Authors: Stanley David, Stanley Karen, Sudheer Bindu.
Aim: To explore perceptions of clinical leadership by nursing staff in areas of remote and rural parts of New South Wales (NSW), Australia.
Background: Bullying and threats to belonging in nursing are not new, with evidence suggesting that bullying behaviours are also evident in rural and remote environments.
Method: The methodological approach was qualitative and involved a thematic analysis of interviews from 56 nurses in 14 remote and rural health organisations. Ethical approval was secured, and a standard interview schedule was used, following participant consent.
Results: A thematic analysis was employed to code and categorise the interview data using a constant comparative method. The results generated 5 themes. A significant thread within each theme was that of bullying and threats to belonging. This article focuses on this thread and associated issues for rural and remote nursing practice.
Conclusion: This study identified that some participants held disproportionate power, due to their close relationships to their local community or because of their longevity in the clinical area. This led to threats to the culture of safety and resistance to change, leading to perceptions or experiences of bullying of new or established staff as they struggled to find a way to belong.
Implications for Nursing Practice: There is limited empirical data about the implications and impact of bullying and threats to belonging in rural and remote (R&R) areas of practice; this paper adds to the data in this practice domain and supports and confirms previously published findings.
Practitioners need to recognise the scope and impact that bullying or threats to belonging can have (particularly in R&R areas of practice). This article discusses further evidence of the scope and negative impact of bullying behaviours and offers several recommendations for managers or practitioners to limit or address bullying behaviours. Including: offering more robust educational and clinical support; recognising and limiting bullying; finding ways to bolster staff support; offering appropriate community-focused orientations; implementing of a reward system to support innovation and a positive workplace culture; applying the CRANA plus app and other staff support systems and implementing recruitment and retention strategies and take account of the difficulties faced by new staff moving to R&R environments.
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