What stresses remote area nurses? Current knowledge and future action.
OBJECTIVE
Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands-resources (JD-R) model.


METHODS
A comprehensive literature review was conducted using the meta-databases Ovid and Informit.


METHODS
Remote Australian primary health care centres.


RESULTS
The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high-demand, low-resource context, the JD-R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems.


CONCLUSIONS
There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD-R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress.
Lenthall
Sue
S
Centre for Remote Health, Flinders University and Charles Darwin University, PO Box 4066, Alice Springs, Northern Territory, 0871, Australia. sue.lenthall@flinders.edu.au
Wakerman
John
J
Opie
Tess
T
Dollard
Maureen
M
Dunn
Sandra
S
Knight
Sabina
S
Macleod
Martha
M
Watson
Colin
C
D001291:Attitude of Health Personnel; D001315:Australia; D006801:Humans; D008507:Medically Underserved Area; D009726:Nurses / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D013315:Stress, Psychological / Q000209:etiology*; D000078329:Workforce