Abstract
AIM: The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. BACKGROUND: Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. METHOD: Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. RESULTS: Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. CONCLUSION: Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. IMPLICATIONS FOR NURSING MANAGEMENT: Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.