Degree of Value Alignment “ Why NSW Rural Nurses Resign: A Grounded Theory Study of Rural Nurse Resignations

Currently in Australia nursing is continuing to face workforce shortages due to the challenge of retaining staff; this is especially true for rural areas. Current research indicates that job dissatisfaction is implicit in nurse resignations however the identification of the underlying reasons that contribute to job dissatisfaction remains elusive. This grounded theory study explores the reasons why NSW registered nurses resign from rural hospitals. Twelve registered nurses who had resigned from rural hospitals were interviewed in fourteen face-to-face, semi-structured interviews. The substantive theory that emerges from this study to explain rural nurse resignations is titled degree of value alignment'. Findings indicate that nurses resign from NSW rural hospitals when hospital values change and nurses are unable to realign their values to the hospitals. A decreased degree of value alignment between nurse and hospital is paramount in rural nurse resignations; the greater the degree of value alignment the greater the possibility of nurse retention. The theory emerges around the core category of conflicting values' which explains the conflict between nurses' personal values “ how nurses perceive nursing should occur “ and organisational values “ how the hospital enables nurses to carry out nursing. The conflict in values between nurse and hospital arises because of a number of reasons. These include rural area health service restructures, centralisation of budgets and resources, cumbersome hierarchies and management structures that inhibit communication and decision making, outdated and ineffective operating systems, insufficient and inexperienced staff, bullying, and a lack of connectedness and shared vision between nurse and hospital.