Why do nurses leave rural jobs? This DBA candidate is seeking answers

Learn more about the Doctor of Business Administration program.

With a shortage of nurses in many provinces, Canadian hospitals struggle with staff retention. In the segmented case of rural hospitals, research by Royal Roads University Doctor of Business Administration candidate Nathan Banda found that internal factors around job satisfaction and support are critical in many nurses’ decisions to leave for urban centres.

Nathan Banda is director of surgical services at Grande Prairie Regional Hospital and Queen Elizabeth II Hospital in Alberta. He started his career as a health care aide before becoming a licensed practical nurse, then a registered nurse. While Banda was working as a site manager in central Alberta in 2018, the region lost 64 per cent of its nurses in the first six months of the year.

That prompted him to ask, “What factors led nurses to leave?”

Banda’s RRU DBA research, Factors That Affect Nurse Retention in Rural Canada: Strategies for Managing Nursing Shortages in Rural Alberta was funded by a Mitacs Accelerate Internship and involved interviews and surveys of nurses and their managers, which then informed group discussions.

Banda notes that previous studies have highlighted the importance of work placements in rural areas for nursing students, and that ensuring lifestyle needs of nurses outside the workplace are met, including availability of recreation facilities and amenities. But the external factors that mattered highly in rural Alberta, according to his research, included having family and social connections and support in the community. 

However, Banda’s research findings suggest that on-the-job frictions and lack of support can cause nurses to leave for other institutions. These include: lack of management support, including insufficient feedback or regular check-ins; an overwhelming workload, especially compared to peers in urban centres; and disrespect shown to nurses by doctors, a concern that was “pervasive” at the four sites where he conducted his research.

“My research says it’s not money,” he says. “I should be happy in my workplace. I need to feel respected. I need to have a voice. And if I feel disrespected, if I don’t have support from my managers, I will not stay even if you pay me more money. That’s a significant finding in my research.”

Banda also says he believes if managers and physicians understand that how they conduct themselves has an effect on nurse retention, they’ll act differently.

“There are two things here: recruitment and retention. My focus here is on… let’s shut the back door. Let’s keep who we have.”

Learn more about Royal Roads’ Doctor of Business Administration program.