Manual for nursing in rural and remote settings

Nursing in rural and remote areas is diverse, challenging and rewarding. You
can be almost certain that wherever you go you will gain new skills that will
also be useful and relevant later in your professional life and in other settings.
Wherever you work in rural and remote areas you will need expertise and
confi dence in cross-cultural issues and other local norms and customs you
will encounter. Ask your potential employer and seek special advice.
Remote areas can present quite unique experiences and you may have less
peer-group support than you are used to but there may be some special terms
and conditions in your contract or employment conditions to help support your
work in such areas. Find out as much as you can about the health setting and
the community before you set out.
Experienced rural and remote area nurses fi nd their lifestyles the most
rewarding of all nursing work. We hope you will come to love it too.
Selection
Make your selection carefully. Short-term tenure and turnover are expensive
and potentially compromise the quality of your service. Respond to your
applicants promptly. Ensure that applicants know they will be required to
provide: referees, current professional registration documentation that can
be verifi ed, results of a criminal record screen, relevant medical screening,
a current driver’s licence (if required), and documentary evidence of any
credentialing required for the position (immunisation etc).
Offer of employment and appointment
Ensure your offer of employment is comprehensive and clear. It should
clearly state such things as type of employment, duration of contract, terms of
probation, salary, salary packaging, leave, other allowances, reimbursements
and other entitlements. Particular expectations such as shift work, on-call
and weekend work should be clear.
Induction
Organise for your new nurse to be met and welcomed on their arrival. Ensure
that any allocated accommodation is ready for occupation. Include a ‘starter
pack’ of essentials, including milk, cereal, bread and condiments, particularly
if they will arrive at the end of the day or at night. Simple things like a
tablecloth or bunch of fresh fl owers can make a big difference. Depending on
the timing and circumstances of arrival, one or more nights for them in a hotel
or motel might be a good fi rst option.
Orientation programs
Remember that experienced rural and remote area nurses once had to learn
what they now take for granted! Putting out the ‘welcome mat’ for a new
staff member is the fi rst step toward ensuring their retention. The second is providing them with information, support and encouragement to help them
succeed and not to feel inadequate or inept.
If the workplace is in an Indigenous community, cultural orientation needs to
be arranged as well as organising a mentor or guide who may help navigate
any cultural taboos and norms that may present.
An ideal orientation will take at least a week and will introduce your new staff
member to key people in the community and region, provide some geographic
orientation, and enable them to begin familiarisation with the facilities of the
organisation and the workplace itself. Stories abound of nurses who have
been frustrated by the time taken to locate things that experienced people take
for granted. Being able to access information effi ciently contributes much to a
new employee’s competence.