Case Study Part 1

You are a new graduate nurse, passionate about working in rural and remote communities and are starting a new graduate guarantee (NGG) within a small community hospital in Northern Ontario. You identify as a nonbinary, biracial, first-generation settler, Buddhist, new graduate nurse. You learned about the health disparities faced by individuals living in rural communities such as shorter life expectancy, higher rates of smoking, obesity, substance abuse and mental health conditions, and you aim to be a positive contributor to this community’s health outcomes. You have grown up and completed your BScN within a large urban city. Although you are aware of the difference in resource allocation, you haven’t faced a lack of resources within your clinical placements. You are unsure how long you will remain in rural nursing but approach the job as a new learning opportunity and experience.

Within your first week of orientation, you are surprised you are the only new NGG hire. Many of your nursing friends discussed looking for NGGs but did not get one. As per the NGG, you are assigned a preceptor for a 3-month orientation before starting your independent practice on a medicine unit. During your first shift you realized that the hospital only has two units; one small 8-bed unit emergency and primary care center and one 15 bed unit for all admitted patients. You are shocked that there is only one small health center/hospital for all the neighbouring communities. What surprises you, even more, is that the nurses provide a lot of the primary care that would have been provided by nurse practitioners (NP) or physicians in the city. Patients with any general health inquiries presented to the emergency/health assessment unit to get advice on their medical conditions. Many of the skills and the assessment completed by the nurses are outside their scope of practice. As you continue your orientation you see the trust that the local community has in all the nurses who work in the hospital and the unique cultural practices the nurses provide. The nurses tell you that they enjoy their practice in the small tight-knit community. Many of the patients remember the care provided by the nurses many years later. You slowly become part of the community and consider staying within rural nursing longer than you originally anticipated.