The practice of rural and remote nurses in Australia: A case study.

AIM AND OBJECTIVE: To delineate contemporary practice of registered nurses working in rural and remote areas of Australia. BACKGROUND: Despite the implementation of strategies to address challenges reported by rural and remote nurses, concern remains over safety and quality of care, the well-being of nurses and retention of the nursing workforce. Twenty years on, geographically dispersed nurses still experience scarce human and material resources. DESIGN: A multiple case study design was implemented. METHODS: Nurses were recruited from 240 sites. The study comprised three phases of data collection. First, a content analysis of 42 documents relating to the context of nursing, specifically rural and remote nursing; second, a content analysis of an online questionnaire (n = 75); and third, a thematic analysis of semi-structured interviews (n = 20). COREQ reporting guidelines were used. RESULTS: Each phase of data collection informed subsequent data collection and analysis within the study. Following triangulation of data from each phase of the study, the major themes reported are "a medley of preparation for rural and remote work"; "being held accountable"; "alone, with or without someone"; and "spiralling well-being." CONCLUSIONS: Regardless of strategies, challenges of nursing in rural and remote areas persist. Issues of isolation, stress, burnout and a lack of organisational commitment to employees affect the retention of rural and remote nurses. While useful, professional development courses and graduate certificates are yet to make an impact on reducing these issues. RELEVANCE TO CLINICAL PRACTICE: Registered nurses argue for more experience rather than more education to facilitate transition into this nursing area. The finding that experience is perceived as more valuable than education suggests the need for innovative ways to gain experience to practice in rural and remote nursing. Lack of organisational commitment requires attention to promote the well-being of nurses and patient safety.

Personal qualities needed by undergraduate nursing students for a successful work integrated learning (WIL) experience.

BACKGROUND: International research has shown that during work integrated learning (WIL) undergraduate nursing students may experience stress, self-doubt, and coping issues, however personal qualities these students bring to their WIL journey or those needed to succeed during WIL remain unknown. OBJECTIVE: To describe the views of students midway through their Bachelor of Nursing program regarding personal qualities they bring to and need for WIL success. DESIGN: This article reports on a descriptive study that used an electronic questionnaire to collect the data. SETTINGS AND PARTICIPANTS: Bachelor of nursing students (n = 421), who were studying fulltime or part time equivalent, at a regional university in Queensland Australia, were invited to complete the anonymous electronic questionnaire that was developed by the research team following an extensive review of literature. Inclusion criteria required participants to have completed at least one WIL experience and be midway through their three-year Bachelor of Nursing program. METHODS: Data were collected during January and February 2017. The electronic questionnaire consisted of demographic, forced choice questions, and open-ended questions. This paper presents the qualitative analysis of responses to two of the open-ended questions that focused on personal strengths and work integrated learning experiences. Data were analysed using the inductive content analysis approach. RESULTS: Six personal qualities were identified including: enthusiasm to succeed, commitment to learning, self-motivation, confidence, effective communication skills, and compassion. CONCLUSIONS: Pre-entry screening of applicants to bachelor level nursing programs and the delivery of learning opportunities that encourages both reflection and debriefing may assist in describing personal qualities needed to succeed in WIL.

Women's successful transition to motherhood during the early postnatal period: A qualitative systematic review of postnatal and midwifery home care literature.

OBJECTIVE: To undertake a systematic review of available qualitative research literature to determine what women need to successfully transition to motherhood during the early postnatal period and whether postnatal home care delivered by midwives supports this process. DESIGN: The transition from woman to mother is a significant occurrence, one that requires adjustments on physical, psychological and social levels. A qualitative systematic review design was chosen to ensure both humanistic and interactive concepts related to what women need to successfully transition to motherhood during the early postnatal period were identified. The systematic and structured search uncovered 33 research articles for detailed review. Two team members, using the qualitative research checklist from the Critical Appraisal Skills Programme, appraised the quality of the research articles. A total of 19 articles met the quality criteria and were included in the data evaluation process. SETTING AND PARTICIPANTS: Research teams from Asia-Pacific, Europe, Middle East and North America generated the 19 qualitative journal articles. MEASUREMENTS AND FINDINGS: Data evaluation included identification of research aim, presence of a research question, type of methodology, data collection processes, sample information, data analysis techniques and study outcomes. Data was analysed using an inductive content analysis approach. Four themes were identified from the qualitative systematic review process including: women and midwives connecting, identification and meeting of women's individual needs, family and cultural influences and, education and support. KEY CONCLUSIONS: The ability of women to connect with midwives during the early postnatal period assisted them overcome barriers and to successfully transitioning to motherhood. Although all four themes were determined to be key to effective postnatal transition, overwhelmingly the findings showed postnatal midwifery home care to be important in women's successful transition to motherhood in the early postnatal period. IMPLICATIONS FOR PRACTICE: Strategies are needed ensure women have access to midwives in the early postnatal period.