Nurse of the Week Ben Busey is no stranger to crises. In addition to working as an Urgent Care Nurse Manager at the Roseburg VA Medical Center in Oregon, Busey is also a part of the VA’s Disaster Emergency Medical Personnel System (DEMPS), which deployed him in Puerto Rico after Hurricane Maria struck. So, he was ready to serve when COVID-19 started to spread in beleaguered New Orleans.
The 34-year-old Busey spent two weeks at the VA in New Orleans at the height of the pandemic, and says, “The first day I walked in there, two people died within the first two hours of me arriving. They had just run out of body bags, the ICU.” In addition to coping with the strained hospital resources, like most frontline nurses he did all he could to maintain connections between isolated patients and their loved ones: “I would end up calling them in the middle of the night to give them updates on a small improvement on my patient, just because I knew that they couldn’t see their family member and they weren’t allowed to be on the unit with them, and they were probably just worrying all the time about how their family member was doing.”
Warned of the PPE shortage in advance, he packed N95 masks for his trip, and used his small supply sparingly, often wearing the same mask for as many as five shifts in a row. Upon his arrival, he quickly learned that it is unwise to make assumptions merely because your age and health place you in a fairly low-risk group. As Busey recalls, “The person who oriented me for a couple of hours that first day when I arrived, he had just come back from being ill with COVID and he was 31. The way he described it, he said every day he sat in his room and he wondered am I dying, because he felt so sick and short of breath…” Fortunately, Busey himself returned unscathed; his test results after his return to Oregon proved negative.
Busey worked night shifts, and provided strong, capable support during his two weeks in New Orleans. When he came back to the Roseburg VA Medical Center, the Center presented him with official recognition for his work during the crisis.
For more on Dan Busey’s experience in New Orleans, visit here.
Counties across Oregon are suffering from a shortage of primary care Nurse Practitioners (PCNPs), according to a 2019 survey. A recent study from the Oregon Center for Nursing found that despite the promising national statistics reported by the American Association of Nurse Practitioners (AANP), which estimates that over 75% of NPs are practicing in primary care settings, the distribution of these NPs is severely lacking in Oregon.
As PCNPs are vitally needed to compensate for the shortage of physicians, their unavailability is severely felt in parts of Oregon, which is one of the 22 “full practice” states in the US. In contrast to the AANP’s national figures, a state-specific study of Oregon indicates that only one third of practicing NPs (35%) are working in primary care, with another 22% focusing on a combination of specialty and primary care. Of the 22% with combined practices, 62% spend less than half their time on primary care.
Surprisingly, the shortage of primary care NPs tends to be more evident in urban counties, whereas rural counties appear to be better served. Although there are fewer PCNPs by number in rural counties, the proportion of PCNPs is actually higher in rural areas when measured against per capita population figures.
The Oregon Center for Nursing makes three recommendations:
- Communities should promote incentives such as student loan repayment programs and grants to attract PCNPs to practice in their areas. In addition, incentives could be devised to encourage primary care physician groups to hire NPs and include them in their existing practices.
- The education system in Oregon should examine ways to increase the number of PCNP graduates. Currently, some 70% of the PCNPs practicing in Oregon received their degrees in out-of-state schools. This indicates that the facilities within Oregon are not able to meet present needs for the education of PCNPs, and until the state expands educational opportunities for PCNPs, it will be necessary to fill the gap with graduates from other states.
- Community leaders and health officials should explore the reasons that affect NP decisions to focus on primary care. In addition to considering the question of why PCNPs are being drawn more to rural areas in Oregon than urban counties, these officials should ask “Why do NPs choose to work in non-primary care roles? What incentives might change their minds? Once these underlying reasons are understood, communities can use this knowledge to attract NPs to provide primary care in their communities.”
For more details, visit here,
or click the following link to see the full
report (PDF file).