What can we learn about improving workforce retention from five words?

The challenges of recruitment and retention of health professionals in rural and remote Australia are well documented. Increases in need arising from an ageing population and the burden of chronic disease, together with decreases in workforce supply globally, creates further challenges in rural and remote regions where high turnover is frequently reported. This study focused on rural and remote managers, and sought to understand where management practices can have the greatest impact in improving health workforce retention. This study used Social Exchange Theory to explore the influence of management practices. Social Exchange Theory proposes where there are effective employee-manager workplace relationships and where there is perceived organisation support from the employee's perspective, organisations will observe improvements in retention, as well as improvements across a range of performance indicators. This study examined the words that health professionals and managers use to describe what it is like to work in rural and remote northern Australia. The aim of the study was to determine whether similarities and differences in the perceptions of managers and health professionals about working in rural and remote regions could provide opportunities to improve retention. This qualitative research study used a purposive sampling method to recruit participants who were either managers or health professionals working in rural and remote regions of northern Australia. Twenty-four semi-structured interviews were conducted in-person or via telephone depending on the participant's location. Participants were asked to provide five words that best described working in rural and remote regions from their perspective and then from the alternative perspective. That is, health professionals in rural and remote regions described their work experience and then how they perceived that their manager would describe it. Conversely, managers described it from their perspective and then how they perceived that remote health professionals would describe it. The research found similarities and differences in each group's perceptions about working in rural and remote northern Australia. Few managers hesitated in describing the health professionals' perspective, yet many health professions paused and contemplated whether their manager really understood what it is like to work in rural and remote regions. These findings provide evidence beyond the differences and similarities; they suggest that effective management practices provide an opportunity to improve retention. Managers should explore, through professionally supportive relationships, where misaligned perceptions may be translating into unrealised potential and poor retention of otherwise competent and passionate health professionals