School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Qld 4053, Australia.
Rural Remote Health. 2024 Sep;24(3):8696. doi: 10.22605/RRH8696. Epub 2024 Sep 20.
Nurses play a vital role in the provision of health care in rural, remote and isolated locations. Consequently, the current global nursing workforce shortage has significant and far-ranging implications for these communities where there are enduring issues with workforce maldistribution and shortage, instability, high staff turnover and health disparities. This article provides an analysis of existing literature on what rural, remote and isolated practising nurses view as important for the attraction and retention of this workforce in the Australian context.
A structured scoping review informed by Arksey and O'Malley's framework for conducting scoping studies was undertaken. Six electronic databases were searched in August 2022. Cosgrave's person-centred retention improvement framework (which includes attraction) for addressing health workforce challenges in rural contexts was used to guide the synthesis and interpretation of information from the included studies. Key themes were identified inductively, conceptualised within Cosgrave's framework and mapped to the overarching lifecycle stages of attraction, retention and resignation, also referred to as turnover or decision to leave.
Twelve articles met the inclusion criteria for this review. Six themes related to attraction, retention and resignation were identified: (1) demanding role and scope of practice; (2) values divergence and professional opportunities; (3) continuing professional development and mentoring; (4) social, lifestyle and personal or family; (5) management and organisation; and (6) pay and incentives. The issues articulated within each of these themes overlapped, highlighting the complexities involved.
Limited empirical research that combines a person-centred and whole-of-lifecycle approach to understanding the rural and remote nursing workforce was found. However, our analysis of existing evidence suggests that such approaches are required to appropriately plan for and target solutions that centre nurses' specific needs and experiences for the future nursing workforce. Relatedly, limited translational research on the nursing workforce that explicitly includes and engages with nurses was found. Such research is fundamentally needed to improve retention outcomes.
护士在农村、偏远和孤立地区的医疗保健提供中发挥着至关重要的作用。因此，当前全球护士劳动力短缺对这些社区产生了重大而深远的影响，这些社区长期存在劳动力分布不均和短缺、不稳定、员工高流动率以及卫生差异等问题。本文分析了现有的文献，探讨了农村、偏远和孤立地区的执业护士认为在澳大利亚环境下吸引和留住这一劳动力队伍的重要因素。
采用 Arksey 和 O'Malley 的框架进行了结构化的范围综述，以指导范围综述。2022 年 8 月，对六个电子数据库进行了搜索。Cosgrave 的以人为主导的农村背景下解决卫生人力挑战的保留改进框架（包括吸引力）被用来指导对纳入研究的信息进行综合和解释。使用归纳法确定了主要主题，将其概念化在 Cosgrave 的框架内，并映射到吸引力、保留和辞职（也称为离职或决定离开）的总体生命周期阶段。
符合本综述纳入标准的文章有 12 篇。确定了与吸引力、保留和辞职相关的六个主题：（1）要求苛刻的角色和实践范围；（2）价值观分歧和职业机会；（3）持续的专业发展和指导；（4）社会、生活方式和个人或家庭；（5）管理和组织；（6）薪酬和激励。这些主题中的每一个都涉及到一些问题，突出了所涉及的复杂性。
我们发现，关于理解农村和偏远地区护理劳动力的以人为主导和全生命周期方法的实证研究有限。然而，我们对现有证据的分析表明，需要采取这种方法，为未来的护理劳动力队伍制定和有针对性地解决以护士为中心的具体需求和经验的方案。相关地，我们发现关于护理劳动力的转化研究有限，这些研究明确包括并使护士参与其中。这种研究对于改善保留结果至关重要。
