Advanced Education for the Role of Rural Nurse Generalist

Why 4 years when 3 will do? Enhanced knowledge for rural nursing practice

In Australia, debates over the appropriate length of undergraduate nursing programs have a long history. Submissions from both universities and industry to key government reports have consistently argued that the current minimum entry level of practice, a three-year program, is too short to enable students to gain the knowledge and skills necessary for the contemporary nursing role. Despite these submissions, the established entry level for nursing practice in Australia remains a three-year undergraduate bachelor degree. However, there is a small group of high-achieving students who will begin practice at the end of a four-year program. Little is known about these programs, or the students who are currently enrolled in them. Designed as a collaborative endeavour, based on co-operative inquiry, the study discussed in this article aimed to provide an insight into aspects of a four-year undergraduate nursing program. Potentially, the broader theoretical and clinical preparation that is possible in a four-year program provides students with enhanced learning opportunities that will enable them to graduate with more confidence and greater ability. In this study a four-year program provided an opportunity for a regional university to prepare students for the demanding realities of a complex area of practice, rural nursing.

Educating for rural nursing practice

BACKGROUND

Rural hospitals in Australia, as in many countries, face challenges in ensuring that appropriate, quality services are provided.

AIMS

The overall aim of this study was to explore the issues that impact on the ability of rural hospitals to provide effective health care.

METHODS

We used a qualitative descriptive method and purposive sampling, and conducted interviews in hospitals in rural Victoria, Australia. The data collected enabled major issues that impact on hospital service delivery to be identified. Using thematic analysis, global themes were extracted and organized around a thematic network.

FINDINGS

The workforce was an important theme. Whilst the impact of medical shortages on hospital function has been considered in other studies, little consideration has been given to the rural nursing workforce. The need to maintain an appropriately educated rural nursing workforce emerged as one of the major issues that impact on rural hospital service delivery. In Australia, there has been a great deal of discussion about the educational preparation required for rural nursing practice, with the emphasis on postgraduate study. However, the majority of rural nurses do not have postgraduate qualifications and face significant barriers in obtaining them. Although the vast majority of literature claims that postgraduate preparation is vital for rural nursing practice, this research suggests that the future rural nursing workforce will be recruited from undergraduate courses in regional universities. However, there is a need to include specific theoretical and operational preparation in undergraduate education, to enable nurses to make the transition to rural practice more readily.

CONCLUSIONS

Rural nurses are central to the delivery of health services in rural hospitals. Future rural nursing recruitment and retention hinges on ensuring that they have the confidence, knowledge and skills to deliver safe, appropriate and effective care.

Addressing social, political, and health issues. The student congress strategy

The authors describe a classroom instructional strategy used to resolve current social, political, and health issues. The strategy includes participation in group work and database searching in the preparation of proposed resolutions. The class serves as a Student Congress, voting for or against the resolutions presented. This instructional model could be used in any university classroom if the goal is to enhance critical-thinking skills and to heighten a sense of social and personal responsibility.