A Rural "Grow Your Own" Strategy: Building Providers From the Local Workforce

Rural health care leaders are increasingly tasked with the responsibility of providing health access to 21% of the national population with only 10% of the provider workforce. Provider recruitment strategies offering loan repayment have had some success in the short term but are less impactful at creating a long-term retention rate, unless the providers have an existing connection to either the community in which they are working or rural health care. Responding to these data, a demonstration project and study has been underway in Colorado to test a rural focused "grow your own" advanced practice registered nurse (APRN) model. Phase 1 is designed to measure recruitment of RNs from inside rural communities to return to school and become primary care providers within those communities. Phase 2 will measure completion of education and phase 3 will measure retention rates in those communities. This article reports on phase 1 of the project, which is recruitment. The project offers stipend support with assistance in the school application process, educational support, clinical and job placement assistance, and monthly coaching. In addition, communities were asked to provide matching funds to support the APRN students with a goal of creating a self-sustaining model that will build a continuous pipeline of APRN providers. This strategy avoids the costly need to recruit and relocate providers who have no ties to the community. Thirty-four of 36 nurses (94%) responded to the study survey. Survey results suggested that the combination of financial, community, and employer support utilized in this model could serve to create a new and sustainable strategy for building a rural APRN provider workforce pipeline. The ultimate outcome has the potential to ensure that all people in rural areas have access to a high-quality, well-educated primary care provider.