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Collaborative project seeks to improve recruitment and retention of nurses in rural North Carolina

BOONE—Professors in Appalachian State University’s Walker College of Business have embarked on a yearlong study to identify factors that impact the hiring and retention of nurses in

rural North Carolina.

The study is being supported and co-developed by the Northwest Area Health Education Center (Northwest AHEC) of the Wake Forest University School of Medicine and part of the North Carolina AHEC system. It is being led by Dr. Dinesh S. Davé and Dr. Joseph A. Cazier from Appalachian’s Department of Computer Information Systems, and Dr. Michael J. Dotson from the Department of Marketing.

The study will focus on the 17 counties served by Northwest AHEC.

“One of the core missions of Northwest AHEC is to make sure we have a quality health care workforce across the region,” said Michael P. Lischke, executive director of Northwest AHEC.

The study will seek to answer two questions: What are the most important factors that influence a nurse to accept a job in a rural environment, and what are the most important factors that influence a nurse to stay in a job in a rural environment?

The researchers will use a variety of research methods to find the answers, including focus groups, surveys and statistical methodologies. Approximately 1,000 nurses from across the region will be asked to participate in the study, including students who are not yet practicing in health care, and nurses in rural and urban settings.

“Anecdotally, we have heard that the nurse-to-patient ratio affects retention as well as the support nurses receive from their administration,” Davé said. “And sometimes, students think they might be a good nurse, but when they begin practicing nursing they realize it’s not the profession for them.”

Lischke has seen the health care profession change over the years. “Because health care in general has been forced to operate more like a business, it is just now starting to adopt practices that other industries have been using for years when it comes to recruitment, retention and workforce development,” he said.

“Applying a business model to health care will become even more crucial as the region and state face a growing number of retirees and others needing health care. It goes beyond supply and unfortunately promotes and escalates bidding war for employees,” Lischke said.

“Attracting and keeping nurses can be viewed as a marketing problem,” Dotson said. “Every health care organization that hires nurses wants to make a job offer in such a way that nurses will be attracted and respond favorably to it,” Dotson said. “The other side is that health care organizations have to be careful when they make the offer to make sure that they can do what they promise. It’s basically an exercise in building positive relationships.”

Dotson said very few studies have looked at recruitment and retention of nurses in a rural setting. “The focus groups will provide us with the exploratory research to get a handle on what’s going in the rural areas of the state,” he said.

“We are really looking forward to the outcomes of this study and have high hopes that it will really start a paradigm shift in how health care is contemplated, especially in the nursing field,” Lischke said. “In all of the 88 different health care careers that we have, nursing is one of the most pivotal as our communities grow.”


Michael Lischke

(336) 713-7744 or Terry Gray at (336) 713-7724 at Northwest AHEC

Dinesh Davé

(828) 262-6239

Michael Dotson

(828) 262-6195

Joseph Cazier

(828) 262-6184

Pronunciation guide

Lischke: LISH key

Dinesh Davé: Da NEESH


Cazier: Caw see air