Barriers to Nursing Workforce Retention and Attraction in Rural Areas

In Oregon’s rural communities, complex socioeconomic barriers continue to hinder nursing workforce stability. This qualitative study explores the real-world challenges healthcare employers face in retaining and attracting nurses across community-based settings. Findings from Coos County offer data-driven insights and next-step solutions tailored to underserved regions.
Rural Nurse Retention Barriers

Barriers to Nursing Workforce Retention and Attraction in Rural Areas

Healthcare employers in Oregon’s rural areas face persistent difficulties in attracting and retaining nursing professionals, particularly in long-term and ambulatory care settings. Through a collaborative pilot study with the Southwest Oregon Workforce Investment Board, the Oregon Center for Nursing conducted focus groups across Coos County to identify themes influencing workforce sustainability. These themes encompass both practice-related factors—such as workload, salary competitiveness, and leadership structure—and broader community concerns including housing quality, employment opportunities for spouses, and access to essential services.

The methodology relied on structured interviews using a custom questionnaire developed from past embeddedness research and literature. Feedback from six practice-specific focus groups was analyzed using the Framework Method, producing 132 unique codes and 35 thematic clusters. This process revealed consistent barriers around misaligned expectations, community integration difficulties, and compensation limits. Yet, it also highlighted significant attractors such as organizational culture, flexible schedules, and the area’s natural beauty.

These findings suggest that while employers can identify barriers, broader community collaboration is needed to craft lasting solutions. The report emphasizes the value of shared local leadership in reducing resistance to nurse recruitment and in scaling solutions that reflect both community and practice-level needs. Future replications of this model aim to verify its effectiveness statewide in addressing Oregon’s nursing workforce maldistribution.

What's Inside

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Focus group interviews conducted across different practice settings in Coos County

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Coding categories applied during qualitative analysis of practice and community responses

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Thematic areas identified across findings from multiple focus groups
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Cover page of Oregon’s Nurse Vacancy Crisis brief, published by the Oregon Center for Nursing in 2024.
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