In collaboration with: Jessica Hamner, MPH

Problem Statement: Public Health Nurses (PHN’s) play a critical role in advancing and improving population health particularly in high need areas, both rural and urban. Despite the recognized value, recruitment and retention barriers for PHN’s steadily increased in local health departments. In order to determine varied and economically feasible measures to improve retention and recruitment, it is necessary to first identify the scope of the problem, specific influential factors, the existence of any correlations between rurality and recruitment/retention issues, and posited opportunities for improvement.

Approach: This project utilized a three-phase process of development, deployment, and analysis of electronic surveys of PHN’s to acquire a comprehensive view of what variables affect recruitment and retention and to determine which factors, if any, are responsible for the correlation between rurality and recruitment and retention issues.

Products/Outcome: Preliminary results indicate that 80% of the local health departments surveyed have a problem with either recruitment, retention or both, and 46% of responding counties saw a decrease in the number of PHN’s on staff from the previous year. Additionally, while a large percentage of the responding nurses included compensation as a factor in workplace satisfaction and/or as a factor in looking for new employment, a larger percentage included other factors as a possible and/or probable component of workplace satisfaction.

Implications: The issue of retention and recruitment of PHN’s in California is an issue that is both fixable and reaching a crisis level. The removal or reduction of the services of the public health nurse in the local health department only serves to increase health inequities of the most fragile populations. In order to coordinate a systematic reversal of the current decline in retention and recruitment rates, a reevaluation of economically feasible measures above and beyond increased compensation is necessary.