Nurse retention in rural United States: A cluster analytic approach

Abstract

This study explores the factors that influence a nurse's choice to continue working in a rural area as compared to those working or commuting to urban areas. The current and predicted nursing shortage tends to have disproportionate effects in rural areas. An understanding of how nurses make the choice of which type of environment to work in is critical to addressing this shortage. A comprehensive literature review suggested a number of factors worthy of investigation, and these were assessed through six focus groups and 1046 usable surveys. Results produced four distinct clusters: those who wish to keep their current job and stay in the nursing profession (52%), those who wish to leave their current job but stay in the profession (30%), those who are ambivalent about their current job and the profession (13%), and those who wish to leave their current job and the profession (5%). Findings from this study suggest that the decision to continue working in a rural area is dependent on the altruistic nature of the nurse and job, job satisfaction, stress, and value congruence. This illustrates that rural health providers can increase retention by further aiding their employees and increasing job satisfaction while reducing stress.

Nurse turnover: A longitudinal survival analysis of the Korea Nurses' Health Study

“…These hospitals play important roles in increasing the number of nurses in the workforce. However, there are large gaps in payment among hospitals and poor nursing work environments in small-and medium-sized hospitals; these factors are highly associated with nurse turnover (Dotson et al, 2012;Park & Ko, 2020). Considering that estimated turnover costs range from 0.75 to 2 times the annual salary of the individual (Jones & Gates, 2007), motivating nurses by providing monetary incentives as well as nonmonetary support is critical.…”

Concept analysis of nurse retention

“…Dotson, Dave, Cazier, and McLeod () found that motivation intrinsically includes the elements of competence, self‐determination, interest, excitement, curiosity, excitement, and high levels of task involvement, all of which can be influenced by internal and external forces in the workplace. Their study found that increased motivation could bring improvements in work performance and satisfaction, which also contribute to better retention.…”

“…For example, recruiting and retaining professional nurses has always been more challenging in rural areas, especially in more remote areas and underserved regions of the world (Dieleman et al, ; World Health Organization, ). Additionally, compared to urban areas, rural healthcare facilities experience higher rates of nursing shortages along with greater challenges in retaining staff (Dotson et al, ). Internationally, nurses migrating from developing nations to industrialized countries further perpetuates nursing shortages in already underserved regions of the world.…”

Nurses’ experiences of working in rural hospitals: An integrative review

“…Nurses employed in rural hospitals are often required to take on additional, unplanned responsibilities, new or expanded roles and work across various clinical areas such as emergency, medical, maternity and mental health (Schlairet, 2017). This diversity and complexity of clinical practice is why rural nurses are often referred to as "expert generalists" and requires nurses to have a strong theoretical and practical knowledge base (Dotson, Dave, Cazier, & McLeod, 2013;Kenny & Duckett, 2003;Knight, Kenny, & Endacott, 2016). Rural nurses often work within a broad scope of practice and often work independently or with limited backup which can contribute to a heavy and potentially stressful workload (Dotson et al, 2013;Hunsberger et al, 2009).…”