Nursing in Canada

Source: McMaster University

by Theresa Noonan

The sustainability of the nursing workforce and delivery of quality patient carecould be threatened in rural areas of Ontario, according to a McMasterUniversity study.

The New Healthcare Worker: Implications of Changing Employment Patterns inRural and Community Hospitals identifies concerns that need to be addressed ifresidents in less populated areas of Ontario are to receive the best care.

The Ontario Ministry of Health and Long-Term Care commissioned McMaster's NursingHealth Services Research Unit (NHSRU) to conduct a study on the rural nursingworkforce. It focused on 19 rural hospitals in Local Health Integration Network(LHIN) 2 in southwest Ontario, and examined how employment patterns haveevolved.

Dr. Andrea Baumann, lead author on the study and Co-director of NHSRU,McMaster University site, says that while it is difficult to create an accurateprofile of nurses in rural hospitals because the available data is limited andout of date, study findings indicate that new nursing graduates and experiencednurses from urban settings find it hard to transition to rural nursingpractice.

Nurses refer to rural nursing practice as a specialty. Rural nurses needbroad skill sets and knowledge from a variety of specializations. They arecross-trained because they work across diverse patient care areas.

The research team found some rural hospitals do not have the resources toimplement government strategies designed to address nursing workforce issues.

Managers prefer a high proportion of part-time staff to ensure coverage intheir units, but hiring part-time nurses has not created the flexibility neededto cover units on short notice. The researchers found that having enough staffto meet contingent demands is challenging in rural hospitals.

"The rural workforce needs to be renewed, but there is concern aboutwhere the new staff will come from and how they will be integrated," saysBaumann.

Hospitals in rural areas have a smaller pool of staff to draw from thanthose in urban centres, and rural hospitals recruit few young graduates.Innovative co-op programs for high school students and scholarships to studyrural nursing should be made available, says Baumann.

The recommendations for change are listed in the report available on theNursing Health Services Research Unit website.