Why do nurses stay in Australia’s small rural hospitals? Why do they leave?

Miss Sarah Smith1, Professor  Elizabeth  Halcomb1, Dr  Jenny Sim1, Dr Sam Lapkin1

1University of Wollongong, Wollongong , Australia


Access to healthcare for rural populations depends on an adequate, skilled workforce, however recruiting to rural areas can be difficult. Rural areas depend on nurses to provide much of the healthcare from small rural hospitals, however it can be a stressful occupation with its own unique issues and work environments. These issues can make rural nursing  particularly susceptible to increased turnover and shortages which is an ongoing concern worldwide. Australia is not immune to this phenomenon with ongoing difficulties in recruiting and retaining nurses to rural areas and significant shortfalls of nurses predicted in the future .

The presentation will provide an insight into the factors that impact on nurses’ intention to leave rural hospitals. Both quantitative and qualitative data will be presented which was collected as part of a large national study of the experiences of nurses working in rural hospitals throughout Australia. Besides investigating nurses’ intention to leave their workplace the national online survey also explored what factors impact job satisfaction, missed care in rural hospitals and examined the professional practice environment within small rural hospitals.

Participants were registered and enrolled nurses and dual registered nurse/midwives working in Australian small rural public hospitals. 543 nurses responded to the online survey however 160 responses were removed due to less than 50% of the survey being completed leaving 383 total responses for analysis.

The findings of this study will provide an understanding as to why nurses choose to leave rural hospitals and may be used to inform future initiatives to increase successful recruitment and retention of skilled clinicians. The findings may also assist in developing future nursing curricula and campaigns to attract nurses to rural hospitals and better prepare them to work in these unique and rewarding environments.


Sarah is a PhD candidate with the University of Wollongong.  She is an early career nurse researcher who completed nursing honours with UOW in 2015 and was awarded runner up of the Australian Primary Health Nurses Association’s new graduate Nurse of the year award in 2016. Sarah has experience in general practice nursing and rural hospital nursing and she currently works as a registered nurse in a NSW rural hospital where she was nominated for a NSW Health Rising Star Award. Her current research is investigating the nursing workforce in Australian rural hospitals.