Going rural but not staying long: Recruitment and retention issues for the rural dietetic workforce in Australia

Aim: To determine the recruitment and retention issues for rural based dietetic services. Methods: A sequential explanatory mixed methods approach was used to examine six case study sites of dietetic practice, in a geographical area covering 30 000 km² in rural New South Wales, Australia. Quantitative data were obtained from document searches of human resource records between 1991 and 2006. Data were tabulated and counts and proportions used. Qualitative data were obtained from in-depth semistructured individual interviews conducted with 40 key informants including past and present dietitians (n = 28), dietetic managers (n = 3), health service managers (n = 6) and other key influencers (n = 3). The interviews were thematically analysed using the NVivo 7 program. Themes were coded into common categories, using a constant comparison inductive approach. Results: Ninety individual dietitians (94% female) were employed across the six sites over 15 years. The majority were new graduates with less than 1 year of experience. Approximately one-third remained in their position for less than 6 months while 32% remained for 2 years or longer. Key themes emerged from the qualitative data around the characteristics of a rural role, line management of dietitians in a rural site and establishing and maintaining rural staff. Conclusion: Recruitment and retention in rural areas may be improved in the future through strategies to reduce perceived professional isolation, improve management support, access to continuing education and the development of career pathways.