Any rural NPs out there? Your general advice is requested!

[FullGlass, BSN, MSN, NP]

Hello. I'm a new grad AGPCNP who will shortly be starting my first job at a rural FQHC. The clinic is large and state-of-the-art, located in a rural mountain community of about 3,000 people. The nearest small hospital is 20 miles away. The nearest large town (100,000 people) is 50 miles away (one hour drive).

The clinic is the only clinic in town, so it serves everyone, from the poor to the wealthy. We have an awesome medical director, along with another doctor, and several NPs and PAs. Other staff includes LPNs and medical assistants. While providers take turns being on-call, there is also an after-hours RN phone service for patient questions. We are also equipped for telemedicine for specialists like psych, etc.

The main industries are logging, tourism, and a power utility lineman school. The area draws many visitors for the scenery, state and national parks, fishing, hiking, and camping. There is also a Native American owned casino and hotel.

Would love any advice or insights on both the clinical and personal lifestyle aspects of rural healthcare. I am very excited!

[MathewB]

I can give you a little insight, but just from the RN aspect: I haven't graduated with my DNP yet.

My first position was in a small, rural ER. There were no board-certified ER docs, just Family Practice docs. We obviously flighted a lot of serious stuff out. That said, it was an amazing learning experience. Those ol' country docs knew a lot of tricks which I learned. Later in my career I worked in a more urban setting, and those tricks served me well. I found a had aquired some skills which were normally -at least in that urban institution- assigned to other departments. Little stuff, like hematoma blocks, casting, etc. Nothing super complicated, but it was usually "farmed out" to other departments.

Excessive EtOH is common everywhere, even in rural areas. As well, methamphetamines seem to be the abused drug of choice. We saw way more farming injuries in the rural setting (as you could imagine), and the gunshot wounds tended to to rarely come to us in the rural setting, as the firearm of choice was a hunting rifle versus the comparitively puny hangun and therefore the victims more frequently died prior to EMS arrival.

Being from a rural area myself, there was no culture shock, but I heard a co-worker or two from Chicago complain that it was "so boring" there in "Hicksville." While it's true that there was not a whole lot in the way of big city entertainment, High School plays can be fun, as well as outdoor activities, local fairs and festivals, fishing and the like. My grandpa used to say "Only the boring are bored."

On that note, I am not certain where you are from, but NOBODY likes to be told "The way we did things back in XXXXX was better. The way you do it is dumb." Be friendly, observant and respectful, and you'll fit in in no time.

Kind of brief, but those are my two cents worth!

Edited to add: I would love to work at the place you described!

[203bravo, MSN, APRN]

Edited to add: I would love to work at the place you described!

Me too.