Developing a community-based nursing and midwifery career pathway - A narrative systematic review

Area of Science:

• Nursing and Midwifery Practice
• Healthcare Workforce Development
• Community Health Services

Background:

• Community nursing and midwifery roles are evolving due to increased home-based care needs driven by an aging population and chronic conditions.
• Current community nursing roles lack clear definition and appeal, contributing to a looming workforce shortage.
• Effective transition support is crucial for retaining professionals in community practice.

Purpose of the Study:

• To systematically review and synthesize evidence on transitioning into community nursing and midwifery practice.
• To identify factors that define, enable, or inhibit contemporary pathways into community practice.
• To inform strategies for supporting early-career professionals in community nursing and midwifery.

Main Methods:

• Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Narrative synthesis of twelve included papers examining community nursing and midwifery pathways.
• Thematic analysis using a framework for early career specialty practice transition.

Main Results:

• A paucity of research defines community nursing as a distinct scope of practice, unlike midwifery.
• Key themes identified were 'the self' (professional/personal), 'transition processes', and 'sense of belonging'.
• Pre-entry exposure and planned, individualized transition stages (pre-entry, incomer, insider) are vital for successful integration.

Conclusions:

• Community nursing requires specialist knowledge despite its generalist description; midwifery has a defined scope.
• A strong sense of professional and personal belonging within the community is essential.
• Transition processes must be planned, individualized, and acknowledge prior experience and the specialized nature of community practice.