Rural Nurse: What are the Duties and Responsibilities?

traumaRUs, MSN, APRN

Nursing in rural areas pose special problems for nurses. The biggest issue of course is simply the distance to the referral hospital. It makes a huge difference when you have an acute myocardial infarction (AMI) come in to the ER and the nearest cath lab is an hour away by ground. Rural can mean different things to different people also. It is one thing to live 20 miles from a major city and quite another to live in the interior of Alaska where the nearest city with a hospital is more than 100 miles away and the only road is closed for six months of the year. Other issues for rural nurses include:

Professional isolation - distances from conferences, meetings all impact the continuing education of nurses in rural areas.

Transportation for patients may be difficult to find. This makes it very hard for patients to get to appointments and they may neglect their preventive health measures as a result.

Privacy issues - in small communities there is often an atmosphere of familiarity where nurses are well known in the community and much may be expected of them. Confidentiality must be maintained at all times.

Nursing students that live in rural areas might find it hard to secure employment upon graduation as most rural hospitals would want an experienced nurse.

Qualities

Resourcefulness is one of the most important qualities of the successful rural nurse. He or she must be able to think on their feet and realize that strong assessment skills are mandated in positions where there are few ancillary personnel.

At critical access hospitals (CACH) there might not even be a physician or other provider in the building 24/7. Critical access hospitals receive cost-based reimbursement. The CACH is a rural hospital that is kept open to provide healthcare to a rural area that otherwise would have no hospital.

Self-confidence and ability to be succinct with assessments and subsequent interactions with other providers is another important quality. When patients present to an ER, it is paramount for the nurse to be able to quickly assess the patient, contact the provider on call whether in person or by phone and also initiate protocols for care if in place.

Work Environment

Workplaces can be varied just as in the city. You can work in an office, a hospital or even a dialysis unit. The only difference is that it is usually on a smaller scale.

Duties and Responsibilities

The duties and responsibilities may be quite varied and various job duties might overlap. In a large urban facility there are usually individuals that handle individual job duties. However, in a rural facility, the nurse might also be the phlebotomist, transporter and EKG tech. It can bring new meaning to "other duties as assigned."

Resources

Rural Health Concern - this is an article from Medline from the National Institutes of Health

The American Hospital Association offers practical healthcare reforms tailored to rural communities.

Critical Access Hospitals - here is an article about CACH's from the American Hospital Association

Health Resources and Services Administration (HRSA) is an arm of the government that "entirely dedicated to producing policy-relevant research on health care and population health in rural areas."

Rural Nurse: What are the Duties and Responsibilities?

Qualities

Work Environment

Duties and Responsibilities

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