ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Wednesday, October 2, 1996 TAG: 9610020010
SECTION: EDITORIAL PAGE: A-7 EDITION: METRO
SOURCE: JANET HARDY BOETTCHER
IN SOUTHWEST Virginia, as in many other rural regions, the sky is blue, the trees are green, the creeks run clear and lively - and few see the special health-care risks and needs leading to increased disease, disability and death. The truth is sobering: Access to adequate, appropriate health care in rural areas, such as Southwest Virginia, is a challenge that needs special attention.
There's been much progress in meeting the health-care needs of Southwest Virginians, but some issues still are disturbing:
*The overall death rate for Southwest Virginia is 33 percent higher than in the rest of the state. The Virginia Health Department reports that in 1994 the death rate was 7.9/1,000 for the state and 11.7/1,000 for the Southwestern region.
*Teen pregnancy and infant mortality rates are higher here than in many areas of the state.
*Access to health care is probably the most difficult in the state - there are many miles and mountains between the people and their health-care providers.
*There are few primary-care providers and many of them are aging. (The physician/population ratio is 1:2,809 in Southwest Virginia and 1:1,540 in the state as a whole. As many as 25 percent of physicians in rural communities are at or above retirement age.)
*The poverty, unemployment and high school drop-out rates continue to be among the highest in the state, making the funds available for health care lower than the state average.
These facts are in line with statistics from other rural areas across the nation.
We all know that no one is going to solve these dilemmas for us. It is up to those committed to the people in Southwestern Virginia to roll up our sleeves, work together and do for ourselves. Such a proactive stance is in the proud tradition of America's first frontier.
It is in this spirit that Radford University's School of Nursing has developed an educational program for registered nurses aimed at improving the availability of advanced-practice nurses in Southwest Virginia, specifically family nurse practitioners.
Radford University recently was awarded $715,000, to be disbursed over three years, by the U.S. Public Health Service, Division of Nursing, to begin a family nurse practitioners concentration in its graduate nursing program. The program has accepted applicants for this fall semester and plans to have the first graduates ready to sit for the certification examination in two years. The program specifically focuses on the special health-care problems of those who live in rural areas.
Professional nurses have always been out in the field, side-by-side with patients. Registered nurses have a long history of delivering general, personal health care to individuals, families and communities. As always, professional nurses are educated to address the holistic health-care needs of the patient and family within a community context.
The RNs who complete this FNP concentration at Radford University will obtain a master of science degree with a major in nursing. They will study the roles and theoretical background of nursing care in general and primary health care specifically. They will take courses with extensive clinical experiences to enable them to be ready to practice in rural areas, where there's a great demand for primary health-care providers.
Qualified applicants who live in rural areas and have a guaranteed rural place of practice receive priority admission. Studies show that the best way to increase the number of primary health-care providers in rural areas is to enroll those who already live and learn there.
The expectations are that the increased availability of these front-line practitioners will improve access to quality health care, thus improving the dismal outcomes we are now experiencing.
Prior to this offering, programs available for nurse practitioner education for RNs were all located in urban areas far away from Southwestern Virginia, in Norfolk, Richmond, Northern Virginia or Charlottesville. Some distance-learning opportunities have been made available, and that has helped. But the trend of urban-educated nurses returning to the cities has held true, and rural communities still go underserved.
Recent surveys indicated that approximately 75 percent of Radford University's nursing alumni practice in Southwestern Virginia or in other rural areas.
It is fitting that as health care changes, Southwestern Virginia nurses have a regional place to retool so they can continue to serve their communities. The problems are not going to go away. The availability of more advanced practice nurses with special skills, working closely with their communities, can help make the region's health outcomes match its impressive beauty.
Janet Hardy Boettcher is chairwoman of Radford University's School of Nursing.
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