Nurses who work in rural and remote communities in Canada: a national survey.

BACKGROUND: In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. METHODS: A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. RESULTS: Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. CONCLUSIONS: The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

Development of a strategic plan for food security and safety in the Inuvialuit Settlement Region, Canada.

BACKGROUND: Current social and environmental changes in the Arctic challenge the health and well-being of its residents. Developing evidence-informed adaptive measures in response to these changes is a priority for communities, governments and researchers. OBJECTIVES: To develop strategic planning to promote food security and food safety in the Inuvialuit Settlement Region (ISR), Northwest Territories (NWT), Canada. DESIGN: A qualitative study using group discussions during a workshop. METHODS: A regional workshop gathered Inuit organizations and community representatives, university-based researchers from the Inuit Health Survey (IHS) and NWT governmental organizations. Discussions were structured around the findings from the IHS. For each key area, programs and activities were identified and prioritized by group discussion and voting. RESULTS: The working group developed a vision for future research and intervention, which is to empower communities to promote health, well-being and environmental sustainability in the ISR. The group elaborated missions for the region that address the following issues: (a) capacity building within communities; (b) promotion of the use of traditional foods to address food security; (c) research to better understand the linkages between diseases and contaminants in traditional foods, market foods and lifestyle choices; (d) and promotion of affordable housing. Five programs to address each key area were developed as follows: harvest support and traditional food sharing; education and promotion; governance and policy; research; and housing. Concrete activities were identified to guide future research and intervention projects. CONCLUSIONS: The results of the planning workshop provide a blueprint for future research and intervention projects.

Growing an innovative faculty-driven management team in a distance-delivery NP education program: thinking outside the box to meet the nursing education and health needs of northern British Columbia, Canada.

PURPOSE: The purpose of this article is to describe how one university in northern British Columbia (BC) dealt with the issues of nurse practitioner (NP) program administration in light of its geographic context. DATA SOURCES: Reflections of the management team during the first 2 years of implementation of the faculty-driven approach. CONCLUSIONS: Our experience reflects family NP (FNP) faculty shortages internationally, the challenge of attracting qualified candidates to centers outside the urban mainstream in today's competitive academic job market, as well as the need to develop NP faculty capacity in BC, Canada. The team management approach evolved organically, based on program need, available human resources, and the culture of the faculty. The team approach for program leadership and coordination is a good fit for this NP program. IMPLICATIONS FOR PRACTICE: Implementing the team management approach has allowed the continuation of an NP program situated in a northern Canadian community that is consistent with the program's unique focus in preparing NPs to practice in often-underserved northern, rural, remote, and Aboriginal settings. While the approach provides for continuation of a quality program, it also ensures the availability of graduates well prepared to take up practice challenges in rural and northern communities.