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Importance of Nursing in Rural Communities

The rural nurse plays an essential role in providing healthcare for citizens of small and isolated communities across the U.S. In fact, it is estimated that at least half the healthcare providers in rural areas are registered nurses. They may be the first and only point of contact for rural healthcare consumers. As demand for healthcare professionals in general is expected to rise, the need for rural nurses will also rise, and graduates of RN to BSN programs may find more opportunities than ever before.

Rural Healthcare Has Unique Challenges

Even now, almost two decades into the 21st century, about a quarter of the U.S. population — almost 60 million people — still lives in rural areas.  Those who dedicate themselves to rural nursing face significant challenges.

Rural populations tend to be poorer than those in urban areas — more than 30 percent of all food stamp recipients live in rural areas. Many citizens lack health insurance because their jobs do not provide coverage. Healthcare is often covered by programs such as Medicaid (for low-income individuals) and Medicare (for the elderly). Residents of underpopulated areas travel farther to get care and may even have difficulty finding transportation to clinics or hospitals.

Statistics show that living in a rural area carries significant risks. The risk of dying from injuries and automobile accidents is higher in underpopulated areas. Country living appears to present considerable stresses, with high blood pressure and stroke more common in rural than urban areas. More young people in rural areas abuse alcohol and start smoking earlier than urban youth.

Mental health services in rural areas may be limited or even non-existent even though the suicide rate among rural men and children is much higher than in urban areas. And the suicide rate among women is increasing.

How Rural Nurses Help

Given the lack of access to specialists, the rural nurse is essential, treating patients with diverse and sometimes complicated conditions. Rural nurses are generalists, providing any care needed, such as dispensing medicine and preparing patients with acute health problems or injuries for transfer to larger facilities. They therefore develop multiple proficiencies, even though their remote location may make training difficult to acquire.

Because many rural nurses have spent their entire lives in the same community, they possess a deep understanding of individual patients and the social environment of the community. For patients, this connectedness fosters trust.

Deep knowledge of local norms includes understanding how best to approach patients to give the best treatment. For example, patients may not appreciate being asked directly about a condition or injury. And knowing regional dialects and speech patterns may not only make it easier to understand patients and their concerns, but also solidify trust in care providers and their treatment plans.

Rural nurses tend to believe that quality care pertains to the whole patient, not just the patient’s condition. Caring for the patient includes making the family feel welcome and heard. Rural nurses may believe that large facilities offer specialized care, but not necessarily better care.

Long-established local health facilities may also be a source of pride for communities. Because hospital and facility staff may see each other frequently outside of work — at church or at school functions — they may see the hospital as a family of sorts.

Planning for the Future

In addition to providing medical and mental healthcare, the rural nurse may play a role in drawing attention to needed healthcare infrastructure in a community. Because most rural nurses grew up where they work and cannot leave to receive advanced schooling, the classroom must come to them.

The Regionally Increasing Baccalaureate Nurses program in North Carolina aims to provide funding and assist with access. In addition, rural nursing students may be the first in their family to receive higher education, or they may not have been encouraged to consider post-secondary training when they were in high school. This program gives nursing students the confidence they need to succeed in advanced and specialized training.

Another avenue that enables improved care in remote areas is telemedicine. Leveraging the power of the internet, telemedicine allows nurses in a different location to provide counseling and examinations in a local clinic or in a patient’s home. For example, nurses can monitor blood sugar and blood pressure, and specialists can examine and support intensive-care patients.

Indeed, for chronic and critical care, telehealth may give small hospitals and clinics the specialist support they need. Telemedicine also saves time in work or school days lost and transportation costs for trips to a distant hospital.

Health improves when patients have easy access to care. However, more than twice as many rural areas experience healthcare staffing shortages as urban areas. Training through RN to BSN programs will make it easier for the rural nurse to upgrade skills and continue providing excellent community-based care.

Learn more about the UNCW online RN to BSN program.


Journal of Advanced Nursing: What Does Quality Care Mean to Nurses in Rural Hospitals

RWJF: Rural Nursing Facing Unique Workforce Challenges

Modern Healthcare: Wiring in Rural Patients

National Rural Health Association: About Rural Health Care

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