Singaporean nursing students' perceptions of a career in community nursing.

Publisher: Blackwell Science Ltd Country of Publication: England NLM ID: 7808754 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1466-7657 (Electronic) Linking ISSN: 00208132 NLM ISO Abbreviation: Int Nurs Rev Subsets: MEDLINE

Publication: Oxford, UK : Blackwell Science Ltd.
Original Publication: Geneva, International Council of Nurses.

Career Choice*; Community Health Nursing/*education ; Students, Nursing/*psychology; Career Mobility ; Education, Nursing, Baccalaureate ; Female ; Focus Groups ; Humans ; Male ; Qualitative Research ; Singapore ; Young Adult

Background: The ageing population and the changing disease profile have been driving the demand for community nurses. However, few nursing students in Singapore aspire to have a career in community nursing following graduation.
Objectives: To explore undergraduate nursing students' perceptions of a career in community nursing and to identify strategies to promote community nursing among nursing students.
Methods: An exploratory qualitative design was used. Four focus group discussions were conducted with a purposive sample of 24 undergraduate nursing students from a university. Interview transcripts were analysed using thematic analysis.
Findings: Four key themes emerged as follows: 'mid-life career', 'limited career progression', 'a difficult transition' and 'international nurses-dominated workforce'.
Discussion: While most participants rejected a career in community nursing immediately after graduation, they planned to join it at the later stages of their lives to accommodate changing life priorities. Limited career progression and increased difficulty in career transition from community nursing to acute care nursing were identified as deterrent factors in the participants' choices of community nursing as a career. Feelings of marginalization and a lack of role models in community nursing were perceived to be the result of the international nurses-dominated community workforce.
Conclusion: Community nursing remains an underrated career. There is a need to foster an optimistic career outlook and mobility in community nursing to entice nursing students into this career track.
Implications for Nursing Policy: Strategies to enhance community nursing recruitment should focus on providing more quality and diverse community placement opportunities in various community care settings, implementing a clearly defined career developmental plan to elucidate the role of community nurses, and improving community care and cultural competencies to develop a skilled and diverse community nursing workforce.
(© 2019 International Council of Nurses.)

Ang, S.Y., et al. (2018) Association between demographics and resilience - a cross-sectional study among nurses in Singapore. International Nursing Review, 65 (3), 459-466. https://doi.org/10.1111/inr.12441.
Baruch, Y. (2003) Transforming careers: from linear to multidirectional career paths - organizational and individual perspectives. Career Development International, 9 (1), 58-73. https://doi.org/10.1108/13620430410518147.
Birks, M., Missen, K., Al-Motlaq, M. & Marino, E. (2014) Babies and machines that go ‘beep’: first-year nursing students' preferred areas of future practice. International Journal of Nursing Practice, 20 (4), 353-359. https://doi.org/10.1111/ijn.12162.
Bloomfield, J.G., Aggar, C., Thomas, T.H.T. & Gordon, C.J. (2018) Factors associated with final year nursing students' desire to work in the primary health care setting: findings from a national cross-sectional survey. Nurse Education Today, 61, 9-14. https://doi.org/10.1016/j.nedt.2017.10.001.
Braun, V. & Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77-101. https://doi.org/10.1191/1478088706qp063oa.
Chalk, D. & Legg, A. (2017) What factors are driving increasing demand for community nursing? British Journal of Community Nursing, 22 (1), 675-681. https://doi.org/10.12968/bjcn.2017.22.1.675.
Charles, S. & Carstensen, L.L. (2014) Social and emotional aging. Annual Review of Psychology, 61, 383-409. https://doi.org/10.1146/annurev.psych.093008.100448.
Deloitte (2018) 2018 Global Health Care Outlook: The Evolution of Smart Health Care. Available at: https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-hc-outlook-2018.pdf (accessed 23 May 2018).
Duah, M.A. (2015) Baccalaureate nursing students' perceptions of community health nursing as a career. Masters thesis. University of Ottawa, Ottawa, Canada. Available at: https://ruor.uottawa.ca/bitstream/10393/33388/1/Duah_Maame_Akyaa_2015_thesis.pdf (accessed 11 April 2018).
Erickson, R. & Grove, W. (2008) Why emotions matter: age, agitation, and burnout among registered nurses. Online Journal of Issues in Nursing, 13 (1), https://doi.org/10.3912/OJIN.Vol13No01PPT01.
Fang, J. (2015) Nursing vacancies among hardest to fill by Singaporeans. Today Singapore Press Holdings Pte Ltd, Singapore. Available at: https://www.todayonline.com/singapore/nursing-vacancies-among-hardest-fill-sporeans-report (accessed 18 December 2017).
Ferguson, C., et al. (2015) Augmented reality, virtual reality and gaming: an integral part of nursing. Contemporary Nurse, 51 (1), 1-4. https://doi.org/10.1080/10376178.2015.1130360.
Goh, Y. & Lopez, V. (2016) Job satisfaction, work environment and intention to leave among migrant nurses working in a publicly funded tertiary hospital. Journal of Nursing Management, 24 (7), 893-901. https://doi.org/10.1111/jonm.12395.
Hickey, N., Harrison, L. & Sumsion, J. (2012) Using a socioecological framework to understand the career choices of single- and double-degree nursing students and double-degree graduates. International Scholarly Research Notices (ISRN) Nursing, 2012, 4-6. https://doi.org/10.5402/2012/748238.
Khalik, S. (2018) More pursuing a career in nursing. The Straits Times. Available at: https://www.straitstimes.com/singapore/health/more-pursuing-a-career-in-nursing (accessed on 23 January 2018).
Khor, A. (2017) Speech by Senior Minister of State for Health, Dr Amy Khor at the MOH Committee of Supply Debate 2017 [Transcript]. Available at: https://www.moh.gov.sg/content/moh_web/home/pressRoom/speeches_d/2017/speech-by-senior-minister-of-state-for-health-dr-amy-khor-at-th.html (accessed 11 April 2018).
Khor, A. (2018) Speech by Dr Amy Khor, Senior Minister of State, Ministry of Health at the community care manpower development awards ceremony 2018, 5 September 2018 [Transcript]. Available at: https://www.moh.gov.sg/news-highlights/details/speech-by-dr-amy-khor-senior-minister-of-state-ministry-of-health-at-the-community-care-manpower-development-awards-ceremony-2018-5-september-2018 (accessed 28 November 2018).
Kloster, T., Hoie, M. & Skar, R. (2007) Nursing students' career preferences: a Norwegian study. Journal of Advanced Nursing, 59 (2), 155-162. https://doi.org/10.1111/j.1365-2648.2007.04276.x.
Ky, D., George, L.S. & Chakrabarthy, J. (2014) Career preferences of preregistration nursing students: exploratory survey. International Journal of Nursing Education, 6 (2), 73-77. https://doi.org/10.5958/0974-9357.2014.00608.4.
Lamont, S., Brunero, S. & Woods, K.P. (2015) Satisfaction with clinical placement - the perspective of nursing students from multiple universities. Collegian, 22 (1), 125-133. https://doi.org/10.1016/j.colegn.2013.12.005.
Lea, E., Robinson, A., Mason, R. & Eccleston, C. (2016) Aspects of nursing student placements associated with perceived likelihood of working in residential aged care. Journal of Clinical Nursing, 25 (5/6), 715-724. https://doi.org/10.1111/jocommunitynursing.13018.
van Lersel, M., et al. (2016) Nursing students' perceptions of community care and other areas of nursing practice: a review of the literature. International Journal of Nursing Studies, 61, 1-19. https://doi.org/10.1016/j.ijnurstu.2016.05.011.
van Lersel, M., et al. (2018) Perceptions of community care and placement preferences in first-year nursing students: a multicentre, cross-sectional study. Nurse Education Today, 60, 92-97. https://doi.org/10.1016/j.nedt.2017.09.016.
Liaw, S.Y., et al (2016) Why not nursing? Factors influencing healthcare career choice among Singaporean students. International Nursing Review, 63, 530-538. https://doi.org/10.1111/inr.12312.
Lim, J. (2017) Sustainable health care financing: the Singapore experience. Global Policy, 8 (S2), 103-109. https://doi.org/10.1111/1758-5899.12247.
Nishino, T. (2017) Quantitative properties of the macro supply and demand structure for care facilities for elderly in Japan. International Journal of Environmental Research and Public Health, 14, 1489. https://doi.org/10.3390/ijerph14121489.
Pung, L., Shorey, S. & Goh, Y. (2017) Job satisfaction, demands of immigration among international nursing staff working in the long-term care setting: a cross-sectional study. Applied Nursing Research, 36, 42-49. https://doi.org/10.1016/j.apnr.2017.05.008.
Rognstad, M., Aasland, O. & Granum, V. (2004) How do nursing students regard their future career? Career preferences in the post-modern society. Nurse Education Today, 24 (7), 493-500. https://doi.org/10.1016/j.nedt.2004.07.015.
Sheikhi, M.R., Fallahi-Khoshnab, M., Mohammadi, F. & Oskouie, F. (2016) Skills required for nursing career advancement: a qualitative study. Nursing and Midwifery Studies, 5 (2), e30777. https://doi.org/10.17795/nmsjournal30777.
Shinan-Altman, S. (2018) Assessing social work and nursing students' intentions to work with dying patients. Social Work Education, 37 (1), 108-118.
Teo, P., Mehta, K., Thang, L.L. & Chan, A. (2006) Ageing in Singapore: Service Needs and the State, Routledge, London.
Thurtle, V. (2005) Why do nurses enter community and public health practice? Community Practitioner: The Journal of the Community Practitioners' and Health Visitors' Association, 78 (4), 140-145.
Wareing, M., Taylor, R., Wilson, A. & Sharples, A. (2017) The influence of placements on adult nursing graduates' choice of first post. British Journal of Nursing, 26 (4), 228-233. https://doi.org/10.12968/bjon.2017.26.4.228.
Wong, C.H. & Landefeld, C.S. (2011) Academic geriatrics in Singapore. Journal of the American Geriatrics Society, 59 (11), 2145-2150. https://doi.org/10.1111/j.1532-5415.2011.03630.x.
World Health Organization (WHO) (2015) The World report on ageing. Available at: https://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf;jsessionxml:id=8C23F9C232E2A50390B2D72F5BEC153E?sequence=1 (accessed on 4 March 2019).
World Health Organization (WHO) (2018a) Ageing and health. Available at: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (accessed 4 March 2019).
World Health Organization (WHO) (2018b) From alma-ata to Astana: Primary health care - reflecting on the past, transforming for the future - Interim Report from the WHO European Region. Available at: https://www.who.int/docs/default-source/primary-health-care-conference/phc-regional-report-europe.pdf?sfvrsn=cf2badeb_2 (accessed 8 March 2019).
Wu, L.T., et al (2015) Why not nursing? A systematic review of factors influencing career choice among healthcare students. International Nursing Review, 62, 547-562. https://doi.org/10.1111/inr.12220.
Zhou, J. & Walker, A. (2016) The need for community care among older people in China. Ageing and Society, 36 (6), 1312-1332. https://doi.org/10.1017/S0144686X15000343.

Keywords: Career choice; Community nursing; Nursing; Nursing students; Nursing workforce; Singapore

Date Created: 20190612 Date Completed: 20200413 Latest Revision: 20220411

20231215

10.1111/inr.12528

31184377