From ER to Picket Line: How Rural Health Care Providers Are Rallying for Change

Bria Schurke, who grew up in Ely, has a unique story. In her small town, healthcare often comes from certified nurse practitioners (CNPs) instead of doctors. This is a common scenario in rural areas where it’s tough to attract physicians, and clinics often face tight budgets. Inspired by the care she received, Schurke decided to enter medicine herself.

Now, she’s a physician associate (PA) at Essentia Virginia Hospital, working in the emergency room. The challenges of rural healthcare weigh heavily on her.

“We are the forgotten part of this country,” Schurke says. “In the ER, I see the struggles people face daily. Many live in poverty. We need people who genuinely want to make a difference in lives—not just collect a paycheck. That’s the mission of PAs and CNPs.”

In the past year, Schurke and her colleagues have taken significant steps to improve their working conditions. They voted to unionize with the Minnesota Nurses Association (MNA). However, Essentia has not moved forward with negotiations for a collective bargaining agreement. They are currently appealing to the National Labor Relations Board, citing concerns that a strike could disrupt healthcare across the entire region.

The role of PAs and CNPs is vital in areas like Ely. A 2022 study by the National Rural Health Association shows that about 60% of rural communities rely on these practitioners for primary care. Their presence helps fill gaps that often arise due to a lack of physicians.

As healthcare needs grow, particularly in underserved areas, the demand for PAs and CNPs is rising. Experts emphasize that these practitioners play crucial roles in improving patient outcomes and making healthcare accessible.

With ongoing changes in healthcare policies, the visibility and importance of roles like Schurke’s will continue to increase, shedding light on the realities of rural health systems.



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