Targeting the nurse practitioner workforce: Influences and barriers in choosing rural practice

Mykell Barnacle, Allison Peltier, Heidi Saarinen, Christine Olson, Dean Gross


Background and objective: Recruitment and retention of primary care providers are projected to worsen in rural regions. Nurse practitioners (NPs) are a crucial solution to the shortage of primary care providers in rural America. Little research exists regarding factors influencing new NPs’ decisions to practice in rural settings, as well as practice readiness. The purpose of this study is to explore factors influencing new NPs’ decision to practice in rural settings.

Methods: A survey of family nurse practitioner (FNP) graduates in a rural state was conducted. The survey measured rural background, current practice environment, the impact of rural clinical experiences on readiness to practice, and perceptions of rural NP practice.

Results: The data collected over five years (N = 42) indicated several factors that influenced an NP’s decision to choose a position in a rural or underserved setting. A wide scope of practice, rural roots, a desirable job offer, and strong relationships were influential when choosing rural practice.

Conclusions: Most respondents (69%) were not practicing in rural or underserved areas. Among those who were, the ability to practice to the full scope of education and autonomy were the most important factors. However, respondents were also apprehensive and intimidated with the broad skill set required in rural care. Implications: This study provides insight into factors and barriers for new graduate NPs in choosing a rural practice setting as well as possible solutions to the rural workforce shortage.

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Journal of Nursing Education and Practice

ISSN 1925-4040 (Print)   ISSN 1925-4059 (Online)

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