Retaining CRNAs who provide obstetrics services in rural communities: Results from a national survey

Purpose

Examine retention factors and challenges among CRNAs who provide obstetric services and assess whether these factors differ between rural or urban areas.

Methods

Cross-sectional analysis of weighted data from a survey of CRNAs that are members of the American Association of Nurse Anesthesiology and provide obstetric anesthesia services. CRNAs selected reasons why they chose to work in their geographic area, factors that make them want to stay in their job, and challenges that make them want to leave their job.

Findings

Among all respondents (1213), 39% reported practicing in rural areas. Overall, 64% of respondents reported practicing in staffing models without medical direction, with 88% of those in rural areas working without medical direction. The following factors were “very important” for choosing to provide obstetric anesthesia services in a rural area: scope of practice (74%), job autonomy (72%), respect (64%), and work–life balance (62%). Controlling for staffing model, gender, and age, CRNAs practicing in rural areas were more likely to select “concern about care availability” as a reason factor and “the need to be on call” as a retention challenge.

Conclusions

Findings indicate that CRNAs choose to work in rural areas because of concern for care availability and the sense of autonomy, scope of practice, and control they experience in these areas, among other factors.