Improving Work Environment Perceptions for Nurses Employed in a Rural Setting

Context: Effective recruitment and retention of professional nurses is a survival strategy for health care facilities, especially in rural areas. Purpose: This study examines the use of the Individual Workload Perception Scale to measure nurse satisfaction by a small rural hospital in order to make positive changes in the work environment for nurses. Methods: Baseline work environment perceptions of nurses employed in a rural Kentucky hospital were assessed using the Individual Workload Perception Scale, a validated 38-item instrument. Nurses reviewed the results and brainstormed on potential interventions to address areas of concern. The 4 interventions selected for implementation by the nursing staff included (1) implementation of a shared decision making or governance model; (2) enhanced role of licensed practical nurses within the organization; (3) augmentation of administrative support on night and weekend shifts; and (4) utilization of wireless communication devices. After implementation of the interventions, staff nurse perceptions were reassessed using the same tool. Findings: The follow-up survey revealed improvements in all areas measured by the Individual Workload Perception Scale, with the greatest improvement in the perception of the work environment noted among night nurses. The increase in positive work environment perception among these nurses, with greater than or equal to 11 years of professional experience, was statistically significant. Conclusions: Tools exist to support the development and evaluation of interventions to improve the work environment for nurses practicing in rural health care settings. By addressing issues of specific concern, both job satisfaction and retention of this talented pool of professionals can be enhanced.