"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. This is the first of two papers describing that advice. It focuses on RNs in acute care, long-term care, home care, community health/public health and primary care roles in rural and remote communities across the country. The RNs were generous with their advice and gave many rich examples. While they were enthusiastic about their nursing practice and encouraging of other nurses to work in rural settings, they were intent that improvements be made in several key areas: education available to new practitioners and themselves, working conditions for rural and remote nurses, leadership, organizational supports and policies that better support rural and remote practice and communities.

"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. Recommendations for educators were to offer programs that prepare nurses for the realities of outpost nursing and provide opportunities for accessible, flexible, relevant continuing education. The outpost nurses in this study counselled administrators to stay in contact with and listen to the perspectives of nurses at the "grassroots," and not merely to fill positions but instead to recruit outpost nurses effectively and remunerate them fairly. The study findings highlighted the multiple interrelated strategies that nurses, educators and administrators can use to optimize practice in remote northern communities.