Rural Nursing — Could It Be for You?

Shannan Needleman and her daughter Taylor

Alumna Shannan Needleman and her daughter Taylor

When I graduated from The University of Texas School of Nursing, Austin was saturated with new graduate nurses. Finding the ideal job was next to impossible. Many nurses sacrificed their dream job temporarily in order to stay in a town they had grown to love. Others ventured into a new chapter of their life and relocated.

Few nurses I knew at the time considered a job in rural nursing. For some, the thought of not being in a teaching hospital or a large medical center with an expanded education department and support staff was out of the question.

Starting a solo career can be intimidating. However, what I learned when I started my career is that nurses who graduate from the UT Austin School of Nursing are knowledgeable and prepared. While it is understandable to lack confidence right out of school, you can take comfort in the fact that you have all the skills and education you need to be successful. With this in mind, I encourage new graduate nurses to look beyond the familiarities of Austin. The rural areas in Central Texas are growing and in need of expertly trained nurses. There are many advantages to living outside the city limits, yet still close enough to wander back to Austin.

For instance, Baylor Scott & White has just opened a state-of-the-art 46-bed medical center in the picturesque town of Marble Falls. Nestled in the Texas Hill Country, the town sits on the banks of Lake Marble Falls and Lake LBJ. It is conveniently located just 48 miles northwest of Austin, 75 miles north of San Antonio and 200 miles south of Dallas.

Primarily a vacation destination in the summers owing to the proximity of the beautiful Colorado River and lakes, the town empties as the weather cools. Residents then have the freedom to easily move about their city, ranchers tend to their cattle and crops and retirees golf. Marble Falls offers a relaxed, family-centered lifestyle with plenty of space.

Sound Appealing?

I decided to contact Betsy Patterson, chief nursing officer for the Baylor Scott & White – Hill Country Region, and ask her a few questions about rural nursing.

Shannan Needleman: Since your doors opened in August 2015, how has the hospital been performing?

Betsy Patterson: Our volumes have been significantly higher than projected, which, of course, is a great problem to have.

SN: What kind of nurse is your hospital looking for? What needs do you currently have? 

BP: We need peri-operative, OB, ICU, ED, and medical-surgical; so, we are hiring in those areas for the Marble Falls Medical Center. Currently, we have openings in all of our areas.

SN: What are some of the advantages for nurses when working in a rural hospital opposed to an inner-city hospital? 

BP: Nurses from some of our other rural facilities actually completed a study about this very topic a few years ago. Dr. Phyllis Tipton oversaw the project. The general response was that owing to the smaller size, staff experienced close-knit relationships with their colleagues as well as the reward of caring for members of the communities where the nurses lived. Smaller hospitals have more of a family atmosphere. The team mentality is also very strong in the smaller facilities.

SN: How does the hospital entice nurses to move to Marble Falls?

BP: We have had a strong interest from nurses in San Antonio, Austin and even Dallas. The Marble Falls area itself is close enough to Austin to reap the benefits of the city, but out enough to enjoy less of the density that cities bring. There are living options from acreage, to small town, to waterfront to Bee Cave/Lakeway area, which is very much an extension of Austin. In fact, quite a few of our staff members live in that area.

SN: Is there plenty of housing in the area, both homes and apartments?

BP: Apartments and rental properties are limited, but there are housing complexes in the Bee Cave area. We also have nurses who live in west Georgetown, Cedar Park and Leander. Some staff commute from the Round Rock and Pflugerville areas as well. Apartments and new home subdivisions are currently being built in Marble Falls.

SN: What attracts nurses to the area?

BP: Many people enjoy the constant lake levels and beautiful topography. The town of Marble Falls itself is a nice size. Nearby Horseshoe Bay Resort is also an attraction. There are multiple events year round that attract many tourists and several wineries and breweries in the region.

SN: Would an RN be asked to serve on the floor prior to a management position?

BP: We would not place a new nurse in a management position without clinical experience.

SN: Are you actively seeking registered nurses, clinical nurse specialists, nurses with MSN or PhD degrees, or nurse practitioners to fill certain roles?

BP: Our goal is for all managers and above to have master’s of science in nursing degrees. We do not currently have any manager or director openings, but we always keep succession planning in mind. We encourage internal promotion, so we would welcome nurses with advanced degrees. Our nurse practitioners are often recruited for our clinics.

SN: How can a graduate nurse from UT Austin School of Nursing add to your nursing staff?

BP: Being a new hospital, we must establish infrastructure to support new grads. Our professional nursing practice model is “Safe Passage.” That means not only safe passage through the health care continuum for patients, but also for nurses. We want nurses to have the resources they need to be successful in their careers. We hope to be ready for the May 2016 graduating class.

SN: Is there anything special that you as chief nursing officer can offer nurses?

BP: One exciting thing about Marble Falls Medical Center is that it is a brand new hospital. Nurses can get in on the ground floor and move upward. We anticipate much growth and expansion of both services and volumes. We have the opportunity to build the culture that we want.


Marble Falls offers exciting new opportunities for any nurse. Are you looking for a great area to raise a family and maintain a nursing career? Do you desire a change from your current position? Are you a student nurse who will graduate in the near future? Think outside of the box and explore some opportunities outside of Austin. Below are some hospitals to consider:

  • Rollins Brook Community Hospital, Lampasas
  • Seton Smithville Regional Hospital
  • Christus Santa Rosa Hospital, New Braunfels
  • Baylor-Scott & White Medical Center, Marble Falls

And if you are currently working in a rural hospital, please share some of the benefits you have found with our readers in the comments section below.

—Shannan Needleman, alumna (BSN 1994)

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