Rural Nursing Workforce Sustainability in Australia: A Scoping Review of Global Retention Strategies

Article

Fortabong, Atabong A., Kloot, Kate, Reedy, Natasha, Peck, Blake and Terry, Daniel. 2025. "Rural Nursing Workforce Sustainability in Australia: A Scoping Review of Global Retention Strategies." Australian Journal of Rural Health. 33 (4). https://doi.org/10.1111/ajr.70079
Article Title

Rural Nursing Workforce Sustainability in Australia: A Scoping Review of Global Retention Strategies

ERA Journal ID13436
Article CategoryArticle
AuthorsFortabong, Atabong A., Kloot, Kate, Reedy, Natasha, Peck, Blake and Terry, Daniel
Journal TitleAustralian Journal of Rural Health
Journal Citation33 (4)
Article Numbere70079
Number of Pages15
Year2025
PublisherJohn Wiley & Sons
Place of PublicationAustralia
ISSN1038-5282
1440-1584
Digital Object Identifier (DOI)https://doi.org/10.1111/ajr.70079
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/ajr.70079
Abstract

Introduction
The global nursing shortage significantly impacts healthcare sustainability, particularly in rural Australia, where geographic isolation, professional remoteness and resource constraints amplify challenges.

Objective
To map and synthesise evidence on factors influencing rural nursing workforce sustainability across individual, organisational and systemic levels.

Design
A scoping review following PRISMA-ScR guidelines was conducted. Five databases and grey literature were searched for English-language publications (1995–2024) on rural nursing workforce sustainability. A micro-meso-macro conceptual framework guided the analysis of 33 publications, focusing on baccalaureate-prepared Registered Nurses.

Findings
Key determinants were identified across three levels. Micro-level factors included personal characteristics, professional identity and safety considerations. Meso-level factors, addressed in 32 studies, encompassed health services programmes, organisational culture, management approaches and professional development opportunities. Macro-level factors included community engagement, educational pathways, scope of practice policies and government initiatives. Significant interconnections existed between factors across all levels.

Discussion
While targeted interventions show promise, programmes need systematic evaluation using standardised frameworks. Research priorities include longitudinal effectiveness studies, economic impact analyses and the development of practical implementation tools.

Conclusion
A sustainable rural nursing workforce requires integrated approaches that simultaneously address individual, organisational and systemic factors. Success depends on evidence-based collaboration between healthcare organisations, educational institutions and government bodies to strengthen rural healthcare delivery through coordinated multilevel strategies.

Keywordshealth workforce; multilevel framework; organisational culture; professional development; recruitment barriers; shortages ; systems
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420321. Rural and remote health services
4205. Nursing
Byline AffiliationsSchool of Nursing and Midwifery
Deakin University
Federation University
Centre for Health Research
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Terry, Daniel, Peck, Blake, Baker, Ed and Schmitz, David. 2021. "The Rural Nursing Workforce Hierarchy of Needs: Decision-Making concerning Future Rural Healthcare Employment." Health Care: the journal of delivery science and innovation. 9 (9). https://doi.org/10.3390/healthcare9091232
The Kids Are Alright: Outcome of a Safety Programme for Addressing Childhood Injury in Australia
Peck, Blake and Terry, Daniel. 2021. "The Kids Are Alright: Outcome of a Safety Programme for Addressing Childhood Injury in Australia." European Journal of Investigation in Health Psychology and Education. 11 (2), pp. 546-556. https://doi.org/10.3390/ejihpe11020039
Self-Regulation for and of Learning: Student Insights for Online Success in a Bachelor of Nursing Program in Regional Australia
Peck, B., smith, a., Terry, Daniel and Porter, J.. 2021. "Self-Regulation for and of Learning: Student Insights for Online Success in a Bachelor of Nursing Program in Regional Australia ." Nursing Reports. 11 (2), pp. 364-372. https://doi.org/10.3390/nursrep11020035
Nurses’ Experience of Caring for Patients with Delirium: Systematic Review and Qualitative Evidence Synthesis
Thomas, Nissy, Coleman, Mardhie and Terry, Daniel. 2021. "Nurses’ Experience of Caring for Patients with Delirium: Systematic Review and Qualitative Evidence Synthesis ." Nursing Reports. 11 (1), pp. 164-174. https://doi.org/10.3390/nursrep11010016
Academic and clinical performance among nursing students: What's grit go to do with it?
Terry, Daniel and Peck, Blake. 2020. "Academic and clinical performance among nursing students: What's grit go to do with it?" Nurse Education Today. 88, pp. 1-6. https://doi.org/10.1016/j.nedt.2020.104371
Factors That Impact Measures of Grit among Nursing Students: A Journey Emblematic of the Koi Fish
Terry, Daniel and Peck, Blacke. "Factors That Impact Measures of Grit among Nursing Students: A Journey Emblematic of the Koi Fish." European Journal of Investigation in Health Psychology and Education. 10 (2), pp. 564-574. https://doi.org/10.3390/ejihpe10020041
Television as a Career Motivator and Education Tool: A Final-Year Nursing Student Cohort Study
Terry, Daniel and Peck, Blake. 2020. "Television as a Career Motivator and Education Tool: A Final-Year Nursing Student Cohort Study." European Journal of Investigation in Health Psychology and Education. 10 (1), pp. 346-357. https://doi.org/10.3390/ejihpe10010026
Supervision in Healthcare: A Critical Review of the Role, Function and Capacity for Training
Terry, Daniel, Nguyen, Hoang, Perkins, Alicia J and Peck, Blake. 2020. "Supervision in Healthcare: A Critical Review of the Role, Function and Capacity for Training." Universal Journal of Public Health. 8 (1), pp. 1-14. https://doi.org/10.13189/ujph.2020.080101
Public perception of medical errors: Experiences and risks shared in Australia
Kim, Jeong-ah, Terry, Daniel, Jang, Sunny, Nguyen, Hoang, Gilbert, Julia and Cruickshank, Mary. 2020. "Public perception of medical errors: Experiences and risks shared in Australia." Universal Journal of Public Health. 8 (1), pp. 35-41. https://doi.org/10.13189/ujph.2020.080104
Communities of Practice: A systematic review and meta-synthesis of what it means and how it really works among nursing students and novices
Terry, Daniel R., Nguyen, Hoang, Peck, Blake, Smith, Andrew and Phan, Hoang. 2020. "Communities of Practice: A systematic review and meta-synthesis of what it means and how it really works among nursing students and novices." Journal of Clinical Nursing. 29 (3-4), pp. 370-380. https://doi.org/10.1111/jocn.15100
A critical appraisal of what organisational approaches are pivotal to improve patient safety.
Kim, Jeong-ah, Terry, Daniel, Jang, Sunny, Gilbert, Julia and Cruickshank, Mary. 2020. "A critical appraisal of what organisational approaches are pivotal to improve patient safety. " Journal of Hospital Administration. 9 (1), pp. 26-34. https://doi.org/10.5430/jha.v9n1p26
The data deficit for asthma emergency presentations might surprise you: How RAHDaR addresses the data chasm.
Terry, Daniel R T, Peck, Blake and Kloot, Kate. 2020. "The data deficit for asthma emergency presentations might surprise you: How RAHDaR addresses the data chasm. " Rural and Remote Health. 20 (2). https://doi.org/10.22605/RRH5776
What Australian Nursing Students Value as Important in Undertaking Rural Practice
Terry, Daniel R., Peck, Blake, Smith, Andrew, Stevenson, Tyrin, Nguyen, Hoang and Baker, Ed. 2020. "What Australian Nursing Students Value as Important in Undertaking Rural Practice ." Online Journal of Rural Nursing and Health Care. 20 (1), pp. 32-56. https://doi.org/10.14574/ojrnhc.v20i1.589
Understanding childhood injuries in rural areas: Using Rural Acute Hospital Data Register to address previous data deficiencies
Peck, Blake, Terry, Daniel R and Kloot, Kate. 2020. "Understanding childhood injuries in rural areas: Using Rural Acute Hospital Data Register to address previous data deficiencies." Emergency Medicine Australasia. 32 (4), pp. 646-649. https://doi.org/10.1111/1742-6723.13565
A Narrative Synthesis of Childhood Injury Prevention Programs for Pre-School Children
Peck, Blake, Terry, Daniel and Ervin, Kaye. 2020. "A Narrative Synthesis of Childhood Injury Prevention Programs for Pre-School Children." Universal Journal of Public Health. 8 (6), pp. 193-197. https://doi.org/10.13189/ujph.2020.080602
Workplace Based Assessment Program for International Medical Graduates: An Evaluation of an Australian Trial Site
Terry, Daniel, Peck, Blake and Gazula, Swapnali. 2020. "Workplace Based Assessment Program for International Medical Graduates: An Evaluation of an Australian Trial Site." Universal Journal of Public Health. 8 (6), pp. 198-206. https://doi.org/10.13189/ujph.2020.080603
Occupational Self-Efficacy and Psychological Capital Amongst Nursing Students: A Cross Sectional Study Understanding the Malleable Attributes for Success
Terry, Daniel, Peck, Blake, Smith, Andrew and Nguyen, Hoang. 2020. "Occupational Self-Efficacy and Psychological Capital Amongst Nursing Students: A Cross Sectional Study Understanding the Malleable Attributes for Success." European Journal of Investigation in Health Psychology and Education. 10 (1), pp. 159-172. https://doi.org/10.3390/ejihpe10010014
Traversing the Funambulist’s Fine Line between Nursing and Male Identity: A Systematic Review of the Factors that Influence Men as They Seek to Navigate the Nursing Profession
Terry, Daniel, Peck, Blake, Carden, Clarissa, Perkins, Alicia J. and Smith, Andrew. 2020. "Traversing the Funambulist’s Fine Line between Nursing and Male Identity: A Systematic Review of the Factors that Influence Men as They Seek to Navigate the Nursing Profession ." European Journal of Investigation in Health Psychology and Education. 10 (3), pp. 691-703. https://doi.org/10.3390/ejihpe10030051
Chronic ill health in a regional Victoria setting: A 13-year comparison
Glenister, Kristen, Bourke, Lisa, Terry, Daniel and Simmons, David. 2019. "Chronic ill health in a regional Victoria setting: A 13-year comparison." Australian Journal of Rural Health. 27 (6), pp. 527-534. https://doi.org/10.1111/ajr.12565
Communication training and its effects on carer and care-receiver outcomes in dementia settings: A systematic review
Nguyen, Hoang, Terry, Daniel, Phan, Hoang, Vickers, James and McInerney, Fran. 2019. "Communication training and its effects on carer and care-receiver outcomes in dementia settings: A systematic review ." Journal of Clinical Nursing. 28 (7-8), pp. 1050-1069. https://doi.org/10.1111/jocn.14697
Acute circulatory complications in people with diabetes mellitus type 2: How admission varies between urban and rural Victoria
Gardiner, Gardiner, Robins, Shalley and Terry, Daniel. 2019. "Acute circulatory complications in people with diabetes mellitus type 2: How admission varies between urban and rural Victoria." Australian Journal of Rural Health. 27 (1), pp. 49-56. https://doi.org/10.1111/ajr.12459
Health professional students' rural placement satisfaction and rural practice intentions: A national cross-sectional survey
Smith, Tony, Sutton, Keith, Sabrina, Pit, Muyambi, Kuda, Terry, Daniel, Farthing, Annie, Courtney, Claire and Cross, Merylin. 2018. "Health professional students' rural placement satisfaction and rural practice intentions: A national cross-sectional survey." Australian Journal of Rural Health. 26 (1), pp. 26-32. https://doi.org/10.1111/ajr.12375
Competing food consumption discourses and proper gendered behaviour among over 50s: are you really what you eat?
Malatzky, Christina, Terry, Daniel, Bourke, Lisa, Glenister, Kristen and Ervin, Kaye. 2018. "Competing food consumption discourses and proper gendered behaviour among over 50s: are you really what you eat?" Journal of Research for Consumers. 32, pp. 1-31.
Asthma hospitalisation trends from 2010 to 2015: variation among rural and metropolitan Australians
Terry, Daniel, Robins, Shalley, Gardiner, Samantha, Ruby, Wyett and Islam, Md Rafiqul. 2017. "Asthma hospitalisation trends from 2010 to 2015: variation among rural and metropolitan Australians." BMC Public Health. 17. https://doi.org/10.1186/s12889-017-4704-y