Why is rural nursing important?
Rural areas have fewer nurses than are needed for their communities. As a result, rural residents often go without adequate healthcare, enduring health complications as a result. Rural areas have difficulty attracting and retaining nurses in competition with cities and other affluent areas. Training for registered nurses is rigorous and competitive, and many rural communities have difficulty providing adequate high school preparation for local students to become certified. Rural and tribal healthcare workers have less access to additional training to advance their expertise. Rural and tribal communites have unique needs that constitute a healthcare specialty.

How can the Rural Nursing Project help?
The Rural Nursing Project is making it possible for rural communities to educate and hire their own nursing workforce, focusing on an apprenticeship-like model of education. This “grow-your-own-nurses” program includes the following objectives:
• Research and create a plan to establish a Rural Distance Learning program for nursing
• Improve the affordability of and access to nursing training for rural and tribal communities
• Educate and hire a nursing workforce in rural communities that reflects the community members themselves
This project is based on one called Rural Opportunities Nursing Education (RONE), previously hosted by Lower Columbia College. An evaluation of the RONE program is available here.

How will it work?
AHECWW is working with the Action Now Coalition to develop a Distance Learning Registered Nurse Degree Program. This program will bring nursing education within reach of rural residents throughout Washington. Together with the Washington Center for Nursing, we’re developing the “Rural Nursing Distance Learning and Diversity Initiative” curriculum. Spring 2018 planning includes development of an accredited, employer-supported, registered nurse education program for incumbent healthcare workers in rural communities.

Features of the program are expected to include:
• Distance education to help existing healthcare staff earn additional  certifications including Associate Degree in Nursing
• On-line courses including the required courses for nursing degree programs
• Contract work opportunities so that students work at rural hospitals while completing clinical practice curriculum on-site
• Asynchronous education and modifiable course schedule
• Experienced hospital staff with Bachelors or Masters in Nursing acting as adjunct faculty
• Student support services from college or university affiliates
• Continuing Work agreement: student agrees to work in rural community for an agreed-upon term after graduating

Other Components to Distance Learning
• Development of “Rural Specialty” content
• Tele-health training (“tele-presenting”)
• Team-based care
• Integrated care
• Possible special topics: care coordination, chronic conditions, maternal and infant health, older adult health, behavioral health, pain management, palliative care, quality improvement, management

Action Plan
The Action Now Initiative Coalition, Academic Progression Work Group will present a vetted program at solutions summit October 2018, with implementation goal of fall 2019 pilot sites. The program will be hosted at a college or university, partners with communities to provide local clinical experiences, with online delivery of didactic curriculum. Program clinical practice education sites will move from one area of the state to the next according to need.

Other possible project components
• High School Health Scholars – the AHECWW will explore high school health scholar models and AmeriCorps programs promoted by HRSA

• Rural Residency Program – the AHECWW will explore models for nursing residency training programs based on new Washington and other national programs, transition to BSN program

Where can I find more information?

Data about the Washington State Nursing Supply and Demand is available from the Washington Center for Nursing.

Analysis of the Washington State Nursing Student Diversity Survey Results is also available from the Washington Center for Nursing website.

Information about the Washington State Health Workforce is available from the Sentinel Network.

How can I get involved?
There are lots of opportunities to help with workgroups and committees to get this program launched by autumn 2019. For more information about the program and how to participate, call or email.