Academic journal article Australian Health Review

An Integrative Review of the Role of Registered Nurses in Remote and Isolated Practice

Academic journal article Australian Health Review

An Integrative Review of the Role of Registered Nurses in Remote and Isolated Practice

Article excerpt

Introduction

Nursing practice in remote and isolated Australia can be shaped by many factors, including the characteristics of the community in which they work. Acceptance by the community improves retention of nurses in remote and isolated areas' and allows nurses to be more effective in providing primary health care. Professional support and education opportunities, and the development of good working relationships with other nursing, medical and allied health professionals can reduce feelings of isolation and improve health outcomes for the community.2'3 Mentoring of new nurses can influence their success, particularly in the early stages of their careers, and can determine whether new or novice nurses 'sink or swim'. Weymouth5 identified several factors that can contribute to a nurse's enjoyment of and ability to provide nursing care in remote or isolated areas, including management practices, occupational health and safety and assistance with management of caseloads.

Geographical location and consequently accessibility can impact on nursing practice/1 Difficulties in obtaining supplies and equipment, and evacuation for medical care are common in many remote communities. Nurses in single nurse clinics report feeling unsafe and limited in their ability to provide effective care.7 The availability of infrastructure such as equipment and health information technology can impact on nursing practice." In addition, population differences between metropolitan and remote areas can see differing levels of financial support for health services in each area, which impacts on nursing practice.1

Nursing in remote and isolated areas is reported to be challenging and diverse,5'* yet there is little information about the role of the nurse in this context. In July 2008 the Office of the Chief Nursing Officer, Queensland Health, commissioned a report into the role of registered nurses (RNs) working in remote or isolated areas. This paper reports on the integrative review of published and grey literature on the role of the registered nurse in remote or isolated practice. The impact of the burden of disease on nursing practice is explored, and the concept of remote is discussed.

Search strategy

An extensive search of the literature was performed using the following electronic databases: CINAHL (1982 to present), OVlD MEDLINE (1950 to present), and EMBASE (1974 to present). Search terms included remote area nurse; remote area nursS (where S represents a search term truncation allowing for terms starting with nurs', e.g. nurse, nurses, nursing); nurse practitioner; remote; role; remote centre; single nurse post; Queensland; Northern Territory; South Australia; Western Australia; and advanced nurse practitioner. The references of articles retrieved were searched manually for additional information. A search of the grey literature was also incoiporated, including policy papers (both state and federal governments), government reports, project reports and position descriptions.

Information pertaining to the burden of disease, mortality, morbidity and disability was identified using the above electronic databases. Further information was sought from state, territory and federal websites, including the Australian Bureau of Statistics, Australian Institute of Health and Welfare, and the Department of Local Government Sport and Recreation (Queensland Government). Papers reporting nonAustralian burden of disease data were excluded.

The profile of registered nurses in remote and isolated practice

Registered nurses have been providing care for remote and isolated communities for over 100 years. Nurses in these areas provide care across the lifespan, and frequently are the first point of contact with the health care system.10 Nursing in remote areas has been described as one of the most complex areas of nursing practice.11

Nurses in remote and isolated areas of Australia are typically female. The nursing workforce as a whole is ageing, with the average age increasing from 42 years in 2001 to 45 years in 2005. …

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