A case study of factors influencing remote university nursing graduates and their decision to work in a remote hospital

摘要

The health of the rural population in Western Australia (WA) is predicated on equity and access to healthcare facilities with nurses being the main component of front line staff. There continues to be a nurse shortage particularly in remote regions of Australia where the poor health status of Australian Indigenous people, and an increasing ageing population are a perennial problem. The Kimberley, the setting for this study, is a remote region in the north of WA. It has a landmass of 423,517 square kilometres with a significantly low-density population compared to the total WA population. Nearly half of the Kimberley population is comprised of Indigenous peoples. Broome is the largest town in the Kimberley with a population of 14,997 and is the location of the University of Notre Dame Australia, Broome Campus School of Nursing and Midwifery. Strategies to encourage nurses to work in the region are crucial to the health of the local population. Recruitment from outside the area provides short-term relief, but providing nursing education within this remote region may well provide a more self-sufficient, sustainable workforce.This study explored and described the factors that influenced remote school of nursing graduates from the University in their decision to work in a Kimberley hospital. A single, exploratory, descriptive case study was chosen to underpin the framework of this study with decision-making theory providing a theoretical perspective. This approach enabled an in-depth exploration of the phenomenon and the context. In keeping with the principles of a case study approach to qualitative methodology, there were several sources of data collected from graduates, workforce nurses, nurse managers, documents and a promotional DVD. Collection of data and analysis was a continuous iterative process with themes and patterns emerging until the point of saturation was established.The findings of this study revealed multiple, complex and interrelated influencing factors. Three major themes emerged from the analysis of data: Local exposure, personal factors and professional factors. These influences were further delineated into enabling, or inhibiting influences but it was local exposure that underpinned all factors. It was the balancing of these opposing issues that ultimately led to the graduate’s final decision.