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Nurses Help Fill Healthcare Gaps in Rural Communities

June 2013

Due to a combination of economic factors, many rural communities in the United States face healthcare disparities and barriers to care, including shortages of health facilities, physicians, nurses and other medical professionals. In fact, individuals who live in rural areas often find it difficult to attain even the most basic necessary healthcare. In the past few decades, however, nurses have stepped up in their role as rural health providers, helping to treat chronic conditions and educate rural communities about disease prevention – all fundamental needs within a rural community.

“Many individuals in rural communities simply do not know how to gain access to healthcare. It's important for healthcare providers to understand what those challenges are and to work with the patient to develop plans to meet those challenges,” said Audrey Snyder, Ph.D., RN, assistant professor of nursing and researcher at the Rural Health Care Research Center at the University of Virginia in Charlottesville, Virg. “Nurses in particular can be a valuable resource in bridging that gap between rural patients and access to healthcare.”

According to the University of Washington Rural Health Research Center, the number of rural registered nurses (RNs) grew by 216 percent from 1980 to 2004, with nearly one quarter of the U.S. nurse workforce living and working in rural settings. Due to the ongoing shortage of physicians in many rural areas, hospitals in those communities are starting to depend more heavily on nurses to provide preventative and primary care. Because of that, rural nurses often require training across a broad range of areas, including family medicine and emergency and trauma care. Additionally, advanced education and specialized clinical training are recommended for nurses considering a career in the rural setting.

As part of the ongoing effort to help individuals in underserved communities gain greater access to healthcare, telemedicine has become an integral part of the rural healthcare setting. According to Snyder, as telemedicine becomes more popular in rural communities, it’s important for nurses to have a deep understanding of how telemedicine works and the process for using the technology for specialty consultation. For example, a rural nurse may be responsible for facilitating the telehealth equipment in order for the patient to interact with a specialist via two-way audio and video technology.

“Working in a rural setting requires a high level of adaptability and a broad spectrum of knowledge, as well as a deep understanding of the culture of the community. That knowledge can help better prepare nurses to properly educate and care for underserved communities,” said Snyder. “Additionally, proper education can help nurses educate and empower patients to help take care of themselves through self-care, treatment and maintenance.”

Rural Health Clinics, freestanding practices that are often staffed by registered nurse practitioners (NPs), play an important role in the delivery of health services to medically underserved areas in the U.S. In this setting, NPs are recognized as expert nurses, serving as regular healthcare providers for children and adults, and helping to minimize health disparities that exist among rural residents. Nurses in these clinics help provide access to primary and emergency services that may not otherwise exist for individuals in rural communities, making it easier for families to live and work in those areas.

Additionally, a nurse in the rural setting may work at a Critical Access Hospital (CAH), a remote facility that provides limited emergency, inpatient and outpatient services. In the CAH setting, nurses rotate on an emergency department call schedule and are responsible for helping stabilize patients as quickly as possible for discharge or transfer to a larger hospital when necessary.

“Nurses truly have a unique opportunity in underserved communities to not only provide better access to healthcare, but also improve overall patient outcomes for those individuals,” said Snyder. “Overall, working in a rural environment can be extremely rewarding – patients are always so grateful for the care that you provide to them and their community.”

For more information about rural nursing, visit

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