Rural and Remote Nursing: Advantages, Challenges and Support for RNs

This essay delves into the multifaceted world of rural nursing, meticulously examining the advantages, challenges, and support systems that shape the experiences of registered nurses in these unique healthcare environments. The essay begins by highlighting the educational opportunities available to rural nurses, particularly in chronic disease and palliative care management, emphasizing the development of culturally sensitive approaches and interdisciplinary communication. It then addresses the significant challenges, including limited resources, self-care difficulties, and health care disparities, while also showcasing the benefits of reduced traumatic stress, increased autonomy, and enhanced care coordination. The essay further explores the role of the rural and remote nurse, emphasizing the need for transformational leadership, continued education, and the integration of technology and humanistic approaches to improve patient care. The essay concludes by underscoring the importance of addressing educational needs, providing resources, and fostering a supportive environment to ensure the sustainability and professional growth of registered nurses in rural settings, ultimately benefiting both the healthcare providers and the communities they serve.

Part – A
Educational Opportunities
Advantages for the Registered Nurse Working in the Rural and Remote Setting
Advantage-1 (Chronic Disease Management)
The deployment of registered nurses in rural and remote health care settings provides several
opportunities for learning and self-enhancement. The nursing care knowledge attained at
remote and rural settings proves to be an effective tool to educate prospective nursing care
teams in the context of improving their patient care potential (NMBA, 2018). The initial
educational advantage attained by the registered nurses across the rural and remote health
care settings relates to the community-based chronic disease management (CRANA_Plus,
2019). The registered nurses in the rural health care settings attain the educational
opportunity to investigate the individualized health care challenges and treatment
requirements of the chronically ill patients through face-to-face interaction (Kim, Cho, &
Yoon, 2015). The registered nurses acquire several opportunities to integrate culturally
sensitive health care approaches to the conventional pharmacotherapeutic interventions to
effectively improve overall patient care experience in the rural medical facilities (Nahar,
Kannun, Mikkilineni, Murthy, & Phillimore, 2017). The registered nurses in the remote/rural
treatment settings enhance their expertise and knowledge in the context of implementing
chronic care model despite several limitations in rural health care resources. They gain
experience and knowledge of using interdisciplinary communication strategies to effectively
improve self-management adherence of the chronically ill patients (Davisson & Swanson,
2018).
Advantage – 2 (Palliative Care Management)
The registered nurses in rural health care settings attain educational opportunities to
investigate barriers and facilitators of palliative care management for terminally ill patients.
The registered nurses also gain knowledge of the factors that substantially influence health-
related behavior and quality of life of the terminally ill patients across the rural locations.
They get several educational opportunities to investigate the experiences and preferences of
the terminally ill patients in the context of administering value-based, problem-focused, and
person-centered palliative care interventions across the rural locations (Rainsford, MacLeod,
& Glasgow, 2016). The registered nurses also gain insight into the rural hospice care

requirements and patient characteristics across rural settings. The systematic assessment of
health care equity, medical facilities, socioeconomic resources, family support, cultural
dissimilarities, and health perceptions of the terminally ill patients inside the remote settings
improves nurses’ knowledge of shared decision-making inside the rural health care facilities.
Accordingly, the registered nurses improve their knowledge for expanding the scope of
informed health care choices and emotional support for the terminally ill patients in rural
settings (Baernholdt, Campbell, Hinton, Yan, & Lewis, 2015).
Challenges for the Registered Nurse Working in the Rural and Remote Setting
Challenge – 1 (Limited Health Care Resources)
The greatest educational challenge experienced by registered nurses at rural locations is based
on the categoric assessment of numerous clinical presentations under the absence of expert
supervision (Moran et al., 2014). Limited health care resources, clinicians, educationists, and
physicians in rural health care settings substantially barricades the access of nurses to health
care pathways and communication systems. Eventually, the registered nurses encounter
educational and professional deprivation that adversely impacts their knowledge
enhancement process across rural clinical settings.
Challenge – 2 (Self-Care Challenge)
The extended working hours, organizational pressure, floating shifts, and increased patient
care load drastically impact the self-care capacity of the registered nurses in rural medical
facilities (Lea & Cruickshank, 2015). These factors not only barricade the career
development process of nurses but also impact their clinical skills and educational
improvement in rural health care settings. Furthermore, social isolation, emotional
challenges, and poor quality of work life are some of the significant factors that reportedly
barricade registered nurses’ knowledge acquisition process in the rural treatment facilities
(Bragard, et al., 2015).
Support in the Workplace
Advantages for the Registered Nurse Working in the Rural and Remote Setting
Advantage-1 (Reduced Traumatic Stress)
The registered nurses inside the rural/remote Australian health care settings experience a
comparatively reduced level of traumatic stress than urban nurses (Hegney, Eeley, Osseiran-

Moisson, & Francis, 2015). The reduction in traumatic stress in rural registered nurses is a
direct outcome of their strong interpersonal relations and peer support systems rather than
extended shift hours. This eventually reduces their risk of burnout, depression, and anxiety
during the working hours. Eventually, registered nurses in rural settings more actively deal
with medical emergencies and provide better trauma care support to rural patients. Indeed,
enhancement of medical emergency care or trauma support system in a rural setting is
conducive to a substantial reduction in posttraumatic stress disorder prevalence among
patients affected with potentially traumatic episodes (Handley, et al., 2015). Evidence-based
literature emphasizes a reciprocal relationship between workplace environment, work-related
quality of life, and psychosocial well-being of the registered nurses (Nowrouzi et al., 2016).
Accordingly, a less stressful work environment substantially enhances the mental health
outcomes of the registered nurses that facilitates the utilization of more responsive patient
care approaches in rural health care settings.
Advantage-2 (Autonomy and Care Coordination)
The registered nurses across the rural Australian health care settings experience greater
autonomy and decision-making capacity in the context of providing holistic and person-
centered treatment to the target population (AGDOH, 2018). Their increased care
coordination with patients and other health care professionals substantially optimizes patient
management and consultation processes across the clinical practice environment. The
improved care coordination across the remote rural medical facilities not only reduces the
undesired work duplication but also facilitates the provision of cost-effective treatment for
underprivileged patients. The autonomous and collaborative nursing practice in the rural
health care settings substantially elevates the clinical skills, expertise, and confidence of
registered nurses in the context of resolving a range of complex clinical scenarios (Smith,
McNeil, Mitchell, Boyle, & Ries, 2019).
Challenges for the Registered Nurse Working in the Rural and Remote Setting
Challenge – 1 (Health Care Disparities)
Despite several advancements in the rural nursing practice, serious disparities in the provision
of cardiac care and palliative care services in the rural settings barricades the integrated
functioning of the interdisciplinary health care network in the rural health care settings
(Fernando, Percy, Davidson, & Allan, 2014). Furthermore, ineffective integration of cardiac
care and palliative care interventions constraints the accomplishment of the primary treatment

demands of the chronically ill rural patients. The absence of expensive telemonitoring
technology in the rural health care settings barricades the coordination of registered nurses
with other clinicians and treatment experts of the urban/technologically equipped health care
settings (Thomas, DiClemente, & Snein, 2013). The reduction in health care equity in the
absence of robust and supportive health care policies inside the remote medical facilities
substantially barricades care continuity while reducing the scope for sustainable health
promotion. These restrictions/barriers also prove to be the outcomes of an ineffective nursing
leadership inside the rural medical facilities.
Challenge – 2 (Multiple Responsibilities)
Sustained health care staff shortages in rural hospitals elevate the patient care responsibilities
of nurses to a considerable extent (Smith, Sim, & Halcomb, 2019). The registered nurses in
Australian rural health care settings accordingly utilize primary health care approaches
through the lens of social health determinants while ignoring the economic disadvantage of
the socially stratified and impoverished rural communities (Roden, Jarvis, Campbell-Crofts,
& Whitehead, 2015). The absence of the appropriate number of clinical specialists in rural
health care settings barricades the process of patients’ referral to secondary or tertiary care.
Furthermore, non-compliance with the referral process based on socioeconomic factors in
rural hospitals drastically reduces the quality of the entire rural health care system (V-Dijk, et
al., 2016). These restrictions drastically impact the overall health of the rural communities
and elevate their morbidity and mortality rates as compared to the mainstream urban
population. Furthermore, the elevated interdisciplinary responsibilities of nurses due to lack
of expert clinical support/error reporting mechanism, health care system politics, and
patients’ cultural differences also elevate the risk of treatment inadequacies, therapeutic
errors, and resultant safety episodes across the rural clinical practice environment (Khalil &
Lee, 2018).
Part – B (Role of the Rural and Remote Nurse)
What?
Registered nurses across the rural and remote Australian locations acquire several
opportunities for self-learning and professional development. However, numerous challenges
across the remote clinical settings threaten their sustainability and care continuum across the
clinical practice environment. These facts substantiate the need for identifying the personal

learning/educational needs of the registered nurses in the context of their deployment inside
the remote and rural health care settings.
So What?
The time constraints across the rural clinical settings in many situations force the registered
nurses for administering group therapy to underprivileged patients. This eventually, gives
them a limited scope of catering to the individualized requirements of the patient population.
These outcomes substantiate the requirement of training sessions for registered nurses in the
context of enhancing their skills, experience, knowledge, and proficiency for delivering
person-centered and holistic care to the rural patients (Roden, Jarvis, Campbell-Crofts, &
Whitehead, 2016). Furthermore, the mitigation of stereotypical attitudes of registered nurses
regarding rural clinical practice environment is highly warranted to increase their deployment
inside the rural hospital settings (Bragg & Bonner, 2015).
The registered nurses need to improve their skills and knowledge in the context of identifying
the emergency care needs of the rural patients while stabilizing their clinical conditions and
transferring them to the subsequent care level (Wolf & Delao, 2013). The clinical experts and
health care specialists must cater to these personal learning requirements of the registered
nurses prior to their deployment in rural clinical settings. The registered nurses must learn to
effectively deal with a high degree of complex and variable clinical situations across remote
health care settings (Hounsgaard, Jensen, Wilche, & Dolmer, 2013). They must also learn to
integrate information technology with humanistic approaches, social work strategies,
preventive care methods, and acute medical care interventions in rural hospital settings.
The registered nurses require enhancing their leadership and managerial skills through
capacity building and greater training interventions in the context of improving the quality of
health care services for the rural patients (Terry, Le, Nguyen, & Hoang, 2015). The registered
nurses also need to update their language and communication skills in the context of
providing culturally sensitive interventions to the underprivileged rural tribal masses. The
enhancement of registered nurses’ knowledge and skills regarding video conferencing
psychotherapy is highly needed to effectively improve treatment adherence and accessibility
for rural patients (Simpson & Reid, 2014). The registered nurses also need to improve their
therapeutic communication skills in the context of improving the patient care experience and
satisfaction level across the clinical settings (Thornton et al., 2017).

Now What?
I understand the need for developing transformational leadership strategies in the context of
accomplishing the educational requirements of registered nurses inside rural health care
settings. The development of continued education sessions and award programs under expert
supervision are highly warranted to consistently improve patient management outcomes
across the rural clinical practice environment. The rural hospital administration must provide
the appropriate health care resources and socioeconomic privileges to the rural nurses in the
context of motivating them for administering equitable treatment interventions to the
impoverished and socially stigmatized patients. Most importantly, the nurse leaders should
utilize collaborative models to effectively improve the counseling, teaching, pharmacology,
health education, and legal skills of the fellow registered nurses across the rural clinical
practice environment. I believe that the educational programs and training sessions for the
registered nurses must be administered in a manner to enhance their professional/personal
growth, self-esteem, and self-practice characteristics in the rural health care facilities. This
will not only improve their sustainability in the rural locations but also expand therapeutic
advantage for the treated patients to an unprecedented level.

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