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Rural Nursing in Aotearoa New Zealand and Australia: Embracing Strategic Foresight to Sustain Tomorrow’s Workforce

The problems facing rural nursing in Aotearoa New Zealand and Australia in the contemporary healthcare environment are very similar. Rural nurses manage a myriad of presentations in their work setting, frequently without medical support. Commonly, healthcare services are provided in either small rural hospitals, in the community, in general practice or in nurse-only rural clinics. Operating with limited infrastructure is a distinctive aspect of rural practice (Francis, Chapman, Hoare, & Birks, 2013). Consequently, rural nurses require a greater diversity of skills and knowledge than their urban counterparts, as they frequently face a broad range of challenges (O’Connor, 2014). These challenges are present in part due to the high numbers of visitors, many of whom take part in adventure tourism, and the transient and seasonal workers employed either in hospitality or in vineyards and orchards (Fitzwater, 2008), all of whom require access to healthcare 24 hours a day. In Australia, older people are touring long distances over protracted time frames while living in caravans, campervans, motorhomes or tents. These individuals are accessing health services largely for management of chronic illnesses and, to a lesser extent, medical emergencies, and this further increases the burden (Raven, 2015). In order to manage these unique challenges, rural nurses work within a purview that is frequently termed “generalist specialist” (Jones & Ross, 2008;Bingham, 2016; CRANA Plus, 2018)