Region of Employment and Intention to Remain Practicing or Exit the Profession Among Australian Nurses: A Cross‐Sectional Analysis

TL;DR

This study finds that Australian nurses in rural and remote areas are more likely to stay in their profession compared to those in metropolitan areas, influenced by factors like resilience and career opportunities.

Contribution

The study identifies 7 years of employment as a critical threshold for nurses considering leaving and highlights rural/remote nurses' higher retention rates compared to metropolitan nurses.

Findings

Rural and remote nurses are more likely to remain in the profession than metropolitan nurses (adjusted odds ratio: 2.2).

Seven years of employment is the threshold at which nurses are most likely to consider leaving the profession.

Positive predictors of staying include clinical roles, hospital/community settings, higher resilience, and career advancement opportunities.

Abstract

This cross‐sectional study explored factors influencing nurses’ intention to remain practicing or exit the profession across Australian metropolitan, regional, rural, and remote settings to inform workplace policies, education training, and career coaching.

Evidence on attrition and retention across geographical regions of employment is mixed. While much existing research on the nursing workforce has focused on job satisfaction, work–life balance, and workload, less attention has been given to the influence of work setting, nursing role, resilience, and career advancement opportunities—particularly in nonmetropolitan areas.

Validated scales were used to assess resilience and intention to stay in the profession. Intention to stay was analyzed using ordinal logistic regression and Youden’s statistic was applied to estimate the year nurses were most likely to consider leaving.

Of 1252 survey accesses, 526 (42.0%) resulted in completion and 410 (77.9%) included a response to the intention‐to‐stay question. No statistically significant differences were found in age, gender, early career status, or years of experience among nurses working in different geographic areas. Using Youden’s statistical method, 7 years of employment was identified as the threshold at which nurses were most likely to consider leaving their profession. Compared with metropolitan nurses, those in rural/remote areas were more likely to stay (adjusted odds ratio: 2.2; 95% CI: 1.14–4.10; and p = 0.019). Positive predictors included working in clinical roles, hospital or community settings, higher resilience, and career advancement opportunities.

Region, role, and resilience strongly influence nurses’ intention to stay, with rural and remote nurses more likely to remain than metropolitan peers.

Targeted supports—including mentorship, reflective practice, resilience training, and career coaching—may improve retention, particularly when management practices are tailored to leverage the strengths of rural and remote settings while addressing context‐specific needs to enhance workforce stability across all regions.

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