Perspectives of nurses providing urgent and emergency care in rural health services without in-person medical cover in Aotearoa New Zealand

Overview

In New Zealand, people living in rural areas have worse health outcomes than those living in urban areas, and this is accentuated for Māori.

Working in rural and remote health services requires unique skills and knowledge that cover a broad range of health professional practice. In rural New Zealand nurses are increasingly working without medical in-person cover including in the provision of emergency or urgent after-hours care. This situation has been exacerbated since the COVID19 pandemic which has seen a worsening of the rural medical workforce shortage. In many rural health services including rural hospitals, registered nurses and nurse practitioners who previously had a local medical officer on-site or to call in, are now working with virtual-only medical cover.

While this situation has become common in health services in remote Australia and has been the case in New Zealand in some areas for rural primary care, it is newer for rural health services providing emergency/urgent care.

The proposed research seeks to explore, from a nurse perspective, the impact of this change in workforce configuration. The research may have wider implications for clinical safety and equity of care for rural New Zealand.

Research question

What is the experience of New Zealand rural nurses providing emergency/urgent after-hours care in a rural health centre or rural hospital where there has been withdrawal or reduction of in-person medical cover and support.

Methods could include

• A literature review
• Qualitative - semi- structured interviews and thematic analysis
• Survey
• Supervisors are physically based at a distance from any campus and are from:
  • Centre of Rural Health
  • Department of GP and Rural Health
  • DSM
  • Department of Nursing, University of Otago, Christchurch

Applicants must be eligible for admission to the MHealSc programme at the University of Otago.

Applicants can be based anywhere in NZ, preference will be given to rural health professionals with a nursing background who are rurally-based.

Useful information

• Graduate research at the University of Otago
• Scholarships at the University of Otago