WCTI | News

Thanks to new grant funding, graduates from several ECU College of Nursing departments will be poised to provide health care that makes a big difference in small communities.

The four-year, $2.79 million grant from the U.S. Health Resources and Services Administration is intended to transform the advanced practice registered nurse (APRN) workforce and improve access to health care in rural and underserved areas of eastern North Carolina.

The Advanced Practice Registered Nurse Academic-Clinical Practice Collaborative will bring together students from three APRN concentrations to learn first-hand about the health care needs in areas that have the least access to care and a high prevalence of farmers, fishers and loggers who face different occupational hazards.

“It’s an opportunity to not only give students excellent primary care experiences in rural health, but also to give them hands-on exposure to what it’s like to care for clients in eastern North Carolina,” said Dr. Pamela Reis, an associate professor in the Department of Nursing Science, who will lead the project. “Hopefully this will create investment in wanting to work in rural and underserved communities in the future.”

The project will recruit 84 advanced practice nursing students from nurse practitioner, nurse-midwifery and clinical nurse specialist concentrations over the four-year period and place them in rural communities through a partnership with Vidant Health. The students will also receive specialized training that is designed to help them understand patient needs and provide better care in these areas.

The grant provides part-time students with $11,000 toward their education while full-time students receive $22,000. For each year of financial support they receive, students are asked to provide two years of work experience in rural or underserved communities.

Of the 41 counties in eastern North Carolina, 28 have fewer than five primary care physicians per 10,000 residents, and 30 have fewer than five nurse practitioners.

Although advanced practice registered nurses are educated to provide primary care services, in North Carolina, they are only allowed to do so under the supervision of a physician. Because physicians are more highly concentrated in urban areas of the state, rural areas are often left with few or no primary care options nearby.

Identical bills currently making their way through the state House of Representatives and Senate would remove the physician supervision requirement, paving the way for more primary care providers to serve the communities that need them most.

“There’s a need, but there hasn’t been an ability for them [APRNs] to practice [independently] in rural communities,” Reis said. “Many hospitals in rural communities are closing which probably will impact the ability of our students to work in rural or underserved communities. It’s kind of the perfect storm of opportunity for our students. If this legislation passes, they will be able to go to rural communities and provide care to people who may not be receiving care because of all the closures that are going on in health care facilities.”

Second-year nurse midwifery student Katelyn Veal, who was selected for the program, said she appreciated the program encouraging the primary care aspects of the midwife practice.

“Including midwives in it and recognizing primary care as a significant scope of our practice is important,” said Veal, who worked as a critical care nurse for seven years. “I think a lot of people just consider midwives to be involved in the labor and delivery part of women’s health, but we’re providers that are really uniquely positioned to interface with women annually. They can take advantage of the services we provide —we provide primary care services as well, and we can be utilized in rural parts of the state to increase access to care.”

Veal and other participants will be placed in Vidant Health clinics in rural areas throughout eastern North Carolina to learn first-hand what health care professionals face there in terms of patient care.

Mallory Moore, a Doctor of Nursing Practice student who received her bachelor’s degree in nursing from ECU in 2016, has been placed in a clinic in her hometown of Tarboro as part of the program.

“I grew up going to Tarboro clinics. It has grown quite a bit since then,” Moore said. “It’s really exciting, but it’s kind of intimidating at the same time —I keep thinking they’re going to think that I’m still little Mallory with the big bow in my hair. But I think it’s going to be a cool way to give back and show the community that I’ve grown up, and to help out back home.”

While she currently works at Duke University Hospital, Moore said the transplant unit that she works in regularly gets patients from rural areas, so she’s become familiar with some of the challenges those patients face.