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Focus on Rural Health

People Make it Possible

Rural community members are a big part of new recruit's decision to stay.

By Stacy Kusler on

Christina Brooks didn't enter the University of North Dakota (UND) physician assistant (PA) program planning to go into rural practice. The Grand Forks, North Dakota, native and 2018 graduate of the UND PA program didn't really have any experience in a rural setting until her three-month clinical rotation took her to the North Dakota town of McVille, population 331. She went there to complete the clinical portion of her training, a requirement of the PA program, but that's it.

In her three short months at Nelson County Health System (NCHS), however, Brooks found that a lasting impression had been made and a mind had been changed.

From left to right, Darlene Kelly, NP; receptionist Laurie Ophaug; Christina Brooks, PA-C; and Kim Iverson, RN.

Nurse Practitioner Darlene Kelly has been in the same role at NCHS for 29 years of her 39-year career. She and her clinic nurse manager, Kim Iverson, have seen their share of students from every health profession come through the door to complete various training assignments for their degrees. They weren't prepared for anything different when Brooks began her rotation. Many healthcare facilities and systems use student training as a recruitment strategy. In fact, statistics show that more than half of all medical residents select jobs in the communities where they complete their training. Both Kelly and Iverson noticed something special about Brooks during her training time in McVille.

She expressed a lot of caring for what was going on and was truly interested in their lives, their families, and their health concerns.

"Patients really responded well to her," Kelly said. "She expressed a lot of caring for what was going on and was truly interested in their lives, their families, and their health concerns."

Iverson added that Brooks was "eager to learn and absorb what we were trying to teach her." And while neither Iverson nor Kelly treated Brooks differently than other students they train, Brooks' energy and bubbly personality struck Iverson as important traits for someone who would make a great addition to the team.

The extra care and attention Brooks took with the patients she saw during her training was reciprocated, and those patient relationships were one of the main reasons she loved her time in McVille.

"I really got to know the patients, and the patients were interested in me and how I was liking it [school and training]. I really got to know them, and I loved that aspect," Brooks said.

Kelly noted that patients in McVille are typically open to having students alongside her because they know how important it is for new healthcare providers to learn. "They know the students have to start somewhere," Kelly said.

But little did the patients know that in allowing Brooks into their lives they were performing the important role of recruiter for their community hospital. Brooks signed a full-time employment contract and began working for NCHS in July 2018.

As she celebrates a year in practice, Brooks is loving her role and fitting in well with the care team.

I felt like a celebrity when I came back to practice.

"I felt like a celebrity when I came back to practice," Brooks said. The patients remembered her as a student and expressed their happiness to see her back working. "I hear all the time from patients that they feel blessed to have me, and they thank me for coming back," she said. "I feel equally blessed because of how welcoming people are and that I get to care for them."

Kelly and Iverson have noticed the positive reaction from patients too and enjoy having an extra set of hands in the clinic and hospital.

"She absolutely fits in well with the team here," said Iverson. "She is confident in her abilities and it shows. She is not shy to ask questions."

As for Kelly, who was the sole full-time provider until Brooks joined, she's glad to have some help. "It's certainly a relief to have her around. It can be hard to work alone in the clinic. Having some companionship is nice," she said.

The loan repayment program is a great perk. But I loved it here so much that I probably would have come back anyway.

Brooks attributes the PA program's focus on rural experiences to connecting her with McVille in the first place. Her positive experience with the patients, community, and her mentors, Kelly and Iverson, solidified her choice to work there full time. In addition, because McVille is considered a health professional shortage area, Brooks was eligible to apply for, and subsequently receive, loan repayment funding through the federal State Loan Repayment Program.

"The loan repayment program is a great perk. But I loved it here so much that I probably would have come back anyway," Brooks said.

This article originally appeared in the Summer 2019 issue of North Dakota Medicine.

Stacy Kusler Stacy Kusler is the connection between rural healthcare facilities in North Dakota and qualified health professional job seekers. As the workforce specialist, she assists rural facilities to attract medical providers and other health professionals to their communities by sharing job opportunities. Through her position, Stacy is working to reduce the healthcare workforce shortages throughout the state.