Academic journal article The Qualitative Report

Attributes and Qualifications of Successful Rural Nurse Preceptors: Preceptors' Perspectives

Academic journal article The Qualitative Report

Attributes and Qualifications of Successful Rural Nurse Preceptors: Preceptors' Perspectives

Article excerpt

In 2009, the Department of Health Resources and Services Administration (HRSA) Deputy Secretary announced that the United States is experiencing a nursing shortage that will increase to one million unfilled nursing positions by 2020 (HRSA, 2009). Elements contributing to this nursing shortage include a dearth of nursing faculty, clinical sites, classroom spaces, finances (Rosseter, 2014) and an aging nurse population (HRSA, 2013). Heavy workloads, long work hours, new technology and fatigue also attribute to attrition (Eggert, 2012). Although there are glimmers of hope regarding staffing as an increasing number of nurses under age 30 enter the profession, recruiting and retaining these nurses is of utmost importance (HRSA, 2013).

Retention strategies have varied. At the state level they have included incentives in the form of grants to attract and retain nursing faculty (Allan & Aldebron, 2008). Initiatives to create positive work environments and to improve technology have been discussed (Pricewaterhouse Coopers Health Research Institute, 2007). However, local hospitals need to consider nurses' needs to recruit and retain nurses (Fox & Abrahamson, 2009). Nursing shortages are especially acute in some rural areas because rural nurses are especially hard to recruit and retain compared to urban nurses (Bushy, 2006; Cramer, Nienaber, Helget, & Agrawal, 2006). Lower salaries, longer commutes to work, and the need to have a generalist rather than specialist orientation are factors in higher turnover rates in rural areas (Newhouse, 2005; Trossman, 2001). To attract and retain nurses, workplaces need to provide support, an opportunity for nurses to develop their skills, and nurses need to find meaning in their work.

One way to provide support and increase retention is through the development of the nurse preceptor. Nurse preceptors guide, support and instruct new nurses (Paton, Thompson- Isherwood & Thirsk, 2009). They are selected or they volunteer to work beside nurses. Good preceptors increase the confidence of new nurses and the preceptors themselves also report increased job satisfaction (Ferguson, Whyte, & Anderson, 2000; Zilembo & Monterosso, 2008).

Extant literature concerning nurse preceptors center on preceptor education and support (Hautala, Saylor, & O'Leary-Kelly, 2007; Myrick & Yonge, 2002), the selection, retention or evaluation of nurse preceptors (Altman, 2006; Valentine, 1997), and evaluation of preceptor preparation programs (Heffernan, Heffernan, Brown, & Bronson, 2009; Wilson, Acuna, Ast, & Bodas, 2013), However, few studies were found that only examined the attributes and qualifications of successful preceptors exclusively from the preceptors' perspectives using a qualitative methodology.

Fewer researchers have explicitly explored rural preceptors' experiences. Approximately 17% of the US nurses (RNs and LPNs) work in rural areas (HRSA, 2013). Recruitment and retention of new nurses in rural areas has its challenges. Recruiting takes longer and nurses are more likely to leave rural areas than their urban counterparts (Cramer et al., 2006). Given the different setting and more generalist duties of rural nurses, money (Molanari & Monserud, 2009; Trossman, 2001) perhaps different qualities are needed for successful rural nurse preceptors. Hence, this study could contribute to knowledge about preceptors who work in a rural setting. Findings from this local study could have relevance for nurses in other areas of the United States and the world. Since the nurse preceptor is a teacher, individuals who teach adults in other practice-based contexts could benefit from the findings of this study.

In summary, while duties and roles of preceptors have been explored to some degree in other studies (e.g., Coats & Gormley, 1997; Yonge, Myrick, Ferguson, & Grundy, 2013), there has been less focus on the attributes of nurse preceptors from rural areas. …

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