Addressing the Primary Care Workforce: Nurse Practitioner Students' Employment Plans

Health care reform has resulted in much debate about its impact on the delivery of primary care and concerns about the number of available primary care providers to meet the needs of an already burdened system. Given the projected need for primary care providers, the scarcity of new physicians in primary care training and the track record of nurse practitioners (NPs) in rural areas, NPs have been seen as the solution to helping solve the primary care problem.  However as in medicine, NPs may experience some of the same disincentives to practice in primary care as their physician counterparts and the problem may be worse in some regions of the country.  In order for NPs to continue meeting the need for primary care providers, it will be important to retain graduates from family and primary care adult-gerontology NP programs in primary care settings.

A national internet-based study was conducted using Survey Monkey™ that examined characteristics of 336 family or primary care adult/adult-gerontology NP students’ professional backgrounds and their intended future work and education plans. The primary aim of the study was to determine what factors influence primary care-prepared NP students’ decisions to choose careers in primary care versus specialty practice. 

Preliminary results indicate forty-eight percent of the students plan to seek positions in primary care, while 21% plan to seek specialty positions; 31% were undecided.  Further analysis of the data will determine if factors such as current salary, prior specialty experience, location of current practice, and years of nursing experience influence their decision to enter primary care or specialty practice. 

The discussion of the results of this study has important implications for nurse practitioner educators teaching in primary care programs.  Planning strategies that socialize students toward practice in a primary care setting is one such implication.  Lobbying for federal and private organizational scholarship and loan repayment funding to enhance student employment in primary care is another strategy.