Rural Health
Research Gateway

Nurses and nurse practitioners

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

  • Are Advanced Practice Nurses a Solution to Rural Mental Health Workforce Shortages?
    Maine Rural Health Research Center
    Date: 04/2004
    This paper summarizes the clinical skills and prescriptive authority of advanced practice psychiatric nurses and investigates current trends in their geographic distribution to determine what their future role may be in addressing rural mental health needs.
  • Assessing Rural-Urban Nurse Practitioner Supply and Distribution in 12 States Using Available Data Sources
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 08/2015
    This study compared estimates of nurse practitioner supply in 12 states (statewide and rural vs. urban) derived from two sources: state license records and National Provider Identifier data.
  • Availability of Anesthesia Personnel in Rural Washington and Montana
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/1998
    Anesthesia has historically been an undersupplied specialty. Health personnel issues used to be dominated by the findings of the 1980 Graduate Medical Education National Advisory Committee study, which suggested that anesthesia would be a balanced specialty for the rest of the century. Recent studies, however, have demonstrated that there is an oversupply of all specialists, including anesthesiology. These studies take a "top down" view of health personnel through analysis of national statistics and exploration of subsets of the data by hospital size and rurality. This approach assumes that the databases of the American Hospital Association and the American Medical Association are accurate and do not take into account the presence of certified registered nurse anesthetists (CRNAs), who are the predominant providers of anesthesia care in the smallest and most remote hospitals in the United States. We compared the 1994 master file of the American Medical Association with our local knowledge of the practitioners in the rural areas of Washington state and found numerous small errors. These errors of one or two practitioners made no difference to the analysis of practitioner groups with more than approximately five people, but in the most rural communities the erroneous presence or absence of a single practitioner made a significant difference.
  • Changes in the Rural Registered Nurse Workforce From 1980 to 2004 (Final Report)
    WWAMI Rural Health Research Center
    Date: 10/2007
    With data from 1980-2004 National Sample Surveys of Registered Nurses, and using Rural-Urban Commuting Area definitions, this study describes changes in rural and urban registered nurse demographics, education, and employment characteristics over time.
  • Changes in the Rural Registered Nurse Workforce From 1980 to 2004 (Project Summary)
    WWAMI Rural Health Research Center
    Date: 10/2007
    Current and projected nationwide shortages of registered nurses (RNs) threaten access to and quality of care in most parts of the country. In rural areas, healthcare is frequently challenged by uneven distribution of healthcare providers, including nurses. This report shows changes in the rural RN workforce from 1980 to 2004.
  • Changes in the Supply and Rural-Urban Distribution of Psychiatric Nurse Practitioners in the U.S., 2014-2021
    Fact Sheet
    WWAMI Rural Health Research Center
    Date: 10/2022
    There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatric nurse practitioners by rural-urban status and Census Division.
  • Characteristics of Rural RNs Who Live and Work in Different Communities
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 09/2012
    This policy brief explores why many registered nurses living in rural areas of the United States leave their communities to work in other rural and urban communities.
  • Characteristics of Rural RNs Who Live and Work in Different Communities (Final Report)
    WWAMI Rural Health Research Center
    Date: 09/2012
    This study explores factors associated with registered nurses' decisions to commute away from their rural areas of residence for work.
  • The Contribution of Nurse Practitioners and Physician Assistants to Generalist Care in Underserved Areas of Washington State
    Journal Article
    WWAMI Rural Health Research Center
    Date: 08/2003
    This article uses productivity data from the non-physician clinician (NPC) and physician populations in Washington state to assess the contribution to generalist care made by NPCs, giving special attention to the role of NPCs in rural and underserved areas and the role of women NPCs in the female provider population.
  • The Contribution of Physicians, Physician Assistants, and Nurse Practitioners Toward Rural Primary Care: Findings From a 13-state Survey
    Journal Article
    WWAMI Rural Health Research Center
    Date: 06/2014
    Evaluates a questionnaire that measures weekly outpatient visits and services provided in a rural setting.
  • The Development of Telehealth Laws in the U.S. from 2008 to 2015: A Legal Landscape
    Policy Brief
    Southwest Rural Health Research Center
    Date: 11/2019
    This study examines the scope and evolving nature of telehealth statutes and regulations in the U.S. Our research aims to understand changes in telehealth laws over time (2008-2015), variations in legal frameworks established across the U.S., and the extent that state laws regulate the primary care delivery through the use of telehealth.
  • Factors Associated With Perceived Job Preparedness Among RNs: Results From a National Survey
    Journal Article
    Rural and Minority Health Research Center
    Date: 05/2020
    This article examines perceived job preparedness by demographic and professional characteristics among practicing registered nurses who completed a national survey. Rural and male nurses felt less prepared for nursing practice and may benefit from tailored educational experiences to improve perceptions of being prepared for the workforce.
  • Geographic Access to Health Care for Rural Beneficiaries in Five States: An Update
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 04/2021
    Using data from five states, this study describes the mix of providers caring for rural Medicare beneficiaries, the quantity of care received, and how far rural beneficiaries traveled for care for several selected conditions in 2014. Results are also compared with a similar study of the same states that used data from 1998.
  • Geographic Access to Health Care for Rural Medicare Beneficiaries: A National Study
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 09/2021
    Using national data from 2014, this policy brief describes geographic variation in the mix of providers caring for rural versus urban Medicare beneficiaries, the quantity of visits received by beneficiaries across Census Divisions and types of rural areas, and the distance traveled for care for several serious conditions.
  • Geographic Distribution of Providers With a DEA Waiver to Prescribe Buprenorphine for the Treatment of Opioid Use Disorder: A 5‐Year Update
    Journal Article
    WWAMI Rural Health Research Center
    Date: 06/2018
    This study compares the geographic distribution of physicians, physician assistants, and nurse practitioners waivered to prescribe buprenorphine in 2012 and 2017.
  • Geographic Variation in the Supply of Selected Behavioral Health Providers
    Journal Article
    WWAMI Rural Health Research Center
    Date: 06/2018
    This study examined the supply of select behavioral health providers by metropolitan, micropolitan, and non-core county and Census Division. Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S., with disparities between Census Divisions and rural vs. urban areas.
  • How Could Nurse Practitioners and Physician Assistants Be Deployed to Provide Rural Primary Care?
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 03/2016
    New (2014) rural enrollees in the insurance plans on federal and state exchanges are expected to generate about 1.39 million primary care visits per year. At a national level, it would require 345 full-time equivalent physicians to provide those visits. This study examines how different mixes of physicians, PAs, and NPs might meet the increase.
  • The Maternity Care Nurse Workforce in Rural U.S. Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2017
    Findings are shared from a study examining the maternity care nursing workforce in rural hospital in the United States.
  • A National Survey of RN-to-BSN Programs: Are They Reaching Rural Students?
    Journal Article
    Rural and Minority Health Research Center
    Date: 10/2020
    This study used a national survey of RN-to-BSN programs to better understand their potential role in addressing disparities in BSN-prepared nurses in rural and urban areas. The results are needed to inform policymakers and stakeholders who are responsible for addressing the status and needs of nursing education.
  • Nurse Practitioner Autonomy and Complexity of Care in Rural Primary Care
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2020
    The increasing number of nurse practitioners (NPs) in the rural U.S. has the potential to help alleviate primary care shortages. Using a nationwide source of claims and Electronic Health Record data from 2017, this study constructs measures of NP clinical autonomy and complexity of care.
  • Nurse Practitioner Autonomy and Satisfaction in Rural Settings
    Journal Article
    WWAMI Rural Health Research Center
    Date: 01/2016
    Compares urban and rural primary care nurse practitioners (NPs) by practice location in urban, large rural, small rural, or isolated small rural areas by using analysis of the 2012 National Sample Survey of NPs.
  • Nurse Staffing and Rural Hospital Performance
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 12/2010
    This policy brief examines the impact of nurse staffing on rural hospital performance improvement in the CMS/Premier Inc. Hospital Quality Incentive Demonstration project.
  • Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2015
    This study's purpose was to examine the relationship between nurse staffing levels and care quality in rural nursing homes and to assess potential differences between hospital-based and freestanding rural nursing homes.
  • Perceived Facilitators and Barriers to Rural Nursing Practice
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2019
    A web-based survey was disseminated to a geographically diverse sample of nurses throughout the U.S. to assess perceived barriers and facilitators to nursing practice; job satisfaction; and self-identified challenges in nursing work environments and patient care. Of particular interest were nurses in ambulatory care practices.
  • Prescribing Practices of Nurse Practitioners and Physician Assistants Waivered to Prescribe Buprenorphine and the Barriers They Experience Prescribing Buprenorphine
    Journal Article
    WWAMI Rural Health Research Center
    Date: 10/2019
    This study surveyed rural and urban nurse practitioners (NPs) and physician assistants (PAs) with Drug Enforcement Agency waivers to provide medication treatment for opioid use disorder by prescribing buprenorphine. Rural NPs and PAs reported facing many of the same barriers to providing buprenorphine as rural physicians have reported.
  • Registered Nurse Vacancies in Federally Funded Health Centers
    WWAMI Rural Health Research Center
    Date: 12/2006
    This project summary discusses the registered nurse vacancy rate in federally funded health centers, which varies by degree of rurality.
  • RN-to-BSN Programs: Challenges for Rural Nurse Education
    Policy Brief
    Rural and Minority Health Research Center
    Date: 10/2019
    To ascertain the status of rural-focused nursing education, we surveyed registered nurse to bachelor of science in nursing (RN-to-BSN) programs. Using an American Association of Colleges of Nursing mailing list, surveys were mailed to all schools with RN-to-BSN programs. This report summarizes responses from the 237 that completed surveys.
  • Rural and Urban Differences in Primary Care Pain Treatment by Clinician Type
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 04/2020
    In this brief, we compare 2017 opioid prescribing rates among physicians and nurse practitioners within primary care practices and how these differ for rural versus urban areas.
  • Rural Registered Nurses: Educational Preparation, Workplace, and Salary
    Policy Brief
    Rural and Minority Health Research Center
    Date: 10/2019
    Using national data from census data from the 2011-2015 American Community Survey Public Use Microdata Sample, this brief looks at the reported education levels and worksites of rural and urban registered nurses.
  • Rural-Urban Differences in Educational Attainment Among Registered Nurses: Implications for Achieving an 80% BSN Workforce
    Journal Article
    Rural and Minority Health Research Center
    Date: 05/2020
    Our primary objective was to provide updated information on rural-urban differences in educational attainment. We also examined rural-urban differences in employment type, salary, and demographics among registered nurses in different practice settings.
  • The State of Rural Hospital Nursing and Allied Health Professional Shortages
    Southwest Rural Health Research Center
    Date: 12/2005
    This study estimated shortages of nurses and allied health personnel among rural hospitals to gauge the difficulty experienced by rural hospitals in recruiting such personnel. The study also examined strategies these hospitals use in recruitment and retention of nurses and addressed strategies that might effectively address such shortages.
  • Supply and Distribution of the Primary Care Workforce in Rural America: 2019
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 06/2020
    Maintaining an adequate supply of primary care providers in the U.S. is one of the key challenges in rural healthcare. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S.
  • Supply and Distribution of the Primary Care Workforce in Rural America: A State-Level Analysis
    Report
    WWAMI Rural Health Research Center
    Date: 06/2020
    Maintaining an adequate supply of primary care providers in the U.S. is one of the key challenges in rural health care. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S., providing state-level data briefs.
  • The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 06/2020
    Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This brief describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties.
  • The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S. - A State-Level Analysis
    Report
    WWAMI Rural Health Research Center
    Date: 06/2020
    Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This set of data briefs describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties for every state.
  • Support for Rural Recruitment and Practice Among U.S. Nurse Practitioner Education Programs
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 05/2014
    This brief details nurse practitioner (NP) education programs across the United States to identify those actively promoting NP practice in rural areas. It also describes the use of education methods that may promote rural practice and identifies barriers to recruiting rural students and providing rural NP clinical training.
  • Threats to the Future Supply of Rural Registered Nurses
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 04/2009
    Shortages of registered nurses (RNs) in rural areas of the United States may grow even greater in the coming years as the "baby boom" generation retires and as RNs commute to larger towns and urban areas for work.
  • Tracking the Geographic Distribution and Growth of Clinicians With a DEA Waiver to Prescribe Buprenorphine to Treat Opioid Use Disorder
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/2021
    The increase in clinicians who can prescribe buprenorphine improves access to treatment for opioid use disorder. Small remote rural communities continue to experience access challenges. 63.1% of all rural counties had at least one clinician with a Drug Enforcement Administration waiver, but more than half of small remote rural counties did not.
  • The Washington State Nurse Anesthetist Workforce: A Case Study
    Journal Article
    WWAMI Rural Health Research Center
    Date: 02/2007
    The purpose of this study was to describe the Washington State Certified Registered Nurse Anesthetist (CRNA) workforce and analyze selected dimensions of their clinical practice.