Tackling regional nurse shortages

Ageing populations, growing regional communities and an exhausted workforce are among the factors contributing to a chronic nurse shortage in regional and rural Australia.

With regional hospitals experiencing high workloads and funding pressures, additional staff supports for early career nurses may not be the highest priority. Yet retaining graduate nurses is vital and a University of South Australia study has shortlisted a range of strategies – suggested by the nurses themselves – which require minimal cost or time and can be implemented locally.

Modelling suggests Australia could be short of 123,000 nurses by 2030. The current and forecasted shortage hits hardest in rural and regional areas – an issue the current National Nursing Workforce Strategy is addressing as one of its four key priorities.

Rural and regional hospitals compete with more popular metropolitan sites for graduating nurses, so understanding the needs and preferences of those working in the regions is critical – however research has been minimal.

The recent UniSA study bridges this gap and provides valuable insights on what early career registered nurses believe will improve nurse retention in the regions.

The study, “Addressing the challenges of early career rural nursing to improve job satisfaction and retention: Strategies new nurses think would help” was undertaken by Heidi Rose, Dr Gemma Skaczkowski and Associate Professor Kate Gunn.

Rose, a clinical nurse herself based at Mount Gambier, says nurses who participated in the study worked in regional areas across SA, QLD and WA.

“The aspects of regional work they enjoyed included better opportunities for broader work scope and job progression,” Rose says.

“They also liked the more personal connection with patients that often comes from working in smaller communities, and the community connection.”

She says transitioning from study to a busy healthcare setting can be challenging for any health worker, and the study found this pressure was exacerbated for regional nurses.

“Early career nurses in rural areas often have additional stresses, including those inherent in moving house and leaving family and friends behind to establish a new social network. There is also a smaller workforce to share the load, which can translate to less time spent on orientation and training, and longer work hours.

“Study participants suggested additional workplace supports would make the transition easier, including assistance finding accommodation and transport, and facilitating more social gatherings.

“On the job, they said more time on orientation activities, more contact with clinical facilitators and mentors, and more opportunities for clinical education were important.

“Greater flexibility in work hours and rostering was also a factor, together with having more say in clinical specialty rotations.”

Dr Gemma Skaczkowski says many hospitals are overwhelmed and their capacity to implement new staff support programs and interventions is likely to be limited.

“However, improving the experiences of early career nurses is vital to keep them in rural areas, and prevent further workforce shortages,” Dr Skaczkowski says.

“Pleasingly, many of the strategies suggested by nurses in our study could be actioned at a local level, with little time or financial investment.

“Further research to examine which of these strategies may be most feasible and impactful in practice would be useful.”

The study involved 13 early career registered nurses working in outer regional, remote or very remote Australian hospitals, who had graduated from a Bachelor of Nursing program between 2018 and 2020.  All participants were female, with 11 located in South Australia.