Nurturing the nurturers.

The nurse-retention problem plagues hospitals nationwide, but nowhere is the crisis more evident than in rural areas, where, if nothing is done, more hospitals likely will join the growing numbers that have simply closed. Researchers designed a study to identify effective strategies for managers and administrators to pursue in retaining nurses in rural hospitals. They asked nurses to rate 43 strategies according to the degree of influence each would have on the decision to remain on the job. "Winning" strategies fit into four major categories: (1) self- and professional development, (2) monetary needs, including benefits, (3) internal management, and (4) staffing and scheduling. Among the study's suggestions are these: Managers should increase opportunities for upward mobility to alleviate some of the nurses' frustrations at feeling trapped in one position. If a higher educational level is a prerequisite for upward mobility, hospital managers should simplify the process of obtaining that education. Rural nurses clearly do not believe they are being compensated enough for their efforts. Hospitals must respond accordingly if they intend to maintain an adequate nursing staff. Nurses want to know that when conflicts or disruptions arise, they will have a simple, direct means of resolution. Hospitals should manage conflict through communication and training and support at all primary care levels. Because nurses provide the majority of client care, they must have a more active, participative role in staffing and scheduling policies.