Help Wanted, Experience Preferred, Stamina a Must: A Narrative Review of the Contextual Factors Influencing Nursing Recruitment and Retention in Rural and Remote Western Canada from the Early Twentieth Century to 2023.

Rural and remote communities of Western Canada have struggled to recruit and retain nursing professionals since the turn of the twentieth century. Existing literature has identified the unique challenges of rural nursing due to the shifting context of rural and remote nursing practice. The objective of this narrative review is to explore the history of rural and remote nursing to better understand the contextual influences shaping rural nursing shortages in Western Canada. This narrative review compared 27 sources of scholarly and historical evidence on the nature of rural nursing practices and recruitment and retention methods following the First World War until 2023. The findings suggest that the complex nature of rural nursing practice is a consistent challenge that has intersected with the long-standing power inequities that are inherent in rural marginalization, political influences, the nursing profession, social structures, and organizational design, to perpetuate rural nursing shortages throughout the past century. Integration and collaboration are needed to reduce systemic marginalization and develop effective and sustainable solutions to reduce nursing shortages in rural and remote areas of Western Canada.

Exploring the Impacts of Heteronormative and Cisnormative Ideologies on Fertility Intentions and Family Planning Experiences Within the 2SLGBTQ Community: A Qualitative Case Study.

Objectives: Normative beliefs around gender and sexuality place individuals in the Two Spirit, lesbian, gay, bisexual, trans, and queer (2SLGBTQ) community at risk for poorer health outcomes within the health care system compared with their heterosexual and cisgender counterparts, particularly within gendered areas of care including family planning and fertility intentions. The purpose of this research was to explore the effect that the normative beliefs of heteronormativity and cisnormativity had on the experiences of 2SLGBTQ people engaged in family planning, and to begin to understand how health care providers can provide appropriate, safe, and holistic care. Methods: We conducted a qualitative study using case study methodology and completing semi-structured interviews with 11 participants with diverse genders and sexualities. Findings: For members of the 2SLGBTQ community, family planning is greatly affected by ideals of normal, intersections of identities, health care systems, and community. They may face additional emotional labor and intentional decision-making when related to family planning. Heteronormativity and cisnormativity greatly impact the health care that is received. Conclusions: The findings contribute information in the limited field of research related to the 2SLGBTQ community and may support health care providers in providing holistic care.

Risk Communication in Public Health: Lessons from a Historic Fluoridation Debate in Saskatchewan.

Effective risk communication is critical to gain public support when implementing population-level health interventions. Analysis of previous public health campaigns can provide guidance for future efforts. This case study examined a successful community water fluoridation campaign in Saskatoon, Canada, during 1953/54. The key strategies and messaging used by both sides of the debate were assessed using two publicly available historic data sources: documents in the city archives and newspaper coverage. The anti-fluoridation campaign approaches (e.g. misinformation, innuendo, half-truths and scare words, requesting a plebescite) were similar to those used elsewhere by this movement as described in the literature. Key features of the effective pro-fluoridation campaign included extensive community outreach, involvement of local experts, dissemination of supporting evidence while aggressively addressing misinformation, highlighting the support of relevant health organizations, and ensuring key messages received media coverage. This study illustrates how misinformation and public opposition has posed a challenge to public health efforts long before the advent of social media and highlights strategies, consistent with current risk communication principles, that have stood the test of time.

Filling the Gap between Metropoles and Peripheries: Insights about Hospital Standardization from the British Columbia Hospital Association Conferences, 1918-30.

In this study, we examine British Columbia's Hospital Association conference records (1918-31) to understand how place, gender, and profession shaped debates about hospital standardization during the interwar period. The conference records reveal that hospital standardization was conceptualized as the conformity of smaller, peripheral hospitals to larger metropolitan ones. Arguments about how to best address the gaps in small hospitals were often directed to elite nursing leaders, who suggested improved nursing education as a solution. Hospital affiliation was recommended to ensure adequate training for rural nurses by moving trainee nurses from rural to urban hospitals during the last year of their education. Yet the way that affiliation was conceived was more aligned with the professional goals of the nursing elite, rather than the needs of rank-and-file nurses in small hospitals. These ideas ultimately worked to support the goals of standardization, but obscured the divergent needs of small community hospitals.

A philosophical analysis of anti-intellectualism in nursing: Newman's view of a university education.

Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti-intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti-intellectualism in nursing education. We use John Henry Newman's view of the purpose of a university education as a heuristic perspective to examine anti-intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency-based curricula and business models rooted in neoliberal financial policies reinforce anti-intellectualism in nursing. Anti-intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti-intellectualism. Counteracting anti-intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti-intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized.

The History of Saskatchewan's Public Health Association Policy Initiatives, 1954-86: A Regional Comparison for Preventative Health Policy Work in Canada.

After the Second World War, health prevention work in Canada shifted from a focus on sanitation and hygiene to illness prevention and health promotion. Canada became a significant global leader, beginning with the Lalonde Report of 1974. Yet less is known about the provincial public health associations and how their work differed from that of the national body. The purpose of this article is to examine the Saskatchewan Public Health Association's (SPHA) policy work from 1954 to 1986. Utilizing meeting minutes and newsletters, we found that while both national and provincial associations made efforts to prevent accidents, reduce tobacco use, and fluoridate water, the SPHA tended to advocate more for child health, and the cautious use of nuclear power. At the same time, the SPHA's resolutions tended to ignore emerging factors shaping health, including the social determinants of health, regional inequities, lack of public trust in experts, misinformation, and human psychology. Examining the SPHA's records revealed that region mattered in preventative policy work.

A Closer Look at the Introduction of the NCLEX-RN in Canada.

In 2015, the nursing faculty across most of Canada were informed by provincial nursing regulators that the America-based National Council Licensure Examination-Registered Nurse (NCLEX-RN) was going to replace the Canadian Registered Nurse Examination for our nursing students to become registered as nurses. This change in the exam has presented a number of challenges to both faculty and students as they transitioned from a Canadian exam for the Canadian context to an exam that was originally formulated for nursing registration in the United States. This manuscript examines the differences in the Canadian and American healthcare systems; explores the variations in Canadian and American nursing practice and education; outlines concerns surrounding the use of standardized testing that panders to corporate interests, encourages "teaching to the test" and is costing nursing programs and nursing students considerable resources; and explores the controversy surrounding the validity of the NCLEX-RN in both Canada and the United States. This manuscript asks Canadian nursing leaders, educators, clinicians and researchers to question why Canadians have taken on this exam when Americans themselves state that this exam "gives a false and incomplete picture of practice readiness."

"A Powerful Protector of the Japanese People": The History of the Japanese Hospital in Steveston, British Columbia, Canada,1896-1942.

From 1896 to 1942, a Japanese hospital operated in the village of Steveston, British Columbia, Canada. For the first 4 years, Japanese Methodist missionaries utilized a small mission building as a makeshift hospital, until a larger institution was constructed by the local Japanese Fishermen's Association in 1900. The hospital operated until the Japanese internment, after the attack on Pearl Harbor during World War II. This study offers important commentary about the relationships between health, hospitals, and race in British Columbia during a period of increased immigration and economic upheaval. From the unique perspective of Japanese leaders, this study provides new insight about how Japanese populations negotiated hospital care, despite a context of severe racial discrimination. Japanese populations utilized Christianization, fishing expertise, and hospital work to garner more equitable access to opportunities and resources. This study demonstrates that in addition to providing medical treatment, training grounds for health-care workers, and safe refuge for the sick, hospitals played a significant role in confronting broader racialized inequities in Canada's past.

Conceptualizations of culture and cultural care among undergraduate nursing students: an exploration and critique of cultural education.

Culture and cultural care have become important concepts in nursing education. However, little is known about what nursing students learn about these complex concepts. The purpose of this study was to explore and critique what nursing students learn about culture and cultural care. First and fourth year students were invited to participate in a focused ethnography to explore how nursing education might shape student knowledge of culture over time. Findings revealed that both groups of students supported the essentialist view of culture. Although students supported the ideals of cultural care, students remained unaware of critical views of culture.

Critical ethnography: extending attention to bias and reinforcement of dominant power relations.

AIM: Many forms of critical theory shape nursing research. One approach that is gaining popularity is Carspecken's critical ethnography. This methodology was designed to help researchers understand power relations by merging a critical stance with a complex and dynamic qualitative strategy of inquiry. Despite the appeal of this approach, we argue Carspecken does not adequately address how researchers can minimise researcher biases and dominance when studying power relations. The purpose of this article is to critique Carspecken's implementation of critical theory from the standpoint of lack of attention to bias and reinforcement of oppression. DISCUSSION: The authors explain how greater attention to reflexivity, relationality and reciprocity could reduce opportunities for researcher bias and the potential for oppressive structures and dominant power relations to be reinforced. IMPLICATIONS FOR RESEARCH: Researchers can better address bias and reinforcement of power relations through reflexivity. Bias can be reduced by making explicit values that may privilege particular decisions and observations throughout the research process. Researchers can also reduce bias via relationality or giving participants equal power in decision making and taking action towards social justice. When researchers engage in reciprocity they encourage participants to contribute to all stages of the research process and therein equalise power relations.

Culture theorizing past and present: trends and challenges.

Over the past several decades, nurses have been increasingly theorizing about the relationships between culture, health, and nursing practice. This culture theorizing has changed over time and has recently been subject to much critical examination. The purpose of this paper is to identify the challenges impeding nurses' ability to build theory about the relationships between culture and health. Through a historical overview, I argue that continued support for the essentialist view of culture can maintain a limited view of complex race relations. I also argue that attempts to apply culture theory, without knowledge of important historical, political, and economic factors, has often resulted in oversimplified versions of what was originally intended. Furthermore, I argue that individual-level interventions alone will be insufficient to address health inequities related to culture. Despite new critical conceptualizations of culture and the uptake of cultural safety, nursing scholars must better address the broader organizational, population, and political interventions needed to address inequities in health. I conclude with suggestions for how nurses might proceed with culture theorizing given these challenges.