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Table 4 Major theme and subthemes: Workload and type of work

From: Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions

Subthemes

Example

Workload

I'm doing two jobs and have been doing for two and a half months. Recruitment is happening and it's going, and I hit the wall and my manager said, “Keep on going,” and I said, “Can you just acknowledge how much extra – all you need to do is acknowledge it.” I'm still doing it and I'll still keep doing it, but if I wasn't going on maternity leave I'd be taking[stress] leave at the end of it because you can't do it. (G6-OT-Female-age28)

Broad variety of clinical work

With most professions… there’s a pressure on you to sort of specialize, and I’ve chosen to be a generalist so I like to be able to do everything from three-day-old babies with talipes to 105-year-old little old ladies… A broad range of practices. That’s how I ended up doing what I’m doing. (G4-PT-Male-age 57)

Altruism and making a difference

I discharged a patient yesterday, 19 years old, and he had cerebral palsy. When he came to me as a baby they were told that he would never walk or talk. Now he’s leaving school, walking independently, talks, communicates, he's got a traineeship. And I said to him, “I'm going to discharge you before I retire because you don't need physio anymore,” and they both started crying, him and his mom, and I gave them both a kiss and off they went. And later on in the day I got some lovely flowers. But that's what makes country practice. You won't get that in a big city. (G5-PT-Female-age57)

Direct clinical work (managers)

The clinical side of things, I think, is very rewarding. I'm actually administrative management, and I'm supposed to be solely that, and I cannot do it. I just cannot do it. Whenever I get an opportunity to do some clinical work I say “I'll do it. I'm free.” Because I'm sick of the desk thing. And it's because of the satisfaction with the clinical load. You need to have, I think, that satisfaction. The desk thing –I just get frustrated, I guess because the system is very hard to work within with the lack of resources, lack of funding, and I need the outlet to help me survive. I think treating the patients is why we're here. (G2-MGR-Female-age 44)

Type of work and career progression

I do think money comes into a bit, because you can't – in the city – it's not the only reason why you would go for another job at all, but I think it does come into it, because in the city, you know, you can specialize in seeing one type of child, or one type of disorder, and get paid much more than a rural clinician who has to be good at seeing it all. And that does become frustrating (G2-DT-Female- age 33)

  1. Managers were particularly keen to retain some contact with direct clinical practice. Large workloads, as well as bureaucracy, lack of management support, and inadequate access to continuing professional development (CPD) were frequently mentioned in relation to job dissatisfaction. Such was the level of dissatisfaction that some participants intended to leave their career, not just their job.