'It's complicated': Staff nurse perceptions of their influence on nursing students' learning. A qualitative descriptive study.

Background: During both teacher-led clinical practica and precepted practica, students interact with, and learn from, staff nurses who work on the clinical units. It is understood that learning in clinical practice is enhanced by positive interactions between staff nurses and nursing students. While much is known about preceptors' experiences of working with nursing students, there is little evidence to date about staff nurses' perspectives of their interactions with students in teacher-led practica.

Incorporating Group Medical Visits into Primary Healthcare: Are There Benefits?

Objective: Group medical visits (GMVs) have been touted as an innovation to effectively and efficiently provide primary healthcare (PHC) services. The purpose of this paper is to report whether GMVs have tangible benefits for providers and patients.

Methods: This descriptive study included in-depth interviews with patients attending and providers facilitating GMVs and direct observation.

Development and psychometric evaluation of the Primary Health Care Engagement (PHCE) Scale: a pilot survey of rural and remote nurses.

Aim: To report the development and psychometric evaluation of a scale to measure rural and remote (rural/remote) nurses' perceptions of the engagement of their workplaces in key dimensions of primary health care (PHC).

Background: Amidst ongoing PHC reforms, a comprehensive instrument is needed to evaluate the degree to which rural/remote health care settings are involved in the key dimensions that characterize PHC delivery, particularly from the perspective of professionals delivering care.

Methods: This study followed a three-phase process of instrument development and psychometric evaluation.

The impact of organisational factors on horizontal bullying and turnover intentions in the nursing workplace.

Aim: To examine the impact of organisational factors on bullying among peers (i.e. horizontal) and its effect on turnover intentions among Canadian registered nurses (RNs).

Patient confidentiality within the context of group medical visits: is there cause for concern?

Background: Group medical visits (GMVs), clinical encounters with a medical component delivered to groups of patients, have emerged as an innovative approach to potentially increasing efficiency while enhancing the quality of primary health care (PHC). GMVs have created the need to pay explicit attention to patient confidentiality.

Objective: What strategies are used by providers and patients to address issues of confidentiality within GMVs?

Design: In-depth interviews were conducted with 34 PHC providers and 29 patients living in nine rural communities in British Columbia, Canada.

Group medical visits can deliver on patient-centred care objectives: results from a qualitative study.

Background: Patient-centred care emerged in the late 1960s as a framework to guide providers and decision-makers towards the provision of more effective health care and better outcomes. An important body of literature has since emerged, reporting mixed results in terms of outcomes. To date, assessments of the effectiveness of patient-centred approaches have focused one-on-one consultations.

Anaemia management protocols in the care of haemodialysis patients: examining patient outcomes.

Aims And Objectives: To determine whether the use of a nurse-driven protocol in the haemodialysis setting is as safe and effective as traditional physician-driven approaches to anaemia management.

Background: The role of haemodialysis nurses in renal anaemia management has evolved through the implementation of nurse-driven protocols, addressing the trend of exceeding haemoglobin targets and rising costs of erythropoietin-stimulating agents.

Design: Retrospective, non-equivalent case control group design.

Role transition in rural and remote primary health care nursing: a scoping literature review.

In order to align health services with population health needs, health authorities in sparsely populated rural and northern Canada are exploring how to better organize and deliver primary health care (PHC) services. A significant component of PHC innovation involves changes to the roles, work settings, and practice modes of registered nurses.While many studies have identified the need to revise nursing roles, few have examined the transition itself.

Moving on? Predictors of intent to leave among rural and remote RNs in Canada.

Context: Examination of factors related to the retention or voluntary turnover of Registered Nurses (RNs) has mainly focused on urban, acute care settings.

Purpose: This paper explored predictors of intent to leave (ITL) a nursing position in all rural and remote practice settings in Canada. Based on the conceptual framework developed for this project, potential predictors of ITL were related to the individual RN worker, the workplace, the community context, and satisfaction related to both the workplace and the community(s) within which the RN lived and worked.

"And then you'll see her in the grocery store": the working relationships of public health nurses and high-priority families in northern Canadian communities.

The aim of the study is to examine and articulate the nature of working relationships of public health nurses and high-priority families in small communities in northern Canada. Public health nurses working in northern, rural, and remote communities face unique and varied challenges. Reportedly, the hardest part of their job is working with families who have been deemed high priority or high risk.

Professionalism in rural acute-care nursing.

Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice.This study examines rural nurses experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach.

Public health nursing practice with 'high priority' families: the significance of contextualizing 'risk'.

Public health nurses (PHNs) play a vital role in supporting families at risk; few studies, however, have focused on how PHNs actually work with families to provide support, build trust, and use their clinical judgment to make decisions in complex, at-risk situations. In this study, we report on findings from research that illustrate how PHNs use relational approaches in their work with 'high priority' families. Drawing on data collected from interviews and focus groups with 32 PHNs, we discuss three central features inherent to working relationally with families at risk: (i) contextualizing the complexities of families' lives; (ii) responding to shifting contexts of risk and capacity; and (iii) working relationally with families under surveillance.

Personal characteristics and experiences of long-term allied health professionals in rural and northern British Columbia.

Introduction: Health sciences programs are being designed to attract students who are likely to stay and practice in rural and northern Canada. Consequently, student recruitment and screening are increasingly including assessment of suitability for rural practice. Although retention factors among rural physicians and nurses have been investigated, little is known about factors that contribute to the retention of other healthcare professionals who work in rural areas.

National consultation leads to agrivita research to practice plan for Canada.

A gap exists between research development and its implementation in agricultural health and safety. In order to fill this gap, the goal of this project was to consult agricultural stakeholders across Canada in order to identify the health and safety priorities in research and knowledge translation, and then to propose an approach to bridge the gap. Between April and August 2007, "A National Stakeholder Consultation on Health and Safety Research and its Effective Translation to the Agricultural Sector" was initiated by the Canadian Centre for Heath and Safety in Agriculture.

"There's rural, and then there's rural": advice from nurses providing primary healthcare in northern remote communities.

Nursing practice in remote northern communities is highly complex, with unique challenges created by isolation, geography and cultural dynamics. This paper, the second of two focusing on the advice offered by nurses interviewed in the national study, The Nature of Nursing Practice in Rural and Remote Canada, considers suggestions from outpost nurses. Their advice to new nurses was: know what you are getting into; consider whether your personal qualities are suited for northern practice; learn to listen and listen to learn; expect a steep learning curve, even if you are experienced; and take action to prevent burnout.

"I'm a different kind of nurse": advice from nurses in rural and remote Canada.

The sustainability of the rural and remote nursing workforce in Canada is increasingly at issue as the country becomes more urbanized and the nursing workforce ages. In order to support the retention of nurses in rural and remote communities and the recruitment of nurses to these communities, we require a better understanding of what is important to rural and remote nurses themselves. As part of the in-depth interviews conducted within The Nature of Nursing Practice in Rural and Remote Canada, a national research project, registered nurses (RNs) were asked what advice they would have for new nurses, educators, administrators and policy makers.

The development of a practice-driven, reality-based program for rural acute care registered nurses.

Few education programs adequately prepare rural registered nurses (RNs) for "multispecialist" roles within small acute care facilities. This article describes the development of a post-RN rural acute care certificate program. To plan relevant curriculum and program delivery approaches, a series of focus groups were held with 236 rural RNs throughout British Columbia, Canada.

The experience of capacity building among health education workers in the Yukon.

Background: Capacity building has developed as a health promotion approach that enables people to address determinants of health and to improve health outcomes. Although capacity building has been much discussed, little is known about what it means to build capacity in northern communities. This study explores the meaning and experience of capacity building in the Yukon.

How do registered nurses define rurality?

Objective: The objective of this analysis was to identify the meaning of rurality for registered nurses (RNs) practising in rural and remote Canada.

Setting And Design: An existing Statistics Canada definition was used to stratify Canada's 10 provinces into urban and rural areas. As part of a national multi-method study, a random sample of RNs in these rural strata, plus all RNs working in outpost settings and northern territories, were surveyed concerning the nature of nursing practice.

Insights from a national study.

Aboriginal registered nurses have been identified as an essential group in the delivery of health services in First Nations communities. Despite this, there is a lack of information about this group of nurses in Canada. This article presents information about this group taken from two components of a national study, The Nature of Nursing Practice in Rural and Remote Canada: documentary analysis and a national survey of nurses.

A profile of registered nurses in rural and remote Canada.

Research on nursing practice issues in rural and remote areas of Canada is very limited. This report describes the method and initial results of a comprehensive survey of registered nurses (RNs) practising outside the commuting zones of large urban centres, designed to determine: who practises nursing in rural and remote Canada; the nature and scope of their nursing practice; and their satisfaction with their work, community, and practice supports. Using a mailed questionnaire with persistent follow-up, the data-collection frame included a stratified random sample of rural RNs and the full population of RNs who worked in the northern territories and outpost ("remote") settings.

Rethinking emancipation and empowerment in action research: lessons from small rural hospitals.

A primary goal of action research is social change that is driven largely by the research participants. A major assumption is that through the research process, participants are enabled to take knowledgeable action in their personal, work, or community environments, and that through this action they experience empowerment. Another is that action becomes possible as a result of enlightenment and emancipation through participation in the research.

Maximizing the involvement of rural nurses in policy.

Rural health issues are increasingly recognized as needing attention, but many health policies in Canada are developed for the urban context and universally applied to rural settings. Addressing rural nurses' opportunities for involvement in policy will contribute to our general understanding of rural health while improving community health services. Rural nurses are in a unique position to assist because of their intimate knowledge of their communities and their position as informal community leaders.