Rural Healthcare Brings Challenges and Rewards

  • January 5, 2023

    Driving an hour or more to reach the nearest hospital, waiting six months for an appointment for a simple check-up, taking a flight to get specialty care – these might sound like extreme circumstances, but for many people living in rural areas, this is reality.

    As Premera looked at what we could do to make healthcare work better, it became clear that rural Washingtonians face unique obstacles to accessing quality healthcare. We know we can’t sit on the sidelines as the rural healthcare crisis grows. This is why Premera invested in the University of Washington School of Nursing’s Rural Nursing Health Initiative (RNHI), which offers quarter-long clinical rotations for Doctor of Nursing Practice (DNP) students in Washington and year-long post-graduate fellowships for advanced registered nurse practitioners (ARNP) throughout rural parts of the state.

    Building the rural workforce pipeline

    Studies show that providers who trained in or have experience with rural settings are more likely to practice in those areas. We spoke with two recent RNHI program participants who not only prove that’s the case, but also shine a light on what makes practicing in these communities so special.

    Preicy V. Frianeza-Garin, a DNP student at the University of Washington’s School of Nursing, was inspired to pursue a focus in rural healthcare because of her personal experience. “As a child growing up in an impoverished rural province in the Philippines, I witnessed many family members and relatives die young or at the prime of their lives due to poverty and lack of healthcare,” Frianeza-Garin shared. “Having witnessed such a tragic waste of life, I vowed to make a difference and dared to dream of becoming a doctor one day to help others live a healthy, productive, and long life.”

    fieldGrowing up in a small community, Rodrigo Franco-Lara, a DNP student at Seattle Pacific University, also felt that returning to a rural, underserved area was a calling he’s felt since he was a child.

    Managing with limited resources

    Both patients and providers can face many obstacles in providing and seeking quality care. “Most patients getting their care at the Mattawa Community Medical Clinic are on a monetary sliding scale,” said Franco-Lara. He explained that health providers need to be mindful of providing low-cost but high-quality care and avoid costly laboratory tests that are not absolutely needed to obtain a diagnosis.

    “The lack of mental healthcare and other specialty care tops the list of rural healthcare challenges,” Frianeza-Garin explained. In fact, 35 of 39 counties in Washington are federally designated as Mental Health Professional Shortage Areas with limited access to providers such as clinical psychologists, clinical social workers, psychiatric nurse specialists, and marriage and family therapists.

    Distance from emergency rooms and specialty services continue to be an issue for providers seeking the best care for their patients, but as Frianeza-Garin said, “the resiliency of these rural-based healthcare providers is what sets them apart.”

    The community makes it worth it

    Not only did both students benefit from significant training opportunities, but they also found an inspiring and welcoming place to live.  “For those who want to enjoy the beauty of the outdoors and fully engage with people in a community, living in a rural area is a great experience,” said Franco-Lara. “These small communities have a sense of welcome, warmth, and kindness – and you can feel the tranquility and peace of the outdoors that you cannot get from living in a big city.”

    The RNHI is recruiting for their next clinical rotations and fellowships. Learn more about the application process and deadlines on their website.

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