An interpretive description of the recruitment and retention of locum nurses working in rural and remote Australia

It is widely acknowledged that rural and remote Australians have poorer levels of health than their major city counterparts. As nurses are the most widely and evenly distributed health professional across rural and remote areas of Australia, maintaining a nursing presence is imperative to ensure health care remains available and accessible. Maintaining the competence, health and wellbeing of nurses prepared to work in rural and remote areas is crucial. The presence of a locum workforce is one available strategy that can ensure the needs of the permanent nursing workforce, and the communities they serve, are met.

This interpretive description study explores the phenomenon of the locum nurse in rural and remote areas of Australia. Findings from interviews with 19 participants who chose locum work in rural and remote areas aids understanding of the issues and challenges they experienced and how this impacted on their recruitment and retention. The description component brings elements of the locum nurse role and their experiences to the awareness of others, while the interpretation component provides a level of sensemaking derived from the patterns and themes in the findings that may potentially change the way the phenomena of the locum nurse is normally considered.

Findings highlighted participants’ belief that they had a significant role in supporting the permanent workforce, this was revisited many times throughout their interviews and supported their retention. Receiving support to stay in their locum role was an important aspect that impacted on their experience and their retention to individual locations. Participants revealed the complexity of decision-making when working across rural and remote areas resulting in concern around their scope of practice. Participants chose to pursue a locum lifestyle despite the challenges living away from home presented. The findings of this study provide an understanding of the factors that impact on the recruitment and retention of locum nurses. Whatever motivators supported the predominantly urban-based nurses to come to these areas needs to be fostered and, in some instances, improved so that they find it easy to return. While participants had been retained to the workforce they cautioned that many aspects of their experience may negatively impact on the recruitment and retention of others. Time spent fostering the needs of the visiting locum workforce will ensure the permanent workforce receives the support it needs to maintain a health presence in the absence of sufficient numbers of other health professionals in rural and remote areas.