Factors That Encourage and Support Advanced Practice Registered Nurses to Work in Rural and Safety-Net Settings

Advanced practice registered nurses (APRNs) provide vital care in rural and safety-net settings. Research regarding effective strategies for recruiting and retaining rural or safety-net providers often focuses on physicians or combinations of health care professionals. We conducted a scoping review using MEDLINE and CINAHL to identify effective strategies and research gaps specific to recruiting and retaining APRNs in rural and safety-net settings. We found 13 articles published between 1990 and 2019. Educational experiences and loan repayment obligations influenced APRNs to seek employment in both types of settings. Rural connectedness or satisfaction with the community, having a mentor and supportive work environment, and salary and benefits influenced retention in rural practice. Post-graduate NP residency and an NP-physician team-based care model influenced retention in safety-net settings. We found a limited quantity of evidence for strategies that encourage a strong rural and safety-net APRN workforce, indicating need for additional research.