School of Nursing improves health equity, offers specialized training with new HRSA grant

By Tatum Lyles Flick
Communications Specialist

Isaac Waide, Pam Jones, Christian Ketel and Natasha McClure

Vanderbilt University School of Nursing has received a four-year, $2.8 million Health Resources and Services Administration Bureau of Health Workforce grant for a primary care nurse practitioner residency program that will recruit, train and retain primary care providers with a passion for helping rural and underserved communities. Associate Professor Pam Jones, BSN’81, MSN’92, DNP’13, FAAN, is the grant’s project director, with Associate Professor Christian Ketel, DNP’14, FNAP, serving as primary author and evaluator.

The award builds on a $2.4 million HRSA grant the school received four years ago to develop its Community-Based Nurse Practitioner Fellowship, a postgraduate nurse practitioner/nurse-midwife resident training, hiring and retention plan for community-based health clinics.

The new grant funds five additional advanced practice nurse fellows—three trained in family or adult gerontology primary care, one trained in psychiatric/mental health and one trained in nurse-midwifery—to work full time for one year at a participating community-based health clinic.

The fellows benefit from specialized training in behavioral health and psychopharmacology, maternal health, cultural competency and mitigating issues caused by social determinants of health. They also learn from clinical immersion experiences, mentoring, collaboration with other providers and providing evidence-based treatments for rural or medically underserved clinics.

Nationally, many new providers based in clinics serving rural or underserved populations become overwhelmed and leave their positions within the first few years. The CBNP Fellows effort is poised to tackle that issue and help new practitioners build confidence and resilience  and increase job satisfaction so they continue to practice in communities where they are most needed.

“This program provides, in partnership with our community agencies, a gradual and structured onboarding, and an educational program that gives the new provider additional knowledge and ongoing support from the grant team,” Jones explained

The fellowship will increase access to primary care nurse practitioners for general physical health issues. Behavioral health assistance will be offered as part of holistic primary care and support people with psychiatric conditions that often aggravate other health conditions. Certified nurse-midwifes will promote maternal health through patient education and increased access to providers.

“Chronic diseases, including cardiovascular disease, diabetes, arthritis and depression, contribute significantly to health care costs and affect six out of ten adults, with multiple chronic conditions being common,” Ketel said. “Risk factors such as tobacco use, poor nutrition, sedentary lifestyle and alcohol consumption exacerbate the situation.”

This program is a part of the Vanderbilt School of Nursing’s programs and educational opportunities that focus on community needs and health equity, helping people overcome disparities to live healthy lives.

“VUSN has a long history of developing and managing nurse-managed practices with APRNs and programs that meet the needs of underserved populations,” said Jones, who has seen the good these types of programs can do and how much they are needed. “In my former role as a chief nursing officer, I saw the profound impact of the lack of appropriate primary care in our underserved communities.”

Ketel continued, “Underserved populations often face significant health care disparities, including limited access to quality care and higher rates of chronic diseases. By supporting this program, Vanderbilt School of Nursing demonstrates its commitment to addressing health care disparities, working towards health equity, and producing culturally sensitive health care providers.”

The program seeks new nurse practitioners and nurse-midwives within 18 months of graduation. After a screening process through Vanderbilt School of Nursing, applicants may be chosen to interview with a partner community-based health clinic, where those hired will become full-time employees for one year under the supervision of a mentor. They will also have access to continuing education opportunities, monthly conferences and support/coaching from School of Nursing faculty.

Tennessee Community-Based Health Clinics affiliated with the program include Hardeman County Community Health Center in Bolivar and Neighborhood Health, Vanderbilt University Medical Center, Vanderbilt Primary Care West End and Vanderbilt Midwives Melrose in Nashville.

The School of Nursing team includes Jones, Ketel, Instructor Tonya Elkins, and Associate Professor of Nursing Natasha McClure, DNP, MSN’11. For more information, visit https://nursing.vanderbilt.edu/projects/cbnpf/index.php.

As an innovative program created to collaborate with community partners and support health care needs, the Community-Based Nurse Practitioner Fellowship is one way the School of Nursing supports Vanderbilt’s Dare to Grow philosophy and it supports the passion Vanderbilt nursing faculty and staff have for helping others.

This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number 1 T59HP49666‐01‐00 as part of an award totaling $2,800,000 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.