What is Rural Nursing? We have about 12 RNs that work in our facility, we are Critical Access, about 80 miles away from a larger facility. We are rural, (actually acording to the US census we are Frontier) our county is in the mountains and butts up against a reservation, we have many people in our county that have no running water or electricity.
We have some very wealthy people that have moved here to "live in the mountains" and many that live way below the poverty level, many migrant fame workers and many that just want to "live off the grid".
We are in a big hunting and recreation area so we get ATV wrecks, horse injuries, snowmobiles, motorcycles (ever seen what happens to someone that hits a deer with a Harley?), farm injuries, hypothermia, MVAs (ofcourse), and anything else you can think of.
We take care of all kinds of people, to include our family, friends, old high school teachers, the woman that our husband had an affair with, the person we know was convicted of child molestation, we deliver babies of women we know are drug abusers, we care for our collegues, neighbors (including giving them a ride home from the ER) and many people we don't know.
We are what are known as "Rural nurses" kind of a "Jack of all trades but a master of none." We have great relationships with our docs, RTs and other personell, including the EMTs that bring pts in....we have to.
We have 10 rooms (16 beds), 2 are ICU, 2 are OB, one is a negative pressure, and then we have a 4 bed ER. We have 2 RNs on all the time, and have a "call nurse" to be called in when needed (up to an hour away). We sometimes have the luxury of having another nurse to make 4, at the most, when we have a big trauma. We don't have a pharmacy per say, we get drugs from the pyxis and mix pretty much everything our selves, RT on call, x-ray in house, docs in house or 10 minutes away (we have lots of standing orders for things like chest pain, anaphalaxis, trauma).
In the last year (that I can think of) we had 2 rattlesnake bites, one that went into anaphalactic shock, (if giving Pitocin scares you look up all the possible complications with anti-venom!); a psychotic man that had a methadone overdose then proceded to have an MI (had to ride on the ambulance with him 75 miles to a higher level facility...fun!); 2 teenagers from an MVA that just walked into the ER, bleeding, glass everywhere, one ended up having an IC bleed; a family of 6 in a van that hit 3 horses at night; a 4 month old with respiratory distress that couldn't be shipped out for awhile and ended up having botulism (from honey); 2 teenagers that were hit by a drunk driver, 16 and 18, one came in CPR in progress, never left alive, the 16 year old shipped out, brain had herniated and his mom had to decide on organ donation, and the drunk driver was the son of one of our nurses; plus "boring" old med/surg pts.
I (and all the nurses here) do ER, M/S, ICU, peds, help in surgery, and 4 (we are training some of the others) do all aspects of OB (no high risk). We delivered a VBAC (no we don't do those on purpose) in our ER as she came in by ambulance, crowning, we had to stabilize and ship a woman with twins that was having ctx at 28 weeks and membranes ruptured at our ER entrance (we had no history on either of these women as they were not our pts), we had a beautiful baby boy born to a first time mom with no complications and our nurse realized he was a bit dusky at 12 hours, alerted the doc, did and ultrasound and discovered transposition of the great vessels (average time to diagnosis is 3 days, us...12 hours), but we don't do high risk???
I LOVE my job, I love the nights I work in ER and get that rush when we have an ambulance come in, and I love the team work when we have an MI or a cardiac arrest and we all work together and get the job done. I loved the night I was the only OB nurse on and I helped deliver 2 babies 3 hours apart, had to clean the room in between the 2, I also love the high I get when I am a 1:1 with an ICU pt on a nitro drip, insulin drip, and ART/CVP lines, and I enjoy taking care of the 86 year old lady in with weakness when I have time (not real often) to sit and listen to her how nursing was 60 years ago when she was one.
I have coworkers I KNOW I can count on. I also teach the childbirth classes. It is so nice to see a woman as a CB instructor, be her L&D nurse and then teach her to breastfeed as her MB nurse!
That is what is so great about rural nursing, its like a fortune cookie, you never know what you will get!