The Henry J. Kaiser Family Foundation reports that 58 million Americans belong to rural communities and medically underserved populations that face a shortage of health care providers. Rural and underserved populations include the elderly and homeless, as well as those with limited income or little to no insurance. Organizations like the National Rural Health Association report that these groups experience a lack of providers, limited education about preventative health measures and economic barriers. They also often experience higher rates of disease and medical complications due to a lack of access to primary care.
For these reasons, there is a wide range of opportunities available for nurse practitioners in underserved areas. Nurse practitioners are stepping in to offer a solution to the problem by providing desperately needed assistance in these communities. The demand for nurse practitioners is especially high in these areas because they can perform many of the same services as primary care physicians as outlined in the State Nurse Practice Act.
Clarkson College Nurse Practitioner graduates bring care to people in medically underserved areas across the country. They build strong, meaningful relationships with their patients and work toward a brighter future and healthier generations to come. Their stories demonstrate their commitment to providing compassionate care, no matter the circumstances.
Crystal Dailey, MSN, APRN, FNP
The ability to work in a rural setting is a dream come true for many nurse practitioners. Alumna and Family Nurse Practitioner Crystal Dailey (’15, ’17) always knew she wanted to serve in a small community. “I never had any intention of working anywhere other than a rural setting,” she said. “If anything, I would like to move somewhere more rural!”
Dailey’s nursing career is embodied by her passion for serving the community. She was born near Stapleton, Neb., and prior to earning her Bachelor’s degree, she worked in a small community as a Licensed Practical Nurse (LPN). She completed the Bachelor of Science in Nursing (BSN) degree at Clarkson College in 2015 and went on to earn her Master of Science in Nursing (MSN) degree in 2017.
Dailey works at Rock County Clinic alongside two additional nurse practitioners and two physicians in Basset, Neb. Because the physicians are only available to work three or four days a month, Daily and her fellow nurse practitioners serve as the primary caregivers at the clinic.
Despite many of her patients having low incomes and no health insurance, Dailey strives to provide exceptional care. “The people here are so appreciative of us,” she said. “When you work in this area, you understand the adversities that your patients face. The difficulties that our patients encounter are ones that my fellow practitioners and I live with and experience every day.”
Patients in the community often experience higher than average rates of sickness, according to Daily. She also sees many patients with more progressed illnesses because there is a lack of education about preventative care. “Out here, there is not as much of a focus on wellness,” she said. “People usually don’t keep up with preventative health measures, and many of them have not seen a provider in five or ten years.”
Rona Johnson, MSN, A-GNP, RN, OCN, CHPN
Rona Johnson (’17) has dedicated her nursing career to working with American Indians, one of the most chronically underserved populations in the United States. She was born and raised in Anchorage, AK and grew up with close ties to the Alaska Native community. After earning her BSN from the University of Alaska-Anchorage in 2003, Johnson began working at the Alaska Native Tribal Health Consortium (ANTHC) in Anchorage and earned her MSN from Clarkson College.
Johnson and her colleagues at ANTHC strive to meet the unique needs of Alaska Native and American Indian populations living in the state. ANTHC is the primary provider for the majority of specialty services in the state such
as oncology, internal medicine and orthopedics and often receives patients from smaller hospitals in the region.
“We serve a relatively homogenous population of indigenous people who are very underserved,” said Johnson. “They come from communities across the state, most of which are not part of the road system so they have to get to us by airplane.”
Many patients must take a three-hour boat ride or 40-minute bush plane trip to get to ANTHC, according to Johnson. When they travel to ANTHC, it is often their first time leaving their village. “We typically see a lot of elders who come out of their villages near the end of their lives,” she said. “It can be traumatic for them to leave their communities and the people they see as their family.”
Cost is another major barrier. Many families across Alaska live simple lives by hunting and gathering only what they need to survive. This lifestyle leaves few resources for preventative health care measures. “Many times, people can’t spend the extra money on gas or a hospital visit because they need to spend that money on fuel and oil to heat their home or food for their families,” said Johnson.
Working with individuals who have little knowledge of and access to health care can be difficult, but Johnson says her patients’ innocence and vulnerability are one of the reasons she loves caring for them. “In Alaskan native culture, it’s not just blood that defines family; it’s the community,” she said. “It provides me so much joy and perspective to be able to serve them and be part of their family.”
Mark Huber, MSN, APRN
When Mark Huber (’16) entered the nursing field, he initially saw himself in the emergency room treating trauma patients. However, he saw the needs of underserved populations firsthand while obtaining his BSN and working in the ER.
“One of the things that I found very frustrating about working in the ER is that a lot of people—oftentimes because they didn’t have any other choice—were using the ER as a place to get primary care,” he said. “We often ended up treating emergent conditions over and over again like high blood pressure, diabetes and high blood sugar, which
is a really poor way to manage chronic conditions.”
Huber continued his education and became a Nurse Practitioner in 2016. Completing clinicals in family practice settings encouraged him to move from the ER to an area that would allow him more interaction with his patients. “I really started to like the idea of being able to get to know my patients and manage their chronic conditions in a non-emergent setting and more efficient way.”
His clinical experiences allowed him to work with OneWorld Community Health Center in Omaha, Neb. where he now serves as a Family Nurse Practitioner. By utilizing options such as a sliding fee scale based on a patient’s income, OneWorld is able to provide an open door policy and provide treatment regardless of income, insurance coverage or ability to pay.
“One thing that is nice about working with underserved populations is that you're really able to give back because your patients don't have a lot of other options,” said Huber. “You provide care that people would not be receiving otherwise.”
Huber also frequently treats non-English speaking patients and estimates that between 70–80 percent of his patients are from countries such as Mexico, Guatemala and El Salvador. Despite language barriers, working with diverse populations appeals to Huber. “One of the reasons that I went into nursing was the opportunity to work overseas and provide health care to people who don't have the opportunity to get it,” he said. “In a lot of ways, I’m able to do that every day without traveling.”