliability indicates the need for further improvement but it is capable of discriminating between candidates and shows little evidence of bias.

From placement to employment: Career preferences of Jordanian nursing students.

This study examined employment planning and career preferences of final year nursing students in Jordan. Focus group discussions (n = 4) were conducted by the first author with a convenience sample of 27 nursing students. N-Vivo 9 was used to analyze the qualitative data. The analysis revealed two themes. The first theme focused on "moving from study to work", and comprised two sub-themes: being uncertain and hesitant and being a real nurse. The second theme was "the place where I want to be", and referred to participants' preferences concerning their future career. Participants showed interest in critical care units but they were not optimistic about their future career prospects due to the possibility of being jobless and the perceived low public image of nurses. In addition to the nature of placement atmosphere, gender, family and cultural issues were found to shape participants' preferences. It is therefore important to periodically review the considerations of employment planning and career preferences of nursing students, otherwise devising interventions for sound recruitment of nurses in the future will be flawed.

The history of nurse imagery and the implications for recruitment: a discussion paper.

AIM: This paper presents a discussion of the history of nurse imagery in the context of recent career choice research and the need for contemporary images for nursing recruitment. BACKGROUND: The critical and growing shortage of nurses is a global concern. Understanding how individuals come to know nursing as a career choice is of critical importance. Stereotypical imaging and messaging of the nursing profession have been shown to shape nurses' expectations and perceptions of nursing as a career, which has implications for both recruitment and retention. DATA SOURCES: Relevant research and literature on nurse imagery in relation to career choice and recruitment were identified through a search of the CINAHL, PsychINFO, Sociological Abstracts, PubMed; Medline and Embase databases from 1970-2012. DISCUSSION: Historical images of nurses and nursing remain prevalent in society today and continue to influence the choice of nursing as a career among the upcoming generation of nurses. Students interested in nursing may be dissuaded from choosing it as a career based on negative, stereotypical images, especially those that position the profession as inferior to medicine. IMPLICATIONS FOR NURSING: Understanding the evolution and perpetuation of popular images and messages in relation to the profession has implications for not only how we recruit and retain future generations of professional nurses but also holds implications for interprofessional collaboration between nursing and other health disciplines. CONCLUSION: Strategies for future recruitment and socialization within the nursing and the health professions need to include contemporary and realistic imaging of both health professional roles and practice settings.

Choosing nursing as a career: a narrative analysis of Millennial nurses' career choice of virtue.

The growth and sustainability of the nursing profession depends on the ability to recruit and retain the upcoming generation of professionals. Understanding the career choice experiences and professional expectations of Millennial nurses (born 1980 or after) is a critical component of recruitment and retention strategies. This study utilized Polkinghorne's interpretive, narrative approach to understand how Millennial nurses explain, account for and make sense of their choice of nursing as a career. The positioning of nursing as a virtuous choice was both temporally and contextually influenced. The decision to enter the profession was initially emplotted around a traditional understanding of nursing as a virtuous profession: altruistic, noble, caring and compassionate. The centricity of virtues depicts one-dimensional understanding of the nursing profession that alone could prove dissatisfying to a generation of professionals who have many career choices available to them. The narratives reveal how participants' perceptions and expectations remain influenced by a stereotypical understanding of nursing, an image that remains prevalent in society and which holds implications for the future recruitment, socialization and retention strategies for upcoming and future generations of nurses.