Unprepared and under pressure: Transitioning experiences to emergency nursing in rural and remote areas

Access to quality healthcare in rural and remote Australia remains a significant challenge, with registered nurses (RNs) often the sole face-to-face healthcare provider. Emergency care in these settings requires adaptable, highly skilled RNs capable of managing critical and deteriorating patients with limited support. A gap remains in preparing RNs for these complex demands. The aim of this research was to explore the experiences and preparedness of non-emergency trained RNs, new to the rural and remote environment in managing emergency care.

A qualitative exploratory descriptive design was used to explore the experiences of non-emergency trained RNs in rural and remote settings. Semi-structured interviews were conducted and transcribed verbatim. Data was analysed using thematic analysis. COREQ guidelines were followed.

23 RNs were divided into two cohorts: experienced rural and remote RNs and those new to the rural and remote context. Thematic analysis revealed three core themes: (1) It is more complex than preparedness, (2) Securing the future success of rural and remote RNs and (3) The good, the bad and finding the 'in between'. Participants highlighted a disconnect between metropolitan and rural healthcare expectations and emphasised the need for context-specific training, ongoing professional growth, and a culturally responsive, community integrated approach. Findings indicate unpreparedness extends beyond clinical skills to include confidence, community engagement, and cultural competence. This lack of preparedness impacts job satisfaction, confidence, and the ability to manage rural healthcare complexities, ultimately influencing nursing retention rates globally.

Rural and remote RNs face challenges including limited resources and professional isolation. Findings underline the importance of tailored education, self-reflection and realistic recruitment strategies to support and retain RNs in rural and remote settings and ensure sustainable healthcare in rural and remote communities.