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

Daniel Terry,Blake Peck,David Schmitz,Ed Baker

doi:10.3390/healthcare9091232

Daniel Terry, Blake Peck + Show 2 more

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https://doi.org/10.3390/healthcare9091232

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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.

Highlights

IntroductionThe challenges of sustaining a strong rural health workforce are not new and one that many countries have grappled with and continue to address as they seek to develop more creative ways to resolve this workforce shortfall [2,3,4,5,6,7,8,9]
Seeking to address health workforce shortages in rural and remote areas has been the principle focus of many governments
After excluding for incomplete and any multiple Nursing Community Apgar Questionnaire (NCAQ) completions among students (n = 81), there were n = 804 unique NCAQ results from students across the three years

Summary

Introduction

The challenges of sustaining a strong rural health workforce are not new and one that many countries have grappled with and continue to address as they seek to develop more creative ways to resolve this workforce shortfall [2,3,4,5,6,7,8,9] Such endeavors have yielded insights into the recruitment and retention of health professionals in rural contexts; very little research has focused on the factors that drive students and newly graduated health professionals, such as nurses seeking rural employment [10,11]. The question that remains is what other factors may influence nursing students who do not come from a rural background, and who have had limited clinical placement experiences in rural areas, to geographically relocate there? As such, is likely that as we understand the factors that students consider important for taking up rural practice, this can support rural recruitment and retention further

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