Adapting to scarcity
Plasticity in rural healthcare practice
Bibliographic Data
| ID | 24216415 |
|---|---|
| Authors | Crystal Gaudet (0009-0009-8953-1345, University of Western Ontario, London, ON, Canada), Don Eby (0000-0002-1902-5756, University of Western Ontario, London, ON, Canada), Lisa Shepherd (0000-0001-9551-4546, University of Western Ontario, London, ON, Canada), Frances Kilbertus (0000-0002-1467-4159, NOSM University), Erin Kennedy (0000-0002-1981-0260, University of Western Ontario, London, ON, Canada), Sayra Cristancho (0000-0002-8738-2130, University of Western Ontario, London, ON, Canada) |
| Year | 2026 |
| Pages | 13634593261487148-13634593261487148 |
| Publication date | 2026-09-29 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine (JOURNAL) |
| Journal identifiers | ISSN: 1363-4593 • E-ISSN: 1461-7196 |
| Publisher | SAGE Publications (PUBLISHER • US) |
| DOI | 10.1177/13634593261487148 |
| PMID | 42811453 |
| OpenAlex | W7136471998 |
| Language | EN |
| References cited | 27 |
Rural healthcare practitioners face persistent challenges such as limited staffing, geographic isolation, and broad scopes of responsibility. These conditions require constant adaptation to ensure care delivery. This study introduces plasticity as a conceptual lens for understanding how rural healthcare teams collectively navigate scarcity through flexible role and task shifting. Drawing on constructivist grounded theory, we conducted 19 interviews with nurses and physicians in emergency departments in two rural communities in Ontario, Canada, to explore how plasticity functions in rural healthcare teams. The analysis refined and extended the concept of plasticity by identifying two variations of plasticity: acute (short-term, high-stakes task switching or role expansion) and chronic (long-term role expansion), alongside four interrelated dimensions that characterize this phenomenon in rural settings. While acute plasticity was often empowering, chronic plasticity, exacerbated by the COVID-19 pandemic, contributed to cumulative stress, burnout, and professional demoralization. Our analysis illustrates that plasticity is both a strength and vulnerability in rural healthcare work, enabled through informal learning and relational responsibility to community, yet largely unsupported by formal institutional structures.
Burnout · COVID-19 pandemic · Emergency department · Informal learning · Nurses · Ontario · Physicians · Plasticity · relational responsibility · Resource constraints · role expansion · rural health care · task shifting · Global Health Workforce Issues · Interprofessional Education and Collaboration · Nursing Roles and Practices
| Citation velocity | historical |
|---|---|
| Highly cited | No |