Facilitators, Barriers, and Educational Preparedness of Early-Career Nursing Graduates Entering Practice in Rural and Remote Areas: A Mixed-Method Study

<b>Background/Objective:</b> A nurse staffing crisis is a high-profile issue in the healthcare system. The challenge accelerates when considering the status of the nursing workforce in rural and remote (R&R) areas, where recruitment and retention are mounting problems. The primary focus of this study was to evaluate facilitators and barriers to entry into R&R nursing practice, alongside understanding educational preparedness to practice in these settings in Manitoba. <b>Methods:</b> A sequential explanatory mixed-methods survey and qualitative interviews were used as a study design to explore this emerging problem. Study participants include registered nurses (RNs) and Licensed Practical Nurses (LPNs) practicing in Manitoba's R&R areas within three years of graduation from a nursing program. <b>Results:</b> A total of 77 nurses (56-RNs and 21-LPNs) participated in the survey, while 16 nurses were interviewed subsequently. Having a positive workplace culture (70%), being born or residing in an R&R area before practicing as a nurse (66%), and having a good clinical variety of patients (65%) were identified as key facilitators. Unmanageable workload with inadequate staffing (50%) and inadequate resources and infrastructure (46%) were identified as key barriers to entering R&R nursing practice in Manitoba. Through qualitative interpretive descriptions, the generalist role, autonomy, rural life, and organizational culture were identified as facilitators, while resources, staffing, geography, and expanded roles were identified as barriers. <b>Conclusions:</b> Preparing new nursing graduates for the realities they face in R&R areas is paramount. The current study findings help inform R&R curriculum in undergraduate nursing programs and consider strategies to enhance employment opportunities for new nurses in these dynamic settings.