There are also challenges, but like urban hospitals, most of the time they come down to the quality of management.
Melanie has been in her job less than a year and she recognizes signs of burnout in herself. Turnover is really your best indicator of how well a hospital manages its nurses. Management practices can affect the hospital in other ways.
Melanie's annual salary works out to just over US$50,000 per year while nurses a short distance away are making around $60K. Yes, you can say that cost of living differences would make things cheaper in a rural area, but gas prices are slowly eliminating cost of living differences in the part of the country where she works. Unfortunately, Melanie knows she won't stay at the rural hospital, just 9 months into her job.
Melanie's situation could just as easily have occurred in an urban setting. No matter where you go, nurse turnover is costly and drives up the price of patient care. A nurse has to work at a hospital for two years for the hospital to recoup the recruitment and orientation costs from the initial hire. Not all new graduates leave in their first year and many do so for other reasons than management, , as a study by Brewer et al (2012) demonstrated.
Perhaps one thing the any healthcare system can do is work on their management techniques to promote retention and reduce turnover. That alone could generate millions in cost savings.
*Names and locations have been changed.