The Southern states: NPs made an impact in rural and healthcare shortage areas

Abstract

Purpose To investigate the distribution of nurse practitioners (NPs) in the U.S. Southern region with a focus on rural and underserved areas. Described in this study are the NP characteristics and their workforce distribution relative to rural and health professional shortage areas (HPSAs). Data sources Method: A questionnaire was administered to NPs in 12 Southern states. Other data sources included (a) the Health Resources and Services Administration, which identified HPSAs; and (b) data from the U.S. Census Bureau, to distinguish urban and rural areas. Conclusions Approximately 72% of NPs worked in HPSAs and less than half of the NPs worked in the rural area. Family NPs were more likely to practice in rural and HPSAs. Employment in primary care was more likely to occur in rural and HPSAs. Racial diversity was almost nonexistent within the NP population. Implication for practice This research does demonstrate that NPs are practicing in rural and underserved areas as conceived decades ago, but there is still a great demand and gap to fill. To optimize their effectiveness, NPs need to practice to the full extent of their education. Additionally, more research and strategies to help diversify the workforce is needed.

Nurse practitioners’ job satisfaction in rural versus nonrural areas

“…Rural NPs in particular provide a significant portion of rural healthcare services, especially, where it is difficult to recruit physicians (Kippenbrock, Buron, Odell, & Narcisse, ). A recent study confirmed that NPs are an important workforce in the primary healthcare service delivery to rural and underserved population, especially Southern U.S. states, and those NPs worked in health professional shortage areas and about half of them worked in rural areas (Kippenbrock et al., ). Their healthcare services are considered to be a substitution for primary care physicians with a positive effect on patient satisfaction and lower mortality (Kippenbrock et al., ; Martinez‐Gonzalez et al., ).…”

“…States’ regulatory environments and regulations for scope of practice differ. NPs’ ability to practice to the full extent is often limited by these regulations, reimbursement, and prescriptive authority (Kippenbrock et al., ). Currently, 24 states grant NPs authority without physician involvement in diagnosis and treatment (Gadbois, Miller, Tyler, & Intrator, ).…”

“…Healthcare projections suggest that the demand for NP services will increase, especially because the American population is aging (De Milt et al., ; Shea, ). Furthermore, the United States faces a serious shortage of primary care healthcare providers, particularly in rural areas (Kippenbrock et al., ). Rural NPs in particular provide a significant portion of rural healthcare services, especially, where it is difficult to recruit physicians (Kippenbrock, Buron, Odell, & Narcisse, ).…”

“…This number is expected to increase by 130% by 2025 (Auerbach, ). NPs will have still more opportunities to contribute to healthcare delivery (Poghosyan, Lucero, Rauch, & Berkowitz, ) because the implementation of the Patient Protection and Affordable Care Act and the aging of the U.S. population will further increase the demand for healthcare services (Kippenbrock, Lo, Odell, & Buron, ).…”

Expanding rural access to mental health care through online postgraduate nurse practitioner education

“…Primary care nurse practitioners (NPs) make up the great majority (86.5%) of the NP workforce (American Association of Nurse Practitioners [AANP], ) and are more likely to practice in rural counties and primary care shortage areas compared to primary care physicians (Buerhaus, DesRoches, Dittus, & Donelan, ). Of 1583 NPs from southern U.S. states who responded to a workforce survey, 72% practiced in shortage areas and 47% worked in rural areas (Kippenbrock, Lo, Odell, & Buron, ). Primary care NPs in rural areas are already caring for patients with mental health needs and are therefore ideal candidates for educational initiatives.…”