NP in Rural America

Specialties NP

Published

Specializes in LTC.

I plan to live in a very rural area in the Midwest when I am finished with school. I know that I can work in offices and hospitals as an RN, but is there any opportunity in rural areas for an NP?

My dream is to have my own practice as FNP but how realistic is this? Who do I talk to for information?

Specializes in m/s, icu.

I live in a town of 3,000 in Maine.

FNP's are mostly used in a doctor's office here.

I don't think a NP can have a solo practice without working under/with a MD. Although, the 36 bed hospital i work at uses FNP's in L&D.

There is a very fine line between PA's (physician's assistant) and a NP, I'm not even sure what it is. We have an ortho PA who does some daily rounds on inpatients. Hope these random thoughts might help.

Specializes in Nephrology, Cardiology, ER, ICU.

I live in rural IL and at least here, there are opportunities to work in an office setting. However, IL does not have independent practice. Likely won't either as our nursing practice act is in the legislature now and keeps losing ground.

Specializes in LTC.

Thanks for your thoughts. I was looking at some stats for NP's and it seems like Iowa has 2 or 3 times more NP's than many other Midwestern states. I guess what I need to do is check out the laws in all the states I would consider living in. I have already run across some laws that I think are absurd, like, in Nebraska, it is illegal for a midwife to be present at a home birth, even if written permission is given from the physician.

Thanks for your thoughts. I was looking at some stats for NP's and it seems like Iowa has 2 or 3 times more NP's than many other Midwestern states. I guess what I need to do is check out the laws in all the states I would consider living in. I have already run across some laws that I think are absurd, like, in Nebraska, it is illegal for a midwife to be present at a home birth, even if written permission is given from the physician.

Nurse midwife or lay midwife?

Specializes in LTC.

http://www.hhs.state.ne.us/crl/nursing/midwife/midwife.htm

This is the link where I found the info. It says:

"A Certified Nurse Midwife (CNM) is a registered nurse who has successfully completed a recognized program of study and clinical experience in obstetrical and gynecological services.

The services provided by the CNM may be provided in a licensed health care facility, in the primary office of a licensed practitioner or in any setting authorized by the collaborating licensed practitioner, or within an organized public health agency. A CNM may not attend a home delivery."

http://www.hhs.state.ne.us/crl/nursing/midwife/midwife.htm

This is the link where I found the info. It says:

"A Certified Nurse Midwife (CNM) is a registered nurse who has successfully completed a recognized program of study and clinical experience in obstetrical and gynecological services.

The services provided by the CNM may be provided in a licensed health care facility, in the primary office of a licensed practitioner or in any setting authorized by the collaborating licensed practitioner, or within an organized public health agency. A CNM may not attend a home delivery."

I agree, the law is absurd.

I live in Rural ND and practice in several of the local clinics on a part time basis as I teach in nursing full time. ND is in need to mid-level providers. We can have an independent practice though we need to have a collaborating MD for prescriptive authority. The next legislative session we plan to introduce legislation to get rid of the collaboration law. I am currently in the process of finding a collaborating MD as I want to start a small scale mobile NP clinic as this is a needed service. NP's can start their own practice with a collaborating MD though that person does not need to be on site. I think NP's need to band together and get the BON's to change the rules and take legislative action if needed. We have full prescriptive authority with DEA numbers

Specializes in LTC.

Shadowapollo, Thanks for your info. Rural North Dakota is my number one choice for NP practice. I have a question for you, though. Do you work in clinics part time because you want to teach full time or is it because it is difficult to find full time work in a clinic?

The answer to your question is a NP can absolutely own a practice. Even in states that suck for NPs (like Missouri) you have every right to own a practice regardless of whether or not you work there. If a layperson can own a practice, NPs can too. You have to have the books right (policies/procedures/documented consults, etc) to please the state gov't laws, but this is merely a formality made by the state medical association to protect their sacred ground.

Specializes in Family NP, OB Nursing.

Rural OH, here. I've just been accepted to Ball States FNP program and one of the reasons I pursued my FNP is that in the county (total pop no more than 30,000) I live in 2 FNPs opened up their own urgent care...and they are probably the busiest practice in town. It's either see them or the ER after 5pm.

I really look up to those 2 women because they took all kinds of flak from the MD/DOs in town and really had to fight tooth and nail to get this practice up and running. They have one of the family docs, who used to work ER with them as their collaborting MD, but he's never "in house" simply available.

Specializes in LTC.

It's great to hear successes like that. Thanks for sharing. I wonder what the statistics are for success and failure of NP offices.

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