Having been a DON at one of the Critical Access Hospitals, I tell you that once you start practicing as an APN, there prob won't be much time to work as a staff nurse.
One thing to remember is that as an APRN, you are still an RN. You will do wonders for how the staff think of you if you don't forget that, especially in a small rural community. The best APRN's that worked for me, were ones that weren't afraid to get their hands dirty, and helped get the patient admitted and didn't think it was below them to do those basic nursing skills.
The other thing to consider is how well your coworkers can handle the possible role confusion. ie, are you working as an NP or as a staff nurse. When working with your administrator make sure that you spell out reimbursmnt for any time spent on the floor. This is important when it comes to the Cost Report at the end of the year. Medicare gets pretty weird over things sometimes. The Administrator may decide that it is to much like work to handle that.
Out of curiosity are these clinics rural health clinics?
As to Davids comment about the Stark Violation, that won't affect you in a Critical Access Hospital, since it's understood that you are pretty much everything anyway. That in general is only a problem in places with multiple groups of practitioners. Since there is only 1 group in most Critical Access Hospital, there is no one else to refere to.
As to being held to a higher standard of care, that is correct up to a point. You are looked at at the level you are currently working at to a point. You shouldn't be expected to do a full ROS assessment, but you would be expected to recognize things that a staff nurse might not. It's a gray area, that always gets a lot of heated discusions. You can get lawyer's opinions that will go either way, depending on who's side the lawyer is on. I know of at least 6 APRN's who work as Staff RN's to make some extra money without any problem in the same hospital, but not the same unit they are APRN at.
Congradulations on becoming an APRN. Good luck and enjoy learning your new job. Don't hesitate to ask for things in your contract, make sure you get plenty of CEU time as well as vacation, and a book allowance can be helpfull also. Keep you in the latest PDA and software.
Dont worry about working as a Staff Nurse for awhile, just focus on becoming the best APRN that you can be.