The APPNs in the sample worked an average of 16—20 years as registered nurses, and more than a quarter of these nurses reported specializing in psychiatric mental health care for over 30 years. Ninety-five percent were female, and 81% were white. The mean±SD age of APPNs in the sample was 51.3±8.4 years. A total of 6,563 APPNs (75%) were employed full-time. Most were employed by hospitals (3,154 APPNs, or 36%), solo practitioners (1,554, or 18%), or home health agencies (1,092, or 13%). Other settings, in descending frequency, included group practice, ambulatory care, public health, office nurse, managed care, school of nursing, nursing home, nurse managed practice, school health, hospice, and occupational health. A total of 7,759 APPNs (89%) listed one place of employment, 1,377 (16%) listed two places, and 375 (4%) listed three places. Among those who were working in facilities, a majority worked in institutions with 101—500 beds. These nurses had varying titles, positions, and responsibilities, including 4,357 clinical specialists (50%), 1,209 nurse practitioners (14%), 968 consultants (11%), 391 nurse managers (9%), 749 staff nurses (9%), and 648 researcher-educators (7%). A total of 7,367 APPNs (80%) reported supervising other clinicians.
Broadly, 13% of all APPNs in the sample lived in rural areas, compared with 7% of all psychiatrists living in rural areas (10). The highest ratio of APPNs was found in Massachusetts (14.8 per 100,000 rural population), then Hawaii (11.7), Vermont (10.9), New Hampshire (8.7), Maine (8.5), Connecticut (6.4), and Maryland (5.0). Figure 1 shows a map of the ratio of rurally dwelling APPNs to 100,000 in the rural population by state. The New England area and Hawaii had the highest density of APPNs in rural populations. The northern states had the second highest density of APPNs in rural areas, and the southern states had the lowest density. The ratio of APPNs to 100,000 rural population ranged from .06 to 14.9. The mean ratio of APPNs per 100,000 rural population was 3.0±3.0 at the state level. The five states with the highest proportion of rurally dwelling APPNs were Vermont (77%), Wyoming (67%), Montana (65%), South Dakota (50%), and Arkansas (48%). When compared with total rural population by state, Vermont and Maine had the highest proportion of rural population (62% and 60%, respectively) and the highest ratio of APPNs to 100,000 in the rural population, 10.9 and 8.5, respectively. In 20 states, rural APPNs accounted for 20% or fewer of all APPNs practicing in those states.