Senior Lecturer in Nursing at the University of New England (UNE), Elaine Towner, has shed light on the unique challenges faced by new graduate registered nurses (NGRNs) in rural Australia. Her research, Exploring Experiences of the New Graduate Registered Nurse in Caring for the Deteriorating Patient in Rural Areas: A Qualitative Study, provides critical insights into the realities of rural nursing and offers recommendations to improve both nurse preparedness and patient safety.
Elaine, who grew up and studied in regional NSW, was inspired to undertake this research by her own experiences as a nurse in rural settings. “During my undergraduate education, I attended clinical placements in metropolitan, regional, and rural health services. Beginning my nursing career in regional NSW, I encountered the challenges of rural nursing, where resources and support are limited, and even beginner nurses must work at a high generalist level,” she explained.
Her study, conducted between 2020 and 2024, involved in-depth interviews with seven NGRNs working in rural areas. The findings revealed that these nurses often felt overwhelmed, anxious, and unprepared when managing deteriorating patients. “The new graduates described their experiences as overwhelming, with feelings of stress, fear, and being out of their depth,” Elaine said.
The new graduates described their experiences as overwhelming, with feelings of stress, fear, and being out of their depth.
One of the key themes of the research was the importance of support from experienced rural nurses. “The new graduates highlighted that support from an experienced rural and remote nurse was the most beneficial practice to ensure they could deliver safe nursing care and feel safe themselves,” she noted.
The study also highlighted the growing role of digital technologies in rural healthcare. While tools like Virtual Health are becoming essential for patient care, many NGRNs struggled with their use due to limited exposure during their undergraduate education. “Digital technologies are leading the way for healthcare in rural and remote areas, but this fundamental part of undergraduate education has only recently begun to receive the attention it needs,” Elaine explained.
The research offers several recommendations to better prepare NGRNs for rural practice, including enhanced undergraduate training in digital technologies, simulation-based learning, and structured mentorship programs. “This research has given me valuable insights into how we can improve the experience of caring for deteriorating patients in rural areas for new graduates while ensuring patient safety through adequate training and support,” she said.
Elaine’s passion for improving nursing education is evident in her dual roles as a researcher and educator where she is integrating her research findings into her teaching. Elaine incorporates simulation to recognise and respond to patient deterioration in the curriculum and is now enhancing these simulated learning experiences further to include the use of digital technologies. "A new graduate nurse may be working in a rural health facility with one senior nurse on the shift, in a town with no medical officers. These new nurses are the eyes, ears and hands for the medical officer until they arrive, possibly over hours away, in cases such as premature births, significant trauma, cardiac arrest, seizures, psychosis and more. Tertiary education providers need to prepare students for rural nursing where digital technologies will be a significant part of their practice".
These new nurses are the eyes, ears and hands for the medical officer until they arrive, possibly over hours away, in cases such as premature births, significant trauma, cardiac arrest, seizures, psychosis and more.
Reflecting on her journey, Elaine expressed gratitude for the support she received during her Master of Research degree. “As an academic who loves teaching and learning, research was a new and difficult field for me to grasp. But with good support from my supervisors, this degree has given me a greater understanding of the role of an academic and the profession of nursing,” she said.
Having completed three degrees at UNE, Elaine is deeply committed to the university and the regional lifestyle. “UNE has provided me with exceptional education, and I love regional NSW. I will continue to be passionate about UNE, my students, translating my research into practice, and encouraging the regional or rural lifestyle,” she said.
UNE has provided me with exceptional education, and I love regional NSW.
Elaine’s research not only highlights the resilience and dedication of new graduate nurses in rural areas but also serves as a call to action for policymakers and educators to ensure these nurses are better equipped to meet the demands of their roles.
