title: Nurse Practitioner Autonomy and Satisfaction in Rural Settings.
abstract: Rural primary care shortages may be alleviated if more nurse practitioners (NPs) practiced there. This study compares urban and rural primary care NPs (classified by practice location in urban, large rural, small rural, or isolated small rural areas) using descriptive analysis of the 2012 National Sample Survey of NPs. A higher share of rural NPs worked in states without physician oversight requirements, had a DEA (drug enforcement administration) number, hospital admitting privileges, and billed using their own provider identifier. Rural NPs more often reported they were fully using their NP skills, practicing to the fullest extent of the legal scope of practice, satisfied with their work, and planning to stay in their jobs. We found lower per capita NP supply in rural areas, but the proportion in primary care increased with rurality. To meet rural primary care needs, states should support rural NP practice, in concert with support for rural physician practice.
authors.affiliation: 1 University of California San Francisco, CA, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Spetz
authors.affiliation: 2 University of Washington, Seattle, WA, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Skillman
authors.affiliation: 2 University of Washington, Seattle, WA, USA.
authors.forename: C Holly A
authors.initials: CHA
authors.lastname: Andrilla
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000706:statistics & numerical data* / Q000639:trends; D010549:Personal Satisfaction; D011320:Primary Health Care / Q000706:statistics & numerical data* / Q000639:trends; D017009:Professional Autonomy; D019035:Rural Health Services / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: nurse practitioners; nurses; primary care; rural health care; scope of practice