Primary Care Workforce Gaps

Due to reimbursement limits, many primary care settings do not use BSN-prepared RNs to the full extent of the knowledge and scope of practice. Level of training does matter for primary care RNs, resulting in better skills, greater interpersonal connections, greater autonomy and more patient-centered care.  Instead, many clinics employ LPNs and/or Medical Assistants. Research has shown that the role of RNs in primary care is often task focused and does not fully apply their skills and knowledge. Additionally, many primary care settings are geographically and/or professionally isolated. Thus, a project goal is to enrich community-based primary care RN capacity with professional development (e.g., primary care and care coordination) for primary care RNs at Piedmont Health.

The growth in chronic disease management attributable to changing patient demographics (i.e. the aging population) contributes to an increased demand of about 776,400 RNs by 2030. Twenty-six percent (26%) of US adults have multiple chronic conditions (MCC), and the prevalence of MCC significantly increases with age. The 2011 Institute of Medicine report emphasized that nurses are needed to fill primary care roles and to help patients prevent acute care episodes by focusing on chronic disease management.

Piedmont Health employs 38 FTEs for RN positions; with positions ranging from nurse managers, Triage Nurse, RN Home Care Coordinators, RN Case Managers, and Director of Nursing. Piedmont Health has a mix of BSN prepared RNs and LPNs. Piedmont Health regularly experiences the challenges of attracting and retaining qualified BSN RNs prepared to practice in community-based primary care in remote areas.