The Retention Factors among Nurses in Rural and Remote Areas: Lessons from the Community Health Practitioners in South Korea

Abstract

Purpose: This study analyzed the retention factors of Korean community health practitioners who sustained over 20 years based on a multi-dimensional framework. This study suggests global implications for nurses working in rural or remote areas, even during a worldwide pandemic. Methods: The participants were 16 Korean community health practitioners who worked in rural or remote locations for over 20 years. This study identified nurses' key retention factors contributing to long service in rural and remote areas. This is a qualitative study based on the narrative method and analysis was conducted using grounded theory. A semi-structured questionnaire was conducted based on the following: the life flow of the participants' first experience, episodes during the work experience, and reflections on the past 20 years. Results: First, personal 'financial needs' and 'callings' were motivation-related causal conditions. The adaptation of environment-work-community was the contextual condition leading to intervening conditions, building coping strategies by encountering a lifetime crisis. The consequences of 'transition' and 'maturation' naturally occurred with chronological changes. The unique factors were related to the 'external changes' in the Korean primary health system, which improved the participants' social status and welfare. Conclusion: Considering multi-dimensional retention factors was critical, including chronological (i.e., historical changes) and external factors (i.e., healthcare systems), to be supportive synchronously for rural nurses. Without this, the individuals working in the rural areas could be victimized by insecurity and self-commitment. Furthermore, considering the global pandemic, the retention of nurses is crucial to prevent the severity of isolation in rural and remote areas.