Journal of professional nursing : official journal of the American Association of Colleges of Nursing · 2026
Why do nurses stay? Analysis of educational institutions and financial debt associated with the Nurse Corps program's high retention in rural and shortage areas.
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Kepley Hayden O, Hesgrove Brandon, Donelan Karen, Liu Helen, Kreiger Nina
Аннотация
BACKGROUND: To support nurse workforce needs of rural areas and health professions shortage areas, the Health Resources and Services Administration's (HRSA) Nurse Corps program offers loan repayment and scholarships in exchange for service commitments in these areas.
PURPOSE: This study explores key financial factors associated with retention of participants in rural and shortage areas, including whether participants attended public or private school. Total amounts of loans and student scholarships as well as school type were combined with known predictors of retention to determine any significant outcomes.
METHODS: Administrative and loan data from HRSA for all Nurse Corps applicants and participants were combined with data from a survey of recent program participants. Nurse Corps scholarship amounts and total loan balances of participants at the time of application were examined by participant attendance at either public or private schools. Associations with retention in rural and shortage areas were assessed using hierarchical logistic regression.
RESULTS: Participants' age and satisfaction with their Nurse Corps site were the strongest predictors of retention in rural or medically underserved areas after their commitment. Whether the participant attended public school was significantly positively associated with retention when not controlling for other predictors. However, the significant relationship did not remain when controlling for age and site satisfaction. At the time of application to the Nurse Corps program, loan repayment program participants had close to $140,000 of loans on average, and this was significantly larger for participants that attended private school.
CONCLUSION: Retention in rural and medically underserved areas was significantly associated with age and satisfaction with workplace. Attendance at public institutions served as a mediating variable. Given new federal limits on student loans, the public institution pathway and the Nurse Corps program become more valuable options for future nurses as graduates leave with smaller loan balances and are more likely to serve communities in critical need of additional nurses.
PURPOSE: This study explores key financial factors associated with retention of participants in rural and shortage areas, including whether participants attended public or private school. Total amounts of loans and student scholarships as well as school type were combined with known predictors of retention to determine any significant outcomes.
METHODS: Administrative and loan data from HRSA for all Nurse Corps applicants and participants were combined with data from a survey of recent program participants. Nurse Corps scholarship amounts and total loan balances of participants at the time of application were examined by participant attendance at either public or private schools. Associations with retention in rural and shortage areas were assessed using hierarchical logistic regression.
RESULTS: Participants' age and satisfaction with their Nurse Corps site were the strongest predictors of retention in rural or medically underserved areas after their commitment. Whether the participant attended public school was significantly positively associated with retention when not controlling for other predictors. However, the significant relationship did not remain when controlling for age and site satisfaction. At the time of application to the Nurse Corps program, loan repayment program participants had close to $140,000 of loans on average, and this was significantly larger for participants that attended private school.
CONCLUSION: Retention in rural and medically underserved areas was significantly associated with age and satisfaction with workplace. Attendance at public institutions served as a mediating variable. Given new federal limits on student loans, the public institution pathway and the Nurse Corps program become more valuable options for future nurses as graduates leave with smaller loan balances and are more likely to serve communities in critical need of additional nurses.