Exploring the Multifaceted and Multifunctional Roles and Activities of Rural Nurse Managers
Main Article Content
Abstract
Research on rural nursing has produced limited insight into the complex dynamic of roles and activities fulfilled by rural nurse managers (RNMs). Hence there is a need to explore, understand and delineate these roles to help provide appropriate managerial support and training to improve their capability. This study sought to develop greater understanding of the roles and tasks performed by RNMs, drawing on nurses’ own experiences and understandings. It used in-depth interviews with selected nurse managers working in rural and remote health-care facilities in South Australia. This provided detailed information about RNMs’ roles, responsibilities, tasks, decision making and patterns of work. Meanings were sought from the everyday activities of RNMs who drew distinctions between their roles and those of counterparts working in metropolitan facilities. Both clinical and managerial activities were highlighted but with roles described as ‘expanded,’ ‘extended’ and ‘jack of all trades’ illustrating the multiplicity of activities performed by a single RNM. The nature of rural and remote health-care facilities places special responsibilities on RNMs, creating stress deriving from role conflict and ambiguity. Recommendations are made regarding ways in which the work of RNMs can be better supported whilst addressing the complexities of their jobs. More appreciation of the job stresses needs to be considered when providing support to RNMs who face particular challenges through working in rural and remote areas. Greater understanding of their roles and daily activities can lead to better management oversight and support, but the multifaceted health issues in these areas remain challenging.
Keywords:
Nurse managers, clinical role, management role, rural, remote, South Australia
Article Details
How to Cite
CHISENGANTAMBU-WINTERS, Christine; ROBINSON, Guy M; EVANS, Nina.
Exploring the Multifaceted and Multifunctional Roles and Activities of Rural Nurse Managers.
Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5838>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i10.5838.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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10. Roberts P, Guenther J. Framing rural and remote: Key issues, debates, definitions, and positions in constructing rural and remote disadvantage. In P Roberts, M Fuqua (eds.) Ruraling education research, pp. 13-27. Springer, Singapore. 2021.
11. Smith, S., Sim, J., & Halcomb, E. Nurses’ experiences of working in rural hospitals: An integrative review. J Nurs Manage. 2019;27(3):482-490.
doi: 10.1111/jonm.12716
12. McGrail MR, Russell, DJ, Humphreys JS. Index of access: a new innovative and dynamic tool for rural health service and workforce planning. Aust Health Rev. 2016; 41:492-498. doi: 10.1071/AH16049
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doi: 10.1016/j.healthplace.2012.02.009
15. Kagi E, Rasiah R, Moran M. Experiences of primary health care nurses advancing their careers in a remote Western Australian location. Aust J Rural Health. 2023;31(1):41-51. doi: 10.1111/ajr.12904
16. Wakerman J, Bourke L, Humphreys JS, Taylor J. Is remote health different to rural health? Rural Remote Health. 2017;17(2):3832. doi: 10.22605/RRH3832
17. Carey TA, Fauth JM, Tremblay GC. Rethinking evaluation for improved health outcomes: implications for remote Australia. Am J Eval. 2020;41(2):234-254. doi: 10.1177/1098214018824040.
18. Malatzky C, Bourke L. Re-producing rural health: Challenging dominant discourses and the manifestation of power. J Rural Stud. 2016;45:157-164. doi: 10.1016/j.jrurstud.2016.03.005
19. Larkins S, Evans R. Greater support for generalism in rural and regional Australia. Aust Fam Physician. 2014;43:487-490.
doi: pubmed.ncbi.nlm.nih.gov/25006615/
20. Thomas AL, Wakerman J, Humphreys JS. Ensuring equity of access to primary health care in rural and remote Australia - what core services should be locally available? International Journal for Equity in Health. 2015;14:111. doi: 10.1186/s12939-015-0228-1.
21. Dignam D, Duffield C, Stasa H, Gray J, Jackson D, Daly J. Management and leadership in nursing: An Australian educational perspective. J Nurs Manage. 2012;20(1):65-71,
doi: 10.1111/j.1365-2834.2011.01340.x.
22. Bish M, Kenny A, Nay R. Perceptions of structural empowerment: Nurse leaders in rural health services. J Nurs Manage. 2014;22(1):29-37. doi: 10.1111/jonm.12029
23. Hart SM, Warren AM. Understanding nurses’ work: Exploring the links between changing work, labour relations, workload, stress, retention and recruitment. Econ Ind Democracy. 2015;36(2):305-329. doi: 10.1177/0143831X13505119
24. Malatzky C, Cosgrave, C, Gillespie J. The utility of conceptualisations of place and belonging in workforce retention: A proposal for future rural health research. Health and Place. 2020;62:102279. doi: 10.1016/j.healthplace.2019.102279
25. Bourke L, Dunbar T, Murakami‐Gold L. Discourses within the roles of Remote Area Nurses in Northern Territory (Australia) government‐run health clinics. Health Soc Care Comm. 2021. 29(5), 1401-1408. doi: 10.1111/hsc.13195
26. Onnis L. Clinician-to-manager transitions in remote health work contexts: Lessons from a pilot study. 33rd ANZAM Conference. Cairns, Australia. 2019. https://researchonline.jcu.edu.au/61254/
27. Barclay L, Phillips A, David L. Rural and remote health research: Does the investment match the need? Aust J Rur Health. 2018;26:74–7. doi: 10.1111/ajr.12429
28. Paliadelis P. Nurse managers don’t get the corner office. J Nurs Manage. 2013;21(2):377-386. doi: 10.1111/j.1365-2834.2012.01405.x
29. Chisengantambu C, Robinson GM, Evans N. Nurse managers and the sandwich support model. J Nurs Manage. 2018;26(2):192-199.
doi: 10.1111/jonm.12534
30. Kenny A, Allenby A. Implementing clinical supervision for Australian rural nurses. Nurse Educt in Pract. 2013;13(3):165-169.
doi: 10.1016/j.nepr.2012.08.009
31. Muirhead S, Birks M. Roles of rural and remote registered nurses in Australia: an integrative review. Australian J Adv Nurs. 2020;37(1):21-33. doi: 10.37464/2020.371.5
32. Russell D, McGrail M, Humphreys J. Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking. Aust J Rural Health. 2017;25(1):5–14. doi: 10.1111/ajr.12294
33. Cox CA. Nurse manager job satisfaction and retention: A home healthcare perspective. Nurs Manage. 2019;50(7):17-23. doi:10.1097/01.NUMA.0000558512.58455.68
34. Govasli L, Solvoll BA. Nurses' experiences of busyness in their daily work. Nurs Inq. 2020;27(3):e12350. doi: 10.1111/nin.12350
35. Smith S, Lapkin S, Halcomb E. Sim J. Job satisfaction among small rural hospital nurses: A cross‐sectional study. J Nurs Scholarship. 2023;55(1):378-387. doi: 10.1111/jnu.12800
36. Smith S, Lapkin S, Sim J, Halcomb E. Nursing care left undone, practice environment and perceived quality of care in small rural hospitals. J Nurs Manage. 2020;28(8):2166-2173. doi: 10.1111/jonm.12975
37. Griffiths P, Recio-Saucedo A, Dall'Ora C, Briggs J, Maruotti A, Meredith P, Smith GB, Ball J. The association between nurse staffing and omissions in nursing care: A systematic review. J Adv Nurs. 2018;74(7):1474–1487. doi: 10.1111/ jan.13564
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39. Parry Y, Button D. Nursing and tensions within the Australian health care system. In NJ Wilson, P Lewis, L Hunt, L Whitehead (eds.) Nursing in Australia: contemporary professional and practice insights. Routledge, Abingdon, Oxon. and New York, pp. 11-20. 2020.
40. Smith T, McNeil K, Mitchell R, Boyle B, Ries N. A study of macro-, meso-and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia. BMC Nursing. 2019;18(1):14. doi: 10.1186/s12912-019-0337-z
41. Lenthall S, Dade Smith J. Remote health practice. In J Dade Smith (ed.) Australia’s rural, remote and indigenous health. Elsevier, Chatswood, NSW., pp. 285–315. 2016.
42. Cheon HS, Yrani T. Multiplicity within and between: Addressing multiple roles through role profiles in couples, Journal of Creativity in Mental Health. 2018;13(1):31-42. doi: 10.1080/15401383.2017.1343165
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