Practice Readiness in very remote hospitals: Perceptions of early career and later career registered nurses

  • Kerry-Ann Wilcox
    Discipline of Nursing, College of Science, Health, Engineering & Education, Murdoch University, 90 South St, Murdoch, Western Australia, 6150, Australia
    Search for articles by this author
  • Vicki Cope
    Discipline of Nursing, College of Science, Health, Engineering & Education, Murdoch University, 90 South St, Murdoch, Western Australia, 6150, Australia
    Search for articles by this author
  • Melanie Murray
    Corresponding author at: 270 Joondalup Dr, Joondalup, Western Australia, 6027, Australia. Tel.: +61 8 63047172.
    Discipline of Nursing, College of Science, Health, Engineering & Education, Murdoch University, 90 South St, Murdoch, Western Australia, 6150, Australia

    School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Dr, Joondalup, Western Australia, 6027, Australia
    Search for articles by this author



      To understand the practice readiness of the early career registered nurse in their first five years of practice within very remote hospital healthcare provision.


      The practice readiness of early career registered nurses is often questioned; this is particularly true of nurses in rural and remote settings where, due to a transitory workforce, adequate support may not be forthcoming.


      Qualitative descriptive design using semi-structured interviews involving early career (n = 4) and later career (n = 3) registered nurses in very remote hospitals. Data were analysed using Creswell's six-step approach to thematic analysis.


      Practice readiness includes both professional and personal readiness. Early career registered nurse participants felt not ready for remote area employment. Later career registered nurses suggest that critical care placements in an emergency department or intensive care unit are necessary for preparedness to work in rural and remote areas. Key to supporting and developing practice readiness is organisational support, adequate, consistent staffing, and structured orientation across all departments.


      Early career registered nurses understand their limitations; however, organisational support through appropriate orientation, supernumerary time, and adequate education is often not available.


      To support early career registered nurses to be practice ready, it is the organisation's responsibility to provide the adequate support, information, and preparatory education to ensure an effective transition to practice for future proofing of the rural and remote nurse workforce.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Collegian
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bradshaw C.
        • Atkinson S.
        • Doody O.
        Employing a qualitative description approach in health care research.
        Global Qualitative Nursing Research. 2017; 4 (233339361774228-2333393617742282)
        • Capper T.
        • Brown J.
        • Donovan H.
        • Hegney D.
        • Williamson M.
        • Cusack L.
        • et al.
        Individual and environmental factors that influence longevity of newcomers to nursing and midwifery: a scoping review protocol.
        JBI Evidence Synthesis. 2020; 18: 1271-1277
        • Christopher S.A.
        • Chiarella E.M.
        • Waters D.
        Can generation Y nurses supply areas of shortage? New graduate challenges in today’s job market.
        Australian Journal of Advanced Nursing. 2015; 33: 36-45
        • Cosgrave C.
        • Maple M.
        • Hussain R.
        An explanation of turnover intention among early-career nursing and allied health professionals working in rural and remote Australia - findings from a grounded theory study.
        Rural and Remote Health. 2018; 18 (no pagination)
        • Creswell J.
        Research Design: Qualitative, Quantitative and Mixed Method Approaches. 4th. Sage Publications Inc, Thousand Oaks2014
        • Creswell J.W.
        • Poth C.N.
        Qualitative inquiry & research design: choosing among five approaches.
        Fourth ed. SAGE Publications, Inc, Newbury Park2018
        • Djukic M.
        • Kovner C.
        • Brewer C.
        • Fatehi F.
        • Seltzer J.
        A multi-state assessment of employer-sponsored quality improvement education for early- career registered nurses.
        The Journal of Continuing Education in Nursing. 2013; 44: 12-19
        • Doyle L.
        • McCabe C.
        • Keogh B.
        • Brady A.
        • McCann M.
        An overview of the qualitative descriptive design within nursing research.
        Journal of Research in Nursing. 2020; 25: 443-455
        • El Haddad M.
        • Moxham L.
        • Broadbent M.
        Graduate nurse practice readiness: a conceptual understanding of an age old debate.
        Collegian. 2017; 24: 391-396
        • Fowler A.C.
        • Twigg D.
        • Jacob E.
        • Nattabi B.
        An integrative review of rural and remote nursing graduate programmes and experience of nursing graduates.
        Journal of Clinical Nursing. 2018; 27: 753-766
        • Government of Western Australia
        WA Country Health Service [WACHS]. Nursing & Midwifery Workforce Indicators Q4 2019/2020.
        Government of Western Australia, Perth2020
        • Gwynne K.
        • Lincoln M.
        Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review.
        Australian Health Review. 2017; 41: 234-238
      1. Health Workforce Australia (2014). Australia's Future Health Workforce – Nurses Overview Report. Canberra: Commonwealth of Australia Department of Health. Available from:$File/AFHW%20-%20Nurses%20overview%20report.pdf (Accessed Feb 2021)

        • Hugo Centre for Population and Housing
        Accessibility/Remoteness Index of Australia (ARIA).
        The University of Adelaide, 2020 (Available from:)
        • Mills J.
        • Woods C.
        • Harrison H.
        • Chamberlain-Salaun J.
        • Spencer B.
        Retention of early career registered nurses: the influence of self-concept, practice environment and resilience in the first five years post-graduation.
        Journal of Research in Nursing. 2017; 22: 372-385
        • Murray M.
        • Sundin D.
        • Cope V.
        A Mixed-Methods study on patient safety insights of new graduate registered nurses.
        Journal of Nursing Care Quality. 2020; 35: 258-264
        • Onnis L.L.
        • Pryce J.
        Health professionals working in remote Australia: a review of the literature.
        Asia Pacific Journal of Human Resources. 2016; 54: 32-56
        • Sedgwick M.
        • Pijl-Zieber E.
        New rural acute care nurses speak up: "We're it" but we're not ready.
        Journal for Nurses in Professional Development. 2015; 31: 278-283
        • Smith J.G.
        • Plover C.M.
        • McChesney M.C.
        • Lake E.T.
        Isolated, small, and large hospitals have fewer nursing resources than urban hospitals: Implications for rural health policy.
        Public Health Nursing. 2019; 36
        • Spence Laschinger H.K.
        • Zhu J.
        • Read E.
        New nurses’ perceptions of professional practice behaviours, quality of care, job satisfaction and career retention.
        Journal of Nursing Management. 2016; 24
        • Wang L.
        • Zhang Y.
        • Tao H.
        • Bowers B.J.
        • Brown R.
        Influence of social support and self-efficacy on resilience of early career registered nurses.
        Western Journal of Nursing Research. 2018; 40: 648-664
        • Wakerman J.
        • Humphreys J.
        • Russell D.
        • Guthridge S.
        • Bourke L.
        • Dunbar T.
        • Jones M.P.
        Remote health workforce turnover and retention: what are the policy and practice priorities?.
        Human Resources for Health. 2019; 1799
      2. World Health Organisation (2016). Global strategy on human resources for health: workforce 2030. Geneva: World Health Organisation. Available from: (Accessed Jan 2021)