Healthcare Challenges in Rural and Remote Areas: A Nursing Report

This report addresses the unique challenges faced by nurses providing healthcare in rural and remote areas, using a case study of a 15-year-old adolescent, Madeleine, in a disaster-stricken rural town. The report discusses the implications of these challenges, including limited access to healthcare facilities, financial constraints, and difficulties in communication and transportation. It emphasizes the importance of community health services and the role of nurses in providing quality care, including contraceptive education and addressing the long-term side effects of contraceptives. The report suggests interventions such as telehealth, the involvement of non-physician providers, and increased funding to improve healthcare access and outcomes for rural populations. The report also highlights the importance of considering the patients' financial situations and beliefs to ensure that they receive the best possible care. The report also offers recommendations for rural healthcare services such as nurse-led visits, implementing telehealth, and increasing the number of healthcare professionals in the community. The report concludes by emphasizing the critical role of nurses in bridging the gap in healthcare access and ensuring that remote and rural communities receive timely and appropriate care.

Running head: HEALTHCARE
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Title: Health Care Challenges in Remote and Rural Areas

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Working in rural and remote areas is considered a specialty by itself as the nurses
must have certain skills to help them offer quality services to individuals with austere
context. The nurse should be prepared to deal with the sparse population, long distances
between clients, few resources and also the preferences of the residents which are in most
cases based on their informal social settings. Other challenges like poor transport and long
distances may need a rural based health care provider to help in the patient care unlike in
urban areas where people have greater access to health care facilities. Roden, Jarvis,
Campell-Crofts and Whitehead (2016) claim that community nurses are a core part in health
care workforce in the country considering the diversity in the rural areas. According to
Paliadelis, Parmenter, Parker, Giles and Higgins (2012) rural health care officers require are
broader range of skills for them to offer services effectively.
From the context, it is important the nurse discusses with Maseleine the effects of
unprotected sex. It is also important for her to know the effects that could come along with
contraceptives. Most contraceptive pills have a failure rate of about 0.3 percent but within the
first year of use the failure rate is more than 9 percent due to non-compliance. However they
help in treatment of some disorders like abnormal uterine bleeding and dysmenorrhea. When
these contraceptive pills are used effectively, without missing a dose, anyone who
experiences 3 or more days of heavy bleeding must contact a health care professional. For
those taking the pills for the first time, they may experience nausea which fades away after
some time. Contraceptive pills leads to enlargement and tenderness of breasts (Pazol, Zapata,
Tregear, Mautonr-Smith and Gavin, 2015). To relieve the tenderness one can take salt,
caffeine or wear a supportive bra. In case the tenderness, or breast pain persists seeking
medical advice is important.

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Due to hormonal changes bough about by the birth control pills, one may experience
headaches and migraine. One can use low dose pills to reduce these conditions. There is no
any proven theory linking the use of contraceptive pills with weight gain, though the hips and
the breasts experience fluid retention (Mosher and Jones, 2010). Some studies claim that
there is a weight gain of between 4.4 pounds within 12 months of using the pills. Some
studies claim that contraceptives alter the user’s moods and might lead to fluctuation of
emotions such as depression. Sometimes whenever taking the pills, periods are missed. This
is attributed to stress, thyroid and hormonal abnormalities. When missed or the periods are
light, one is advised to undertake a pregnancy test before commencing the next pack. Other
effects could include decreased libido and vaginal discharge (Gold, Sonfield, Richards and
Frosts, 2009). If the nurse is to administer these pills, a pregnancy test has to be carried out
first as it is not recommended when an individual is pregnant. Madeleine should also be made
aware of the long term side effects of using contraceptives. These pills increase chances of
cardiovascular infections and cancer. However, the nurse should advice Madeleine that using
condoms is the best option for her to control pregnancy.
Rural and remote area residents are limited in their access to health care services. For
residents to access sufficient services, there is need for availing appropriate and necessary
health care services which could be obtained timely (Lao, Zhang and Bai, 2013). Other than
the adequate health care services in a given locality, there are other factor that need to be
addressed too. These could include financial factors, means of accessing the health care
services, confidence of the residents to communicate their needs, their trust and belief of
attaining quality care. From the context, the key responsibility of the nurse is to ensure that
Madeleine attains quality health care services regardless of what she is going through. It
seems that these families are not well up and also accessibility of the nearest health care
facility is a problem. It is 80 km away. Since Madeleine cannot make it to the health care

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facility and also considering that she is a student, the nurse should make herself available so
as to provide the care needed by this client. This could including bringing non-physician
providers on board to help the nurse maximise her services (Young and Chatwood, 2011).
Coming with nurse assistants would help increase the number of appointments per time. The
nurse should also schedule visits with Madeleine. Here the nurse would perform any required
tests and give the prescriptions for the time until the next scheduled visit.
All rural areas are faced by almost the same problems, even for those nations with
majority of their populations is concentrated in the rural areas. Most of the health care
facilities are found in the cities. Unlike in the urban areas where there are ambulances and
emergency services, the rural areas lack this and tend to focus much on their security and
forget their health needs. In most cases, the rural and remote areas are inaccessible due to the
local topography and complicated climatic conditions. Quality communication means in these
remote and rural areas could also be varied. Regardless of all these challenges, it does not
mean these people should be left with their health needs unattended (Finer and Zolna, 2011).
These areas are limited in funding and the local nurse should involve the relevant authorities
so that more funds are allocated for this locality. This would help avail resources to the
community. These funds could be used to build a hospital in this locality as the only available
on is 80 kilometres away. In relation to this, there is need for more health care professionals
in the community. Increasing the number of health care practitioners in the society would
help in delivering a better health care and consistent to the needs of the society (Singh,
Mathiassen, Stachura and Astapova, 2010). They can also incorporate no physician clinicians
to help is delivering these services, though this could not be enough in delivering quality
health care. The nurse in charge should approach the relevant authorities to implement this.
Telehealth is a technology that bridges the patient and the nurse regardless of the
distance between them (Alkmim et al. 2012). Using telehealth in delivery of health care

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services in rural areas reduces the challenges such as poor transport, cost of health care
services, lack of time and other challenges individuals in these areas encounter. Research
indicates that telehealth provides convenient health care options by reducing transport and
time costs. This technology enables doctors to connect patients and deliver quality health care
even to patients with complex health needs. The telehealth care can also expand their services
to schools so that children like Madeleine can access health care services with ease.
According to Goodridge and Marciniuk (2016) telehealth am mHealth are the ways to solve
poor quality of health care in rural and remote areas. Telehealth helps local hospitals in
remote consultations, providing information on diagnostic analysis and home health care
monitoring.

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