Immersion emphasizes role of rural nurse

^{Bachelor of Science in Nursing student Ella Reichenbacher and Essentia Health charge nurse Becky Nelson share a laugh as they prep medication.}

Going into her last semester as senior in the Bachelor of Science in Nursing program, Ella Reichenbacher had completed all of her clinical experiences at Mayo Clinic in Rochester.

It’s a system she respects and knows well, as she also serves as a patient care assistant in its emergency room.

So when she learned about the opportunity to complete a rural immersion at Essentia Health’s hospital in Deer River, Reichenbacher was quick to sign up. “I like trying and learning new things. Since I’ve always been with Mayo, I wanted to learn what it’s like to be a nurse in a completely different setting,” she says.

All Bachelor of Science in Nursing students have the opportunity to participate in the rural immersion clinical experience. This spring, 10 students enrolled in the immersion experience and spent three days in Deer River, a town of 900 people about 200 miles north of Minneapolis.

“As we support students in understanding the full breadth of the discipline and where the discipline serves, we want to provide students with the experience of rural nursing in a critical access hospital so they understand the importance of that role. It gives them a better appreciation of rural nursing in the hospital and helps them understand how it’s different than a health center in the middle of a city,” says Susan Gross Forneris, PhD, RN, CNE, CHSE-A, FAAN, associate dean for Academic Programs.

The opportunity was developed through the Nursing Collaboratory that the University of Minnesota School of Nursing and Essentia Health established in 2021 to foster innovation and improve the nursing pipeline.

“Academic-practice partnerships are vital in fostering innovation within health care and must include evolving clinical experiences for nursing students,” says Carolyn Hughes, DNP, RN, NE-BC, NPD-BC, Essentia Health system senior nursing director. “By providing immersion experiences in rural health, we enhance nursing students’ professional skills and understanding of rural health care, and in return, they bring fresh perspectives to Essentia Health. This collaboration drives forward-thinking solutions and helps to ensure comprehensive care for these communities for years to come.”

Reichenbacher came into the experience excited to learn and a little nervous about the difference she expected to encounter. She arrived on a Thursday night and settled into an on-call room in the basement of the hospital where she would be staying for the next three days. Her shift began at 7 a.m. on Friday and she immediately noticed the lack of noise. “I’m used to it feeling more chaotic, with phones ringing and a lot of people. At Essentia, there are very few people running around because almost everything is being done by the nurses,” she says.

That morning there were nine patients on the unit being cared for by two nurses and the charge nurse, Becky Nelson, AS, RN, who served as Reichenbacher’s preceptor during the immersion.

“Students are great to work with because they are so excited for everything. You can just see the little twinkle in their eye when they’re learning something new,” says Nelson. “If they are coming from the Cities, they get to see what nurses at critical access hospitals have to do and what we have to work with compared to what they’ve seen in bigger hospitals.”

Over their 36 hours together, Nelson and Reichenbacher developed an easy rapport. Reichenbacher was impressed with how much time Nelson took to explain things and how much trust she had in her.

“She gave me the opportunity to do so much, which isn’t always the case. I got to do all the IV meds, which is a small thing, but I haven’t been able to do a lot of that, so I really appreciated it,” she says.

Reichenbacher also appreciated the relationships she established with patients. “When I do clinicals, I don’t usually get the same patient. With this, I got the same patient for the whole weekend. I think I’m going to remember her because she’s my first patient that I built a relationship with,” says Reichenbacher.

These are the experiences that were envisioned when the immersion experience was developed. “The rural immersion experience adds depth to how our students understand the unique needs of a critical access hospital and the relationship of that hospital to the community,” says Carol Flaten, DNP, RN, PHN, assistant dean for Pre-licensure Programs. “This experience supports our students in providing individual patient care and learning about how rural health care is impacted by broader system level initiatives or funding.”

Ella’s photo journal

Positive patient interaction, unit culture

The spring rural immersion experience was an expansion of the initiative, which began with Master of Nursing students in the fall. Andrew Blomberg was one of the first students to participate in it. 

“I really wanted to go into rural health care so I was really happy when the rural immersion opportunity came up,” says Blomberg. 
After witnessing the difficulty his grandparents experienced accessing health care in rural Illinois, Blomberg felt drawn to provide care in a rural community.

“I wanted to go into a critical access hospital coming into the program and Deer River is a critical access hospital, so it was good to experience that,” says Blomberg. “If I had a bad time there, I might have rethought that. But it was really great there. It reaffirmed my commitment.”

During his two-week immersion, the positive patient interactions and the unit culture were memorable. “They did really good work and it was cool to see,” says Blomberg.

Blomberg was so impressed by the experience that after he graduated in the fall and passed his NCLEX, he moved to nearby Grand Rapids and is now a nurse at the hospital. “It was a great learning experience overall,” he says.

As for Reichenbacher, she hasn’t decided where she will practice after graduating, but she appreciated the experience at Essentia Health.

“I liked the autonomy that the nurses have,” says Reichenbacher. “I’ve never seen a single nurse have control over such a wide-range of responsibilities. It made me feel more empowered that you can use all your skills to help the patient, and I realized that serving in a large hospital isn’t the only option.”