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Alley Walters is a fourth-year ²ÝÝ®ÎÛÊÓƵµ¼º½ nursing student in her final year of studies. In the summer of 2020, she worked in Alberta's north as an undergraduate nurse employee (UNE) at the Northwest Care Centre in High Level and St. Theresa General Hospital in Fort Vermillion. In July, she did an Instagram takeover of the ²ÝÝ®ÎÛÊÓƵµ¼º½ Nursing account from the north. Watch that .

I grew up in Grimshaw, Alta., a small rural community in the Peace Country, about nine hours north of Calgary. The population is approximately 3,000 and we have a small community hospital with a 24-hour emergency department, long-term care, public health and homecare — it’s very small. There’s a big sense of community in my hometown and that’s what "rural" is all about.

My mom is a registered nurse in Grimshaw, so I grew up around health care. I really enjoyed seeing how she did her job, and this prompted my interest in the nursing profession. It was a choice between teaching or nursing and I thought, well, in nursing, I can teach, so it’s perfect.

Through taking my nursing at ²ÝÝ®ÎÛÊÓƵµ¼º½, I experienced urban nursing, so when the opportunity for an undergraduate position in a rural setting was presented, I jumped on the opportunity and submitted my resumé. Since our term had ended abruptly [winter placements were cut short due to COVID-19], I knew I needed to look for another opportunity to fill in the lost time. This opportunity was perfect to advance my skills, knowledge and understanding of nursing, especially rural nursing.

I was offered two undergraduate nursing positions, one in High Level, the other in Fort Vermillion. The population in these areas is small and the hospitals serve many even-smaller surrounding communities. Many of these communities are so remote, accessibility is by air only.

During my time in the north, I advanced my skills in that I had to be flexible in the areas in which I worked. This involved working in the ER, OR, labour and delivery (L&D), and acute care. I worked with kids, adults and palliative patients daily, so it was always changing and allowing me to learn new things.

When you enter nursing after graduation, you have knowledge and skills based on your areas of clinical practicums. Coming out of nursing, you are a generalist in all areas and begin to advance your practice and knowledge with experience. If you start nursing in a rural area, you gain a broad range of skills in many different areas and specialties. It may provide you with the opportunity to find your passion as you work with many different populations in many clinical areas. It’s a great way to start your career and to advance existing learnings. For example, my focus in school was around the older-adult population; however, when working in High Level this summer, I was able to shadow an L&D nurse and help with labours, deliveries, C-sections and postpartum. This allowed me to develop another passion for L&D.

With rural nursing, you can get it all. For someone that wants to stay in the city, but who also wants that rural experience, there are locum nursing programs available through Alberta Health Services. I’ve worked with several nurses who have positions in the city, but who come north to do locum nursing [temporary placements] for weeks at a time. For one thing, the pay is great, and you get your housing and mileage covered during the time you service that community. If you don’t want to commit to living up north, you can still have an opportunity to gain experience in a rural setting.

Although there are many positives to rural nursing, one of the biggest challenges is retention and recruitment of staff. Many nurses prefer to stay in urban centres for specialized nursing and others prefer to stay in rural areas for a short time, and then move on. This leads to changes in work environment and frequent turnover. As well, due to lack of resources in these small communities, you must provide care with the resources available. For instance, there are no intensive care units (ICU); therefore nurses must provide ICU-level care until they can arrange for medivac transportation south to a more equipped facility. 

At the start of the summer, when I was hired as a UNE in northern Alberta, I did not know all that I was getting myself into. I knew the basics of rural nursing; however, I did not know how much these nurses need to know and do. I can't describe how this area of nursing has influenced my professional practice and diversified my knowledge in many different areas. If I had never left the city and explored other areas of nursing, it would have been a great loss for my professional identity as a nurse.

To learn more about rural nursing in Alberta, watch these videos by the Rural Health Professions Action Plan: