Registered nurse workforce in primary care: Role clarity, competency gaps, and development needs from a statewide survey study

BACKGROUND: Registered nurses (RNs) are essential to primary care, yet their contributions within Community Health Centers (CHCs) remain poorly delineated. As care shifts toward ambulatory settings, demand for skilled RNs is increasing, but inconsistent role definitions and limited workforce data hinder planning. METHODS: This descriptive, exploratory study surveyed administrators, chief medical officers (CMOs), and RNs across Ohio CHCs to examine RN roles, competencies, and professional development. Surveys captured organizational characteristics, RN demographics, task engagement, learning needs, and interprofessional collaboration using the validated IPEC tool. RESULTS: Sixty participants from 14 CHCs completed the survey. RNs performed foundational tasks but had limited involvement in expanded roles. Learning priorities differed between administrators/CMOs and RNs. Early career nurses reported stronger collaboration values, while experienced nurses demonstrated greater collaborative action. Professional development support was common, yet participation remained modest. CONCLUSION: Findings reveal persistent role ambiguity and underutilization of RNs, underscoring the need for clearer roles, targeted development, and stronger interprofessional collaboration.