An investigation into the recruitment and retention factors of nurses who work across Northern Scotland’s remotest island communities using a life history methodology

Abstract

Background Over the past decade the nursing profession has seen a significant shortage of nurses to meet the ever-increasing demands of the National Health Service (NHS). This has placed recruitment and retention at the forefront of political agendas. In order to meet increasing demand, health boards need to explore new avenues of working especially for remote and rural practice.

A group of nurses are at the forefront of patient care and who’s role incorporates working in some of the harshest environments across the UK. These nurses work on remote and rural islands known locally as non-doctor islands (NDI). These islands are unique to Northern Scotland and cover three health boards, NHS Orkney, NHS Shetland and NHS Highland. These nurses provide 24-hour cover 365 days a year with a diverse skill set that covers primary, secondary and emergency care. This study will explore the factors that influence nurse’s decisions to live and work on the NDIs and furthermore the factors that keep them in post.

Aims and Objectives The overall aim of this study is to understand the life history and career events that influence the trajectory of nurses who work on non-doctor islands across Northern Scotland. To furthermore understand the career journey of nurses and what influences their decision-making process to work on non-doctor islands. To understand the experiences of nurses who work on non-doctor islands and to understand the reasons nurses, remain or leave their employment on non-doctor islands.

Methods This research explored the life history of eleven nurses who work and live on the NDIs. The aim of which is to understand the factors that influence their overall recruitment and retention to the islands. What makes this research unique is the use of a life history methodology. This methodology is used to underpin semi-structured interviews of the nurses, taking them back to their early childhood memoirs and mapping their career and life journeys to the present day.

Results The results show that childhood support networks form an important aspect in their early childhood experiences. It is these experiences where we see the emergence and recurring life history themes of independence, resilience and teamwork. The pathways into nursing were fostered by first-hand experiences of caring and that of family role models. Today we see nurses that form part of the wider island community who have clinical autonomy and work life balance. The move to a non-doctor island for many is their final steppingstone before retirement.

Conclusion This research has identified the factors that influence nurse recruitment and retention to NDIs. The use of a life history methodology has facilitated an insight into the life history of the participants from their early childhood memories to the present day.