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Training ‘Unicorns’

A student takes the blood pressure of a community member as part of Western's Wellness Elevated program.

Western plans program focused on rural nursing

On a nondescript Tuesday in the med-surg unit at Gunnison Valley Hospital (GVH), things are pretty quiet. But don’t say the ‘Q’ word out loud. You just might jinx it. In a place like this, quiet can turn to chaos in an instant, and even on a quiet day, the nurses have their hands full. It wouldn’t be unusual for any one of them to be responsible for a hospice patient while watching over someone who just got out of surgery, all while caring for a pediatric patient and another with a bowel obstruction.

“Because we are rural and the only hospital within 70 miles, we get it all,” GVH’s Director of Patient Care Services, Jen Gearhart, said.

In a bigger facility, nurses often specialize in palliative care, pediatrics, orthopedics, obstetrics, or any of the dozens of ailments or infirmities you might encounter in a hospital. They might even work in a part of a hospital that sees only one kind of patient. But not at GVH. Here, rural nursing, which requires practitioners to be experts in just about every type of care, might be considered a specialty of its own.

Difficulty finding nurses willing or able to cultivate such a broad skill set is one reason GVH relies so heavily on a relatively small nursing staff and traveling nurses who earn high wages for signing short-term contracts and then leave, only for another traveler to fill the void.

Bridging the Gap with a New Nursing Program

Even before the COVID pandemic put an incredible strain on healthcare workers, the number of nurses was woefully inadequate to meet the needs of people across the United States. Today, post-pandemic, the healthcare staffing shortage has become a crisis, specifically in Colorado and especially in rural areas.

According to a report on workforce trends released by the consultancy Mercer, employers will need to hire more than 1 million nurses across the country by 2026. Of the 29 states where demand is outpacing supply, Colorado ranks behind only two other states and is projected to be more than 10,000 nurses short of what will be needed.

To address the shortage, Western Colorado University is developing a nursing program over the next 33 months that will focus on the unique needs of rural communities as the gap between supply and demand grows toward a breaking point. “There’s a tremendous need for nurses,” Western Professor of Exercise & Sport Science Lance Dalleck, who served as the Principal Investigator for the grant, said. “So this is a  big opportunity for Western.”

To start moving graduates into the workforce quickly, Western’s nursing program will offer students three different options: a traditional 4-year Bachelor of Science in Nursing (BSN), an accelerated BSN program that would allow students to earn their degree in approximately 18 months, and a Certified Nursing Assistant (CNA) program that will only take a few months for students to complete.

A layered approach like that will allow students with a CNA certification to return for more education if they choose. It will also enable CNAs who are currently working in the valley to continue their education without leaving the valley and creating staffing shortages.    

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“We lose one to two staff a year who are pursuing their career goals, mostly for nursing,” GVH Chief Nursing Officer Nicole Huff said. “We have had challenges recruiting their replacements for many different reasons, like the high cost of living, no housing, and low wages compared to competitors. So, we have had to default to travelers who make twice as much as permanent staff, and they too are short-timers.”

Huff said that nurses in rural settings face unique challenges that their urban and suburban counterparts don’t, so they need to be trained accordingly.

A man has his pulse and blood pressure readings taken in a clinical setting.

Rural Hospitals Provide Personalized Care

“Rural nursing is a special kind of nursing that illuminates the skills each nurse possesses. In urban areas, nurses have their ‘specialty.’ In rural nursing, it is an expectation to know  a lot. The ability of a nurse to deliver a baby, then take care of an elderly patient in surgery and then save a life in the Emergency Department tells you that rural health nurses are beyond special.  They are ‘unicorns’ – unique and rare. We need these nurses here in Gunnison.”

GVH’s Amy Eckert, an RN, said the small rural setting can sometimes give patients the wrong impression when they come to the Gunnison Valley on vacation from an urban area and need medical care. “I’ll walk in, and they’re on the phone with a family member on the other end of the line saying, ‘You got to get out of that Podunk hospital. It’s too small for you,’” she said. “But it doesn’t take long. By the end of that day, after initially wondering if they should get out of here, they’re saying this is the best facility they’ve ever been in.”

She said there are many reasons for the change of heart. Part of it is the expert team of medical providers at GVH who have all come to the valley with experience in larger markets, and part of it is the personal touch they provide. “The nurses here want to take care of the people in their community,” Gearhart said. “These are our neighbors and our friends and our kid’s friends.”

Recruiting and Retaining Nurses for Rural Health

While there are only two nurses on duty caring for patients at any time in the hospital’s med-surg unit, Gearhart is hoping to increase that number to three. Of course, other nurses could be called to any area of the hospital in an emergency. But the nurse who can be added to the schedule will likely be one who already lives in the Valley or a traveler.

Having a nursing program at Western will alleviate some of that strain since students who come will self-select to work in a rural environment and will already have a presence in the community, with a place to live from their time in school. To help the program recruit and retain students who can easily transition to employment, the GVH Foundation Board has committed $20,000 a year in scholarship money. The goal is to recruit 20 students each year for the program, which would bring in 80 students total by the time the program is full. “We are incredibly excited about the opportunity to partner with Western to help bring a nursing school to our community,” Gunnison Valley Health CEO Jason Amrich said. “We look forward to helping develop the next generation of nurses who have a passion for Rural Health and who we hope will provide exceptional care to our community members.”

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