To stay or leave: Public health nurse workforce retention in North Carolina

States across the country have been experiencing a steady decline in public health nursing workforce, including North Carolina (NC). Objectives: To better understand retention in the NC Public Health Nurses (PHNs) workforce through an assessment of perceptions of the working environment, stress, intent to stay, and job satisfaction. Design: A cross-sectional online survey using closed and open-ended questions. Sample: The study population comprised of non-supervisory PHNs (n = 672) working at NC local health departments (LHD). Measurements: Retention problem, working environment, and job satisfaction measures were adapted from the revised Casey-Fink Registered Nurse Retention Survey (c) (2009) to fit public health settings. Results: Despite high levels of job satisfaction (79.76%, n = 473), 53% of respondents (n = 323) acknowledged a retention problem within their LHD; 35.32% (n = 203) planned to/considered leaving their position in the next 3 years for reasons other than retirement. ANOVAs and Kruskal Wallis Test results showed that those planning to leave had statistically lower scores on perceived working environment and job satisfaction and demonstrated higher negative stress levels. Conclusion: Like other states, NC is experiencing a PHN shortages predicted to worsen in coming years. To retain the current workforce, LHDs need to work to improve PHNs working environment, increase PHNs' pay, and alleviate stressors.