Addressing the challenges of early career rural nursing to improve job satisfaction and retention: Strategies new nurses think would help

Abstract

AimsTo (a) explore the experiences of early career registered nurses in rural hospitals in Australia and (b) identify strategies they believe would help increase job satisfaction and retention.DesignQualitative descriptive design.MethodsThirteen registered nurses located in outer regional, remote or very remote (herein ‘rural’) Australian hospitals participated in semi‐structured interviews. Participants had graduated from a Bachelor of Nursing program in 2018–2020. Data were analyzed using thematic analysis and an essentialist, bottom‐up approach.ResultsSeven themes related to the experiences of rural early career nursing: (1) appreciate diverse scope of practice; (2) rewarding sense of community and opportunity to give back; (3) staff support determines the quality of experience; (4) feeling underprepared and the need for ongoing education; (5) diverse views on the optimal length of rotation and level of input into choice of clinical area; (6) difficulty maintaining work/life balance due to work hours and rostering; and (7) lack of staff and resources. Strategies to improve nurses' experiences included: (1) assistance with accommodation and transport; (2) social gatherings to enhance connection; (3) sufficient orientation and supernumerary time; (4) increased frequency of contact with clinical facilitators and multiple mentors; (5) prioritizing clinical education across diverse topics; (6) greater involvement in choice of rotations and clinical areas; and (7) desire for more flexible work hours and rostering.ConclusionsThis study highlighted the experiences of rural nurses and explored their suggestions for how to overcome challenges in their roles. Greater consideration of early career registered nurses' needs and preferences is vital to improving and maintaining a satisfied, dedicated and sustainable rural nursing workforce.ImpactMany of the strategies for improving job retention identified by nurses in this study could be actioned at a local level, with little financial or time investment.Patient or Public ContributionNo Patient or Public Contribution.

The Influence of Connection on Early Career Nurses’ Rural Experiences: A Descriptive Phenomenological Study

“…Tey instead pointed to factors such as their connections with people, place, and profession as being primarily related to their employment location. Tis is diferent to the fndings of similar research conducted by Rose et al [33] who also used a phenomenological approach to explore the experiences of early career nurses in rural areas. Rose et al [33] found several factors that infuenced nurses' experiences, including professional factors such as scope of practice, need for ongoing education, specialty rotations, and lack of staf and resources.…”

“…Tis is diferent to the fndings of similar research conducted by Rose et al [33] who also used a phenomenological approach to explore the experiences of early career nurses in rural areas. Rose et al [33] found several factors that infuenced nurses' experiences, including professional factors such as scope of practice, need for ongoing education, specialty rotations, and lack of staf and resources. Tey did, however, also fnd several personal factors that infuenced the early career nurse experience, including the sense of community, importance of collegial support, and maintaining a work/life balance [33].…”

“…Tese tactics include various mechanisms focused on transforming "an outsider to an efective insider" [32] and supporting an employee to adapt to the new environment, behaviours, and knowledge. Suggested mechanisms to achieve this in nursing include structured rotations, staf support, ongoing education, and mentorship programs [6,33,34]. Research by Saks et al [35] has demonstrated the relationship between socialisation tactics and newcomer adjustment, fnding tactics that represent institutionalised socialisation were negatively related to factors such as intentions to quit and positively related to factors such as job satisfaction, performance, and organisational commitment.…”

Differences in shift and work‐related patterns between metropolitan and regional/rural healthcare shift workers and the occupational health and safety risks

“…16,17 To account for such workforce shortages, rural healthcare shift workers may be required to work longer hours, be more on-call or do double shifts more often. 16,18 In addition, those living regionally/rurally are often more isolated and may need to commute longer distances to/ from work which may potentially reduce their sleep and recovery time which could exacerbate the risks of fatigue, increasing the risk of medical errors, workplace and car accidents. 19 It is estimated that a lack of sleep is attributed to causing ~23% of the total car accidents in Australia each year.…”

“…There is, however, a national shortage of healthcare workers, particularly in rural areas, 16,17 and it is predicted that this shortage will reach 100 000 by 2025 16,17 . To account for such workforce shortages, rural healthcare shift workers may be required to work longer hours, be more on‐call or do double shifts more often 16,18 . In addition, those living regionally/rurally are often more isolated and may need to commute longer distances to/from work which may potentially reduce their sleep and recovery time which could exacerbate the risks of fatigue, increasing the risk of medical errors, workplace and car accidents 19 .…”