Solving the Rural Nursing Shortage Through Distance Learning
By Sharon Griggins

John Melcher works on his adult nurse practitioner accreditation in a distance learning classroom on the Olympic Peninsula. Behind him is a fellow student Gayla Burson and librarian Janet Schnall from the UW.                            -Gretchen Harnack

The teacher on TV begins with a cheery, "Hi there, Port Angeles!" Sitting in front of two television monitors, Gayla Burson and Suree Itti are attending a clinical seminar taught at the University of Washington School of Nursing from a classroom in Port Angeles, Washington. One monitor shows them the teacher at the UW, and the other lets them see their own image that's being beamed to Seattle. It's an unusual setting for a seminar, but distance learning support is one answer to the problem of skilled nursing shortages on the Olympic Peninsula.

Distance learning opportunities for nurses seeking advance practice degrees began with a pilot project launched in 1998. Last July, the School received two federal grants to expand distance learning support to Olympic Peninsula students for the next three years. Two master of nursing focal areas — Rural Adult Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner — allow RNs with bachelor's degrees to access classes at three different sites (see sidebar).

The strength of the project, according to Professor Eleanor Bond, Ph.D., director of the Rural-Adult Nurse Practitioner focal area at UW's SON, is that it serves rural nurses in their own communities. "So often, we see nurses come into urban settings for training and then never go back to the rural areas," says Bond. "Offering the opportunity for distance learning builds the knowledge base of health care providers within communities that are badly in need of personnel with specialized training."

For the four nurses in Port Angeles currently enrolled in the Rural-ANP focal area, distance learning has meant that they can pursue their goals without commuting to Seattle. They can carry on with work and family life. And most importantly, they intend to remain in their communities to practice once they have their degrees.

"There was no way I could get to Seattle for these classes," says Leanna Wilson, who started studying for her Rural-ANP master of nursing in 1999. She also works full-time at the 19-bed hospital in Forks, Washington, an hour's drive from her home in Port Angeles. A member of the Makah tribe, Wilson would like to specialize in diabetes and eventually set up her own practice near the reservation in Neah Bay.

Wilson acknowledges that there are drawbacks to distance learning. She misses the contact with other students and the ability to join study groups. And she was challenged by navigating e-mail and the Web to access articles and other classroom materials. But support services help ease any problems she encounters. Wilson especially appreciates the weekly visit from Sue Gilmore, a lecturer who travels to Port Angeles to go through classwork and provide assistance to the distance learners.

John Melcher completed his nursing master's degree at the UW, but decided to pick up courses and clinical placements that will allow him to gain his adult nurse practitioner accreditation. He finds that taking classes while working allows him to put that knowledge into practice immediately. "In Sequim, where I work, we have a large population of retirees," Melcher says. "What I learn here about diabetes, obesity, hypertension and wound management comes into play in my work every day." He is interested in specializing in gerontology.

Gayla Burson moved to Port Angles specifically because of the School's distance learning program. Her husband hates city life, so to continue her education, she decided to look for a rural community with access to a reputable, nationally accredited advanced degree program. They moved to Port Angles from New Mexico and Gayla attends school while working part time in the emergency room at Olympic Medical Center, the local hospital. Burson admits that at the start she had a hard time getting used to going to class on camera. She quickly adds that the distance learners get tremendous support from staff and instructors. "They make tapes for us, send us materials, they are just great about making us feel as if we are right in the classroom," she says. Burson will finish her degree this summer and hopes to work as a nurse practitioner in hospital emergency rooms.

Perhaps the busiest of the four is Suree Itti, who holds down two jobs, goes to school and is expecting her second child this spring. She and her husband own the local Thai restaurant and when Suree is not supervising the kitchen, she works in Olympic Medical Center's emergency room. The prospect of going to Seattle for advanced training was impossible for her family. "It was always my dream to go back to school," she says. "But opening a business and working kept me away. Then I heard about this offering and I thought, this is my chance, it's right here!"

When asked how she juggles all her activities, Suree just laughs. "Everyone asks me, why do you want to do this? Don't you have enough to do? And I say I never regret increasing my knowledge. In this field you have to keep advancing yourself."

Distance support continues to help Olympic Peninsula nurses move forward in their careers. As enrollment grows, Eleanor Bond envisions a network of nurse practitioners on the Peninsula who have graduated and can serve as mentors to new distance learners. "These students are pioneers," she says. "I'm very proud of them. They're going to provide great service to their community."