Health care in crisis: understanding nursing turnover in northern Canada (1).

For decades nurses have provided 24 hour comprehensive health care in isolated communities of Canada. As the only health care personnel in most communities of the north, nurses must meet all health care needs ranging from veterinary assistance to health education, emergency care to mental health counselling. This paper will focus on the structural and psychosocial factors affecting isolated post workers. Considering the intense nature of professional responsibility in these isolated settings, it is not surprising that there is frequent turnover of nurses. The constant change in staff results in poor community and staff morale, limited success of programs and increased expenditures for government due to the high costs of additional relief staff, travel, and orientation. Utilizing a mailed survey (N = 55) and on-site interviews (N = 17) collected in two regions of northern Canada, this paper will outline key issues which produce nursing dissatisfaction and ultimately decrease the effectiveness of health care programs. The paper will conclude with suggestions to increase nursing satisfaction and ultimately improve the provision of health care in northern areas. Native health care is in crisis. Health status indicators such as infant mortality and life expectancy lag far behind national statistics. Death due to accidents and violence are almost six times the Canadian rate. Incidence of suicide is three times the national statistics (1-6). The rate of nursing staff turnover in northern communities is high, and most nurses stay less than 2 years in the north (7,8). Native health demands are increasing and it is becoming more difficult for find nurses to provide health care service.(ABSTRACT TRUNCATED AT 250 WORDS)