Approximately 20 percent of the U.S. population lives in rural areas, yet these communities continue to face a critical maldistribution of healthcare providers, especially registered nurses (RNs), authors Kelley Arredondo, Ph.D., Laura Witte, Ph.D., Alexander Paterson-Roberts, et al. wrote in a research piece on nurse recruitment and retention programs across the U.S., recently published in Medical Care.
Only 16 percent of RNs practice in rural areas, the authors noted. “This significantly impacts rural residents, including over 2.7 million rural veterans receiving care at the Veterans Health Administration (VHA), leading to compromised health outcomes.”
Although physician workforce development has gained much attention, the specific challenges encountered by rural nurses remain insufficiently studied, the authors posed. “It is paramount to recruit and retain rural nurses to foster a robust rural health care workforce to support a healthy ecosystem of care.”
The review aimed to identify not only VHA-specific programs but also national and regional efforts outside the VHA that focus on recruiting and retaining rural nurses, the authors explained about their research.
The researchers found that most programs used a single strategy to recruit or retain rural nurses.
Key findings included:
- Most programs emphasize education, offering initiatives like nursing residencies and pathways for rural students into nursing schools. These opportunities allow future nurses to experience rural practice settings early in their training.
- Few programs take a multipronged approach. Only 22 programs combined two or more strategies to address the complex barriers nurses face.
- Financial incentives are often underused. While scholarships and loan repayment programs are available, lasting improvements in compensation are uncommon.
- Minimal policy or regulatory efforts were identified, highlighting a significant need for support at both the state and federal levels to expand the workforce.
The authors concluded that their findings underscore the importance of multifaceted, targeted approaches to building a sustainable rural nurse workforce. “The scarcity of program evaluations and mental health support identified a critical gap that future programs and strategies should focus on,” they wrote. “By leveraging these insights, policymakers, educators, and healthcare organizations can better align efforts to meet the needs of rural communities and improve health care access and outcomes for underserved populations.”
