Navigating the woods: A nurse practitioner’s journey in rural healthcare, where challenges meet rewards
Melissa Mitchell, DNP ‘22 was working toward her DNP when she suffered the loss of a good friend. With the support of UW disability services, classmates, staff, and faculty she was able to persevere and graduate despite the challenges and grief. After graduation, she was unsure on what to do next. Diane Cashman, a clinical instructor, suggested she apply for fellowships. There were only two adult gerontology fellowships available in Washington state, leading her to the UW Premera Rural Nursing Health Initiative (RNHI) Fellowship.
“When I got the rural health nursing fellowship, I didn’t even know where Republic was!” laughed Mitchell. “But I found out quickly and it’s a great little town,” she added.
Melissa Mitchell in front of the Republic clinic.
Mitchell joined the primary care clinic during the first year Republic participated in the rural health fellowship. She faced the reality of rural healthcare, where specialists were scarce and resources limited. Yet, she found purpose in serving a population of farmers, miners, and loggers, navigating challenges like access to care and limited resources.
“Practicing in rural areas, you need to have knowledge in multiple specialties because unlike in a larger well-resourced area you can just tap the shoulder of a colleague for a consult, in Republic we frequently have to figure it out on our own,” Mitchell said.
“The specialist rotations and nursing didactic courses, you will use it all in this fellowship. You don’t have to spend a career acquiring knowledge, because you will learn it all in this fellowship,” Mitchell said. “Being in this fellowship and working with this population has taught me to work and do more with less resources, but the rewards are immense,” she added.
Winter sunset right outside the clinic door
Completing her fellowship, Melissa remains committed to her work in Republic, grateful for the collaborative team that supports her hybrid role. Balancing in-person and virtual patient care, she is grateful for the opportunity to extend herself daily, recognizing the vital role of nurse practitioners in providing primary care. She also encourages other new grads to take the rural fellowship path, serving as an ambassador at recruitment events and helping with recruitment for Republic’s next cohort of ARNP fellows.
This experience has taught her resilience, adaptability, and the immense rewards of serving rural communities, a journey she started thanks to encouragement of her clinical instructor and the opportunity from the UW School of Nursing’s Premera Rural Nursing Health Initiative (RNHI) fellowship.