Maintaining Best Practice in Rural Emergency Departments; tips, tricks and pitfalls

Gwenhyfar Ferguson1,

1 Country Health SA, SA, 5690, camelgwen@yahoo.com.au

Maintaining a skilled workforce in a rural emergency department presents a specific set of challenges. Barriers to training arise from internal and external issues. External issues include geographical isolation, training course cost and inflexible training delivery. Internal issues include limited or lack of nurse educators, deficient progression planning, limited support and paucity of senior staff and mentors. Due to the identified constraints, training for rural ED nurses is often inappropriate, insufficient and irrelevant.
The rural nurse role of the specialist-generalist has limited exposure to emergency nursing care due to infrequency of presentations. Consequently with high acuity emergency patients the rural nurse may lack confidence and proficiency to manage safe patient care. Meeting these challenges requires innovative solutions.
Developing skills and building a sustainable model of training delivery requires effort from nurses and management. There are transition and skill development tools available. The difficulty is to disband old assumptions about training strategies, now identified as ineffective and build systems on identified staff needs.

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