During my days as a nurse practitioner student, my classmates and I dreaded finding out our new clinical assignments for the semester. Our program warned that we could potentially be placed in rural locations over an hour’s drive from the city. Each student could expect to be assigned to at least one such site. Finally, my day came.
As my clinical advisor handed out envelopes containing information for our next clinical rotation, I feared the worst. I tore open my envelope to reveal my next clinical site, Ashland City. “Ugh”, I groaned. I had never heard of this small town and assumed it would require a lengthy commute. I whipped out my laptop plugging the location into Mapquest (these were pre-iPhone days). Fortunately, to my surprise, the small town of Ashland City was just 30 minutes away, a small victory for me as an NP student.
My experience training in Ashland City was pleasant. The physician I worked with had been practicing in the town for years. He immediately recognized and greeted his patients as they walked through the door. Occasionally during the clinic’s evening hours, one of his (8!) children would drop by to say “Hello” bringing a pizza for hungry staff members. Other days, the clinic’s nursing assistant would lug her vegetable garden’s overflow into the clinic offering me a much appreciated supply of fresh tomatoes and peppers. I loved the community feel of my “rural” experience. And, the 30 minute tree-lined drive home on a two-lane country road really wasn’t all that bad.
While most nurse practitioners across the U.S. choose to work in urban and suburban locations, 18% of the country’s NP population elects to practice in a rural setting. Many city-living nurse practitioners cringe at the idea of practicing rurally, but small town practice may not look quite like you think.
With the long discussed primary care shortage impending, there are now more job opportunities than ever for healthcare providers, especially nurse practitioners. Even more opportunities exist for those willing to practice rurally as many of these areas are medically underserved. Small town family physicians are retiring in large numbers and the U.S. population continues to age. Residents of small towns are finding themselves in need of medical care. This primary care gap presents a promising job market for NP’s.
Nurse practitioners typically practice with greater levels of autonomy in rural regions. Fewer specialists and physicians are available in these small towns giving rural NP’s a more significant role in caring for their patients. With a smaller patient population, nurse practitioners can also take time to become more familiar with their patient’s medical and personal needs fulfilling the traditional role of the primary care provider. Removing the stresses of urban medical practice leads to a higher level of job satisfaction among rural NP’s.
Along with personal career satisfaction, rural practice proves financially rewarding. The cost of living in a rural area is much lower than in the city. Despite a lower cost of living, providers practicing rurally often earn more than their urban counterparts. Higher salaries compensate for the inconvenience of rural living ultimately leading to a much better quality of life. Not only are salaries higher for NP’s practicing in medically underserved areas, additional financial benefits promise to make rural practice an even sweeter deal.
In addition to a higher salary, providers practicing in many medically underserved areas qualify for student loan reimbursement from the federal government. For example, the National Health Service Corps (NHSC) promises to pay nurse practitioners up to $60,000 towards outstanding student loans in addition to their normal salary for just two years of practice in a medically underserved area. NP’s working in an area with slightly less medical need qualify for up to $40,000 towards their student loans for two years of service. Following this initial two year period, nurse practitioners may be eligible for additional loan reimbursement dollars paid in one year allotments.
While many designated rural locations fit the small town stereotype and lie 50 miles from the nearest grocery store, not all locations qualifying as rural or medically underserved are so inconvenient. Many small towns like the one I trained in as an NP student are located near larger metropolitan areas and still qualify as areas of medical need.
Rural life isn’t for everyone, but NP’s looking for higher salaries, loan reimbursement and a higher degree of autonomy should certainly consider small town practice. The financial and personal benefits of working in a medically underserved area prove very rewarding and lead to high levels of career satisfaction and an excellent quality of life. And, practicing rurally, you may just get the occasional basket of garden fresh tomatoes from your favorite LPN.
Do you work in a rural location? Tell us about your experience!