Remote Nurses Research Articles

Association for Australian rural nurses: current events and future challenges

At the time of writing this editorial, Australia was preparing for the national election. The major political parties had commenced campaigning and were taking every opportunity to sway voters by promising to address concerns that have been raised by politically astute constituents. The Association for Australian Rural Nurses (AARN) undertook to lobby the major political parties prior to the national election on behalf of the membership. AARN noted that several of the election promises made leading up to the election have been voiced publicly. In the aftermath of the election AARN will monitor the outcomes of the election seeking to reaffirm the incoming government's pre-election commitments and will seek ongoing support for its activities. The AARN continues to expand its actions with three federally funded projects; namely: mental health emergencies project, falls prevention project and mentor development and support project. The mental health emergencies training project is funded by the Rural Health Support Education and Training Program, and aims to upskill acute care nurses to deal with emergency mental health crises. Members indicated to the executive that these events were increasing, attributing the rise in incidence to the drought and accompanying downturn in rural economies. The members described feeling ill-prepared and voiced their need for additional training. On notification of receiving funding for this project AARN advertised and recruited a project officer, Rod Menere. Rod is a very experienced mental health nurse who has capably developed and conducted the first program. The project continues, with preliminary feedback indicating that the resource is valuable and makes a difference to the confidence of nurses.1 The second project is a ‘falls prevention’ initiative. Initially, AARN was funded by the Australian Government's Department of Health and Ageing to develop a resource for nurses to undertake clinical and environmental assessments to reduce the number of falls among elderly people (over 65) living in a domestic dwelling in rural and remote Australia. Following the success of this program, additional funding was provided to continue the development of the resource, and to conduct training programs for rural and remote nurses throughout Australia to improve knowledge and skills in undertaking clinical and environmental assessment for falls risk.2 Catherine Butt manages this project, and can be contacted at AARN for further information. The third project that AARN is managing is the mentor development and support project. This project is in its second year. The project aims to train and support mentors for undergraduate nursing students who are recipients of a remote/rural nursing scholarship. Donna Lennon, the current project manager, reports that the project has over 60 trained mentors who are actively supporting students. Jane Mills, the inaugural project manager, developed the training program. The program has been well received. Several health services have approached AARN to provide mentor training of nursing staff. The rationale offered is a belief that mentoring strengthens existing workplace relationships and, therefore, may act as a positive recruitment and retention tactic.3 The legacy that AARN leaves through these projects will enhance service provision and improve recruitment and retention of nursing personnel. AARN believes that rural practice is challenging and unless government continues to focus on supporting rural nursing the current workforce shortage will increase.4, 5 Support packages must include incentive initiatives, relocation allowances, locum relief, access to support infrastructure (including online databases and other resources), study leave, flexible rostering and family friendly workplaces. It is further recommended that local governments be encouraged to work with local health providers, and a resource be developed, similar to the ‘Rural Practice Step-by-Step Guide for Leaders of Rural Communities Needing a Doctor’ (1998) for the recruitment and retention of health personnel, including nurses and allied health professionals.6 The National Health Workforce Strategic Framework (2004) articulated concern regarding the continued sustainability of health services.7 They identified the need for health services and health professions to reconceptualise current models of practice and argued that traditional health professions may need to adjust educational preparation and shift their understanding of the role they currently play, and will play in health service delivery. Dade Smith (2004)4 concurs arguing that it is time that a re-examination of the current ways ‘we’ do things is undertaken. The diversity of rural practice contexts provides a unique laboratory for collaborative investigation that seeks to develop new ways of meeting need. Rural health is, by its very nature, pro-active and responsive to change. The potential for innovative, collaborative partnerships to develop and drive the expected re-conceptualisation of models of practice is a challenge that AARN accepts, supports and will take a lead role in facilitating.

Palliative care by nurses in rural and remote practice.

To evaluate the experiences of a group of rural and remote nurses in providing palliative care and to discuss the implications of this evaluation for the development and implementation of professional support strategies. Semi-structured survey comprising 23 items measuring perceptions of the nature of rural and remote practice, the provision of palliative care in these settings and the appropriateness of various professional development strategies; as well as 12 open-ended questions to obtain qualitative descriptions relating to key concepts in rural and remote practice. Rural and remote communities in the Southern zone of Queensland Health. Thirty-one registered and enrolled nurses, all female, who attended a two-day professional development workshop. Identification of characteristics of, barriers against and strategies to support the practice of palliative care in rural and remote communities. High levels of agreement with key statements relating to issues evident in contemporary literature regarding rural and remote nursing practice; qualitative descriptions show congruence with key statements. This evaluation demonstrated congruence between the challenges faced by this group of nurses and those reported in the literature. These nurses identified the importance of peer networking as an integral part of their work, which enhanced their potential as rural and remote palliative care providers.

Infrastructure for reaching disadvantaged consumers: telecommunications in rural and remote nursing in Australia.

Both consumers and health service providers need access to up-to-date information, including patient and practice guidelines, that allows them to make decisions in partnership about individual and public health in line with the primary health care model of health service delivery. Only then is it possible for patient preferences to be considered while the health of the general population is improved. The Commonwealth Government of Australia has allocated $250 million over five years, starting July 1, 1997, to support activities and projects designed to meet a range of telecommunication needs in regional, rural, and remote Australia. This paper defines rural and remote communities, then reviews rural and remote health services, information, and telecommunication technology infrastructures and their use in Australia to establish the current state of access to information tools by rural and remote communities and rural health workers in Australia today. It is argued that a suitable telecommunication infrastructure is needed to reach disadvantaged persons in extremely remote areas and that intersectoral support is essential to build this infrastructure. In addition, education will make its utilization possible.