New Graduate Nuses Experiences in working in rural and remote areas

Australian Nursing & Midwifery Federation (ANMF) (2013) majority of nurses are found to be in the metropolis while minute percentage can be seen in remote and rural communities across Australia. The difficulty in recruiting and retaining workers in remote places has been a serious and long-standing problem by the government (Bennettt, Barlow, Brown, & Jones, 2012). Rural nursing has been considered as a specialist-generalist role. Wherein, the nurse works outside the metropolitan area where people have less access to health care services and facilities (Mills, Birks, & Hegney, 2010). Nonetheless, rural health nurses lack medical and ancillary support resulting for them to work in all aspects as primary care giver and at times working beyond their scope of practice (Mills et al. 2010).

The aim of this research proposal is to have an in depth exploration of the experiences faced by new graduate nurses in working within a rural area. Transition from being a student to working in a clinical setting is a heavy responsibility and considering going to a remote community, since highly experienced nursing professionals are needed in these areas (ANMF, 2013). Aside from that, most of new graduates were unprepared for countryside practice since majority of them were educated in urban area where education was focused on career ambition in these areas (Hart, Morris, Collins, Mcmullen, & Stanis, 2013). New graduate nurses admit that they have limited knowledge and skills as a new practitioner (Bennett, et al. 2012). Thus, employers are expected to provide supportive learning environment for novice nurses to become proficient and skillful health workers (Mills et al. 2010).

Looking at the number of ageing and retiring nurses in geographically remote Australian communities new graduates will be the key in sustaining the imminent shortage of rural and remote area nurses (Mills et al. 2010). Hence, the research proposal will have an in depth exploration of the experiences of neophyte nurses. Knowing the advantages and disadvantages of rural work experience will give information for the government, healthcare agency, and healthcare providers on how to sustain nurses and use in the recruitment process as well. Clearly a positive and beneficial impact will be the outcome of the study including evidence-based data on the experiences of new graduates that can be used to determine what needs improvement in the health care setting and the appropriate programs that will be beneficial for the future new graduate nurses.

Literature Review

The transition process of new graduate registered nurses into the clinical setting encompasses a broad complex combination of physical, emotional, sociocultural, intellectual and developmental issues (Park & Jones, 2010). Newly graduated nurses entering the health workforce are aware of their limitations and have neither confidence nor work expertise to deal with highly intense and dynamic hospital environment (Park & Jones, 2010). Compounding to further complicate the transition roles of newly graduate nurses involved management crisis evident of exhausting initial work experience, discouraging and disorienting workplace resulting to increased level of burnout in their professional practice (Duffield, Roche, O’Brien-Pallas, Catling, King, 2009).

Australian new graduate registered nurses have clear necessities that were not met in their transition from being a student to becoming a practitioner. Expectations including supportive employers and good working environment to enhance their skills to becoming a beginner nurse were taken for granted (Park & Jones, 2010). According to studies of Mills et al. 2010; Hart et al. 2013; Keane et al. 2013; Francis & Mills, 2010, they all agreed that rural and remote areas in Australia showed limited support and guidance for new graduate nurses. There were instances wherein no preceptor appointed to supervise new graduate yet they were given extra responsibilities early in their transition year. In other cases, the novice nurses were given full workload before they become familiar and settled with their work environment and new role (Mills et al. 2010; Hart et al. 2013; Keane et al. 2013; Francis & Mills, 2010).

Hostile staff members result in feelings of social and professional isolation leading to new graduate leaving the workforce in the countryside (Mills et al. 2010; Hart et al. 2013; Keane et al. 2013; Francis & Mills, 2010). Nonetheless, lack of financial support like access to acceptable housing and inflexibility in work place experiences were also cited as a problem in retaining novice nurses in rural and remote areas (Francis & Mills, 2010). In contrast with above mentioned experiences by graduate new nurses in transition (Pond, Dalton, Disher, & Cousins, 2009) reported that there was a support scheme for rural health practitioners that provided multidisciplinary and coordinated framework that aimed to improve clinical competency and workforce retention.

Also, (Bennett, et al, 2012) reported that there were local initiatives for new graduate nurses in New South Wales, Victoria and Queensland. The Early Graduate Nurse Program delivered by Department of Health Victoria in 2010 aimed to address the needs of new graduate nurses while Western Australia Country Health Services launched the Ocean to Outback Program that offers opportunity to have a 3 months rotation in four rural and remote communities in Western Australia (Bennett, et al, 2012). In New South Wales, Gradplus was offered to help and support new graduate nurses through Ramsay Health Care (Bennett, et al, 2012).

The review comprised of journal articles that were published between 2009 and 2013 giving information on the status of rural nursing, identifying new graduates perspective of remote area clinical setting and the factors in the recruitment and retention of nurses in remote Australian communities. The inclusion criteria must report the experiences of new graduate nurses working in small towns and geographically remote settings which were explained in the journal articles but were not the focus of the studies. As a result the research gap was identified.

Identify the gaps

The aim of this research proposal is to have an in depth exploration of the experiences faced by a new graduate nurses in working within a rural area. Evidently, most of the available literature focuses on status of rural nursing, identifying new graduates perspective and the recruitment and sustainment of rural nursing workforce within Australia (Mills et al. 2010; Hart et al. 2013; Keane et al. 2013; Francis & Mills, 2010). Thus, this research proposal wants to address the literature gap regarding the experience of new graduate nurses in rural and remote places in Australia.

Research question/ hypothesis
Research question:
What are the experiences of new graduate nurses in working within rural and remote Australian community?

The hypothesis statement:
The experiences of new graduate nurses working in rural and remote Australian community will be affected by the level of support coming from the agency/hospital, fellow nurses and the culture and workload responsibility of the ward. The aim of this research proposal is to have an in depth exploration of the experiences faced by new graduate nurses in working within a rural area. Hence, the outcome either positive or negative or both experiences of new graduates in transitional nursing within rural and remote areas have a great impact on identifying how to recruit and retain rural nursing workforce. Also, the result of this study can provide evidence-based insight for the government and health care agency to improve the system and make programs on handling and dealing with new graduate registered nurses.

Significance of the study
The findings of this study will provide information on the experiences of new registered nurses in working within rural and remote Australian communities. By identifying the experiences of new graduate nurses in working within remote communities healthcare organization’s will be aware of the pros and cons, limitations and what needs to be improved in the system to be able to use as a retention strategy. By improving the system, it may build new graduates competency, confidence, and retention to the workforce resolving the nursing shortage.

Hospitals can also use the outcome of the study as an evidence-based management in dealing with new graduates in transition. Not only that, knowing the advantages and disadvantages of rural work experience will give information for the government, healthcare agency, and healthcare providers on how to sustain nurses and use in the recruitment process as well.

REFERENCE

Australian Nursing & Midwifery Federation. (2013). More incentives needed for rural nurses and midwives. Retrieved August 31, 2013, from http://anf.org.au/news/entry/more-incentives-needed-for-rural-nurses-and-midwives

Bennett, P., Barlow, V., Brown, J., & Jones, D. (2012). What do graduate registered nurses want from jobs in rural/remote Australian communities? Journal of Nursing Management, 20(4), 485-490.

Duffield, C., Roche, M., O’Brien-Pallas, L., Catling-Paull, C., & King, M. (2009). Staff satisfaction and retention and the role of nursing unit manager. Collegian, 16(1), 11-17.

Francis, K. L. & Mill, J. E. (2011). Sustaining and growing the rural nursing and midwifery workforce: Understanding the issues and isolating directions for the future. Collegian, 18(2), 55-60.

Hart, B., Morris, J., Collins, A., McMullen, P., & Stanis, K. (2013). Fly-in/ fly-out nursing: is it for us? New graduate nurses’ perspective. Rural and Remote Health, 13(2456), 1-4.

Keane, S., Lincoln, M., Rolfe, M., & Smith, T. (2013). Retention of rural allied health workforce in New South Wales: A comparison of private and public practitioners. BMC Health Services Research. 13(32), 1-6. doi:10.1186/1472-6963-13-32

Mills, J., Birks, M., & Hegney, D. (2010). The status of rural nursing in
Australia: 12 years on. Collegian, 17(1), 30-37.

Park, M., & Jones, C. (2010). A retention strategy for newly graduated nurses: An integrative review of orientation programs. Journal for Nurses in Professional Development 26(4), 142-149.

Pond B.R., Dalton L.G., Disher G.J., & Cousins M.J. (2009). Helping medical specialists working in rural and remote Australia deal with professional isolation: the support scheme for rural specialists. PubMed, 190(1), 24-27.