Are Rural or Urban Settings Best for Nurse Practitioner Jobs?

As a nurse practitioner, job opportunities are plentiful in all 50 states. Nurse practitioners have a lot of obvious choices to make — such as which practice setting to choose, which patient population they want to work with, and what career path they want to follow.  

Another important choice is often overlooked, however. As a nurse practitioner, do you want to practice in a rural or urban area? For some nurse practitioners, this choice is very simple. Some already know they want to practice in a rural clinic —possibly, right in their own hometown. Other nurse practitioners couldn’t imagine working anywhere but a large, urban medical center. For many nurses, though, the choice on rural vs. urban location is less clear cut.  

When considering nurse practitioner jobs, choosing between rural and urban environments is a crucial decision. There are definite pros and cons to both settings. And whichever you choose will significantly impact your career and personal satisfaction. Let’s determine whether a rural or urban setting aligns best with your professional goals and lifestyle. 

Advantages of rural settings 

• Greater autonomy and scope of practice: In rural settings, nurse practitioners often enjoy greater autonomy due to the scarcity of healthcare providers. This allows nurse practitioners to utilize their full scope of practice. Nurse practitioners in rural settings are likely to make critical decisions independently and manage a wide range of health issues. For example, some rural nurse practitioners act as primary care providers, handling everything from acute illnesses to preventive care and chronic disease management. Over the 355,000 licensed nurse practitioners in the U.S who are clinically practicing, over 70% deliver primary care, according to the American Association of Nurse Practitioners.  
• Strong community relationships: Nurse practitioner jobs in rural areas entail serving a close-knit community. These professionals can build strong, lasting relationships with patients and their families. For patients, it can lead to better health outcomes. For practitioners, it means becoming an integral part of the community. That allows them to understand and address local health challenges more effectively. For example, nurse practitioners can implement public health initiatives (such as health education and outreach) tailored to the community’s specific needs.  
• Professional fulfilment: Providing essential healthcare services in underserved areas can be highly rewarding. For this reason, nurse practitioner jobs in rural settings often provide a strong sense of purpose and fulfilment. They don’t have to wonder if they’re making a difference in their communities. It’s readily apparent in their day-to-day practice.  

Challenges of rural settings 

• Limited resources: Nurse practitioners in rural settings often have limited access to advanced medical technologies, fewer medical facilities, and shortages of some specialists. Due to limited access to diagnostic tools and equipment or specialized care, nurse practitioners may need to refer or transfer patients to distant facilities. 
• Professional isolation: Nurse practitioner jobs in rural areas sometimes present fewer opportunities for networking with other healthcare professionals. Fewer chances to interact with peers and specialists can limit professional growth and learning.  
• Workload and burnout: In rural settings, nurse practitioner jobs may entail longer hours and heavier workloads. Managing high patient volumes with limited support staff, increased on-call responsibilities, and after-hours care can potentially lead to burnout. 

Advantages of urban settings 

• Access to advanced medical technology: Urban healthcare settings are typically equipped with the latest medical technologies. It’s not uncommon for institutions to conduct research studies and offer more advanced treatment options. This enables nurse practitioners to provide their patients with evidence-based, high-quality care.  
• Diverse population: Nurse practitioner jobs in urban areas allow for experience with a wide range of health conditions, racial/ethnic diversity, and cultural and demographic backgrounds. This allows nurse practitioners to develop cultural competence, and the ability to tailor care strategies for different communities.  
• Professional development opportunities: In urban areas, nurse practitioners have more access to academic medical centers and teaching hospitals. Urban settings typically offer abundant continuing education, professional development, and networking opportunities.  

Challenges of urban settings 

• High patient volume and faced-paced environments: Nurse practitioner jobs in urban areas can be very demanding, with rapid turnover of patients. Time constraints and pressure to see a high number of patients each day can lead to stress and burnout. 
• Administrative burdens. Urban nurse practitioner jobs are often in large healthcare institutions with complex bureaucratic structures. Nurse practitioners in urban settings often must navigate extensive paperwork, documentation to ensure regulatory compliance, and time-consuming insurance-related tasks (such as obtaining prior authorizations).  
• Risk of an unhealthy work-life balance. In urban areas, nurse practitioner jobs may entail long commutes, resulting in limited personal time. Due to the high cost of living, nurse practitioners may feel the need to work additional shifts or extended work hours. 

Considerations when searching for nurse practitioner jobs in each setting  

Do you desire greater autonomy and a close-knit community? Do you aspire to work in primary care or community health? If so, you may want to consider nurse practitioner jobs in rural settings.  

On the other hand, do you view access to advanced technologies as essential for your patients? Do you yearn for networking opportunities and specialized, advanced practice roles? Those are clear indications that urban nurse practitioner jobs may be the best fit for you.  

It’s also important to think about your lifestyle preferences and your family’s needs. Rural nurse jobs typically offer a quieter, more relaxed lifestyle, outdoor activities and a slower pace of life. In contrast, urban nurse practitioner jobs allow access to cultural amenities and more options for dining, theatre, sports, and concerts.  

You’ll also need to take practical aspects of nurse practitioner jobs into account. Compensation is going to be higher in urban areas. However, cost of living is lower in rural areas — and loan repayment incentives are a possibility if you meet the criteria.  

Your choice of rural versus urban settings is a significant decision during your job search. It’s also a highly personal one. Your professional goals, lifestyle preferences, and financial considerations all come into play. You’ll need to carefully weigh the challenges and advantages of each setting. Whether you ultimately decide on a rural or urban setting, a well-informed decision will lead to a fulfilling and rewarding nurse practitioner role.