Strategies to support receptors in rural facilities
Across the United States, rural facilities are navigating financial challenges and workforce shortages. In turn, many organizations have engaged in hiring new graduate nurses, often without having staff who are adequately prepared to support them. The support a new graduate nurse obtains in the first year of their practice is paramount to their success. If support is lacking, they are likely to leave their position. This places a financial burden on the facility, with the average turnover cost for new nurses ranging from $45,100 to $67,500, translating to an annual loss of about $8.55 million per hospital.
The preceptor plays an integral role for the new graduate nurse – but the role of the preceptor is often challenging in a rural facility due to multiple factors. A preceptor has numerous roles, including teacher/coach, facilitator, protector, socialization agent, leader/influencer, and evaluator. Each role has a set of core competencies, and more can be found in the Preceptor Competency Consensus Study.
Rural facilities throughout the United States are designed to provide services for patients across the continuum of care. Due to these challenges, providing support for new graduate nurses entering practice in rural facilities is especially difficult for several reasons. These include:
- Human resources: There may be limited staff available to serve as a preceptor.
- Preceptor burnout: Limited staff leads to the same individuals serving as preceptors for each new hire, graduate nurse, and experienced nurse. This can lead to preceptor burnout.
- Equipment: This includes the availability of equipment or supplies for training.
- Resources: New nurses in rural areas could have limited opportunities to practice some high-risk, low-frequency skills. The preceptor must often become creative to meet the needs of the organization, patient population, and preceptee.
An important evidence-based strategy for overcoming these challenges is recognizing the need for formalized preceptor training. Traditional classroom approaches can prove difficult in rural settings due to the volume of learners and financial resources needed to develop curriculum and maintain and facilitate in-person classes. Therefore, when considering preceptor training options, online asynchronous training should be included.
Alaska Hospital and Healthcare Association’s (AHHA) Collaboration and Training Coordinator Addie Prussing speaks to the value of online training in rural areas. “One of our main priorities at AHHA is offering a variety of resources to our members, and since many of our members deliver health care in a rural setting, our partnership with Iowa Online Nurse Residency Program supports them by providing an online educational resource,” she says. “We provide other online courses to support the needs of our members while reducing some of the barriers that may be in place to accessing such courses, such as cost. It is not required for all preceptors to take but we encourage our contacts at each facility to use it to their advantage and their employees' advantage.”
As Prussing emphasizes, online training allows participants to complete their education during a time that works for them, including downtime at work.
The AHHA isn’t the only organization finding success with online training. ChildServe, a pediatric specialty hospital offering a variety of services and day programs in Iowa, was facing preceptor burnout during its busy summer onboarding season. To address this challenge, the organization developed a structured preceptorship program. Nurses interested in becoming preceptors begin by submitting an application and obtaining approval from their direct supervisor. Once approved, they complete an online course and become eligible for financial incentives while serving as preceptors.
Kyra Macarthy, clinical education specialist at ChildServe, shares that the organization is expanding its educational offerings to support preceptor development at a broader organizational level. “We don’t need to develop our own content or find the time to hold classes,” adds Molly Vander Ley, clinical learning and development specialist at ChildServe. “We can focus on ongoing education and celebrating our preceptors.”
While training should include practical skills, programs should also focus on building attributes needed to be an effective preceptor. Courses can be used as stand-alone educational opportunities or incorporated into a blended learning approach. Many facilities require their preceptors to complete online training before bringing participants together for additional in-person education. This time is used to focus on facility-specific training and allow participants to practice skills with role play, case studies, or scenarios.
Regardless of the type of training used, preceptors need to be prepared for their role, especially in rural facilities. Given the potential financial impact on organizations, rural leaders need to be prepared to support new graduate nurses, despite the challenges that exist. With creative solutions, rural facilities can make a lasting impact on nurses and their patients.
NRHA adapted the above piece from Iowa Online Nurse Residency Program, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.
 | About the author: Jessica Ociepka, MSN, RN-BC, is a program coordinator with the University of Iowa College of Nursing Online Nurse Residency Program. Jess has precepted and mentored new graduate nurses in a large teaching hospital and, more recently, in a rural hospital. Jess continues to staff clinically in a rural facility and teaches the nurse-aide training program at a local community college. |
References
Bruscher, A., & Ociepka, J. (2025). Nursing professional development practitioners’ strategies to support preceptors in rural facilities. Journal for Nurses in Professional Development, 41(4). DOI:10.1097/NND.0000000000001156