Building a Baccalaureate Workforce Using an Academic/Rural Health System Partnership

Americans living in rural areas face healthcare disparities related to geographic location and educational and economical disadvantages. These disparities lead to limited access to healthcare providers and facilities, as well as an overall inability to achieve good health (Harmon, 2013; Healthy People.gov, 2010). Subsequently, residents of rural areas are at greater risk for morbidity and mortality related to higher rates of obesity, diabetes, cardiovascular, and pulmonary disease.

The hallmark of rural nursing practice is the diversity of practice experiences encountered and the wide range of knowledge necessary to address these challenges (Long & Weinert, 2013). In addition to possessing knowledge and skills related to general medical-surgical care, nurses must function as advanced generalists (Harmon, 2013), with sub-specialty knowledge and proficiency in pediatrics, geriatrics, obstetrics, behavioral health, and emergency care. Because rural nurses are often tasked with the stabilization and transport of high acuity patients to higher level facilities, they must also be skilled in community and resource assessment and allocation, technology use, and care coordination across multiple providers and facilities. The IOM Report on the Future of Nursing (IOM, 2010) supports that higher levels of education are needed to provide nurses with the requisite knowledge and competencies necessary to navigate complex healthcare environments such as the rural healthcare setting.  However, only an estimated 30 percent of nurses working in the rural facilities of WNC are Baccalaureate or higher prepared. Many of these nurses have limited financial resources and lack the social support to pursue a Baccalaureate or higher degree.

 The purpose of the RN to BSN Rural Education and Support (RN-BRES) program is to increase recruitment, retention and graduation opportunities for disadvantaged populations in schools of nursing, in an effort to increase workforce diversity, reduce health disparities, and achieve population health equity. This grant-funded program is a collaborative partnership between a local university and a large rural health system.  The program will address the social determinants of health, focusing on providing support to participants to address those determinants hindering successful educational and professional attainment at the individual, social and structural levels. RN-BRES will increase nursing education opportunities for individuals from disadvantaged backgrounds (focusing on economically and socially underserved, and including racial, ethnic, tribal minorities under-represented among registered nurses) by providing student stipends, scholarships, and opportunities for mentorship. The program will also work to increase the public’s access to quality health care by supporting strategies that increase diversity in the nursing workforce. RN-BRES will ensure that, in the participating communities, the right clinicians, with the right skills, are working where they are most needed.

The program has 3 primary goals:

1. Increase the number of students from underrepresented ethnic minorities (UREM) and economically and educationally disadvantaged backgrounds (EEDB) enrolling in and graduating from the RN to BSN program

2. Facilitate the development of an advanced rural generalist competent in the assessment and management of population health across diverse specialties and healthcare delivery environments in the rural environment

3. Increase faculty and healthcare provider’s skill set in care coordination and facilitation in the management of a wide variety of population health issues across the continuum of care.

This presentation will present an overview of initial steps in program development and implementation, to include academic/clinical partnership building and collaboration. Early outcome metrics will be presented and plans for program expansion explored.