The Rural Nursing Workforce Hierarchy of Needs: Decision-Making concerning Future Rural Healthcare Employment

Abstract

Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career.

Tracks to Postgraduate Rural Practice: Longitudinal Qualitative Follow-Up of Nursing Students Who Undertook a Rural Placement in Western Australia

“…Social, cultural, and family ties have been shown to influence the retention of rural health workforces [ 9 , 18 , 20 , 48 ]. For those without a rural background, opportunities to develop social networks in the community are particularly important[ 19 , 20 , 49 , 50 ]. Similarly, immersion in rural culture has been shown to be a major motivator for remaining in rural and remote communities [ 18 ].…”

“…Other prior research has more specifically focused on the influence of student placements on rural recruitment and retention. Terry’s model of ‘Rural Nursing Workforce Hierarchy of Needs’ showed that clinical-related factors were ranked most highly by students in their decision to undertake rural practice after graduating [ 19 ]. These included patient safety, positive relationships among nursing generations, supportive working environments, job satisfaction, autonomy, and respect.…”

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

“…Rural nursing careers can provide a multitude of benefts for individuals, including higher wages, providing a sense of belonging, and allowing nurses to work to their full scope and develop generalist nursing skills [1]. Despite these benefts, there remains a signifcant shortage of nurses working in rural areas, which is expected to continue to grow [2,3] despite an increasing number of graduates [4]. Te rural nurse shortage has led to signifcant eforts to conceptualise and explore ways to retain staf in these locations.…”