Dr Chris Rice - Nurse Recruitment & Retention on the Scottish Isles

Dr Chris Rice is a qualified nurse and paramedic, and Associate Head of Postgraduate Medicine at Edge Hill University in Lankashire.  His doctoral thesis explored the recruitment and retention of nurses staff across northern Scotland’s non doctor islands.

Episode Summary:

01.30  Chris tells us about his professional background and how he became interested in rural practice.

03.25  What does he most enjoy about working in a rural area and what does he find most challenging?

04.57  What are the health services and the population like in Shetland?

10.45  Why did he choose to research recruitment and retention of nurses on the Scottish Isles? 

12.05  What are the skills and competencies that nurses need to work on the Scottish Isles?

17.19  How is the infrastructure on the islands?

19.00  What are the opportunities for training or professional development on the Scottish Isles?

21.10  What were the insights that he had from his research on recruitment and retention?

24.33  What factors play a role in retention?

27.37  What are younger nurses not choosing to come to the isles?

29.45  What are his recommendations for improving recruitment and retention of nurses?

34.30  What is he working on currently?

 

Key Messages:

The biggest reward is holistic patient care, getting to know the patients, becoming part of the community, and a sense of belonging which is unique to rural practice.

Challenges - being on-call 24h a day, being the only medically trained person on the island. 

NHS Shetland covers a population of about 22 000, there are about 5 no-doctor islands, they are remote and accessible by boat, plane or helicopter.  Population on these islands varies from 15 to 450 members of the community.  

Depending on the weather it can be challenging to transport patients off an island, they collaborate closely with other emergency services and they have equipment on the island to help them manage critical patients when needed.  

The healthcare professionals on the ground on the islands are usually nurses who are there 24h a day, living on the islands, provided with accommodation and transport.  Patients are linked to a local GP who may or may not be based on the island.  

What drove him to move to the Scottish isles?  He wanted new challenges for his practice, delivering continuity of care and being part of the community.  He wanted to understand what drove others to make a similar decision.

A variety of skills are needed, primary care, emergency care and chronic disease management.

There is always somebody at the end of the phone, there is always a GP on-call, an advanced practitioner or emergency services.  Ultimately you still need to make the clinical decision for the patient in front of you.

Provided with trauma and emergency training and the Sandpiper trust provides training and a bag with emergency equipment.  

The majority of nurses came to the isles for a change of career, they were looking for something different.  Many of them came to the isles ahead of retirement.  The majority were over 50 yrs of age. The nurses were from A&E, GP or acute medicine backgrounds.

Work-life balance was a key factor for retention of nurses.  

The community finds work for partners of those coming to work on the isles.

Younger professionals are more focused on building a career and this can be easier in more urban areas.

The younger generations tend to go off island to get the experience and build careers and then they return later in life.  

It is important to have an open and honest dialogue about what the job is and what to expect.

There are new training pathways being developed for rural and remote practice.  

 

Contact: [email protected]  

 

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