Nursing Career Options in Rural Areas
Rural nursing, also known as “remote nursing” or “distance nursing,” is defined as a nursing specialty in which a nurse works and practices in an isolated or rural area. “Rural,” however, is not a location consistently defined by the Federal government, state governments or even the residents of a given area. As explained in a U.S. Department of Agriculture Economic Research article by John Cromartie and Shawn Bucholtz, “Defining the Rural in Rural America,” definitions of the term can be based not only upon population densities, but administrative, land-use, or economic concepts as well. Hence, the wide range of citizens considered residing in rural areas. “The share of the U.S. population considered rural ranges from 17 to 49 percent depending on the definition used.”
What Defines a Rural Nurse?
Making up less than five percent of nursing positions, a nurse can be considered a “rural nurse” under some of the following circumstances:
•Practices nursing in an area of low population density
•Practices nursing on a Native American Indian Reservation
•Practices nursing in a National or state park
•Practices as a community health nurse in a non-urban area
•Practices as a home health agency nurse in a non-urban area
Nursing Career Options for Registered Nurses in Rural Areas
There are several employment options available to nurses residing in rural or remote areas.
Most nurses who reside in rural areas find it necessary to commute to work in metropolitan areas due to the smaller number of available nursing positions close to home. This inconvenience is somewhat offset by the higher pay offered by urban hospitals. Changes in staffing schedules from eight-hour shifts to twelve-hour shifts have also decreased the inconvenience by eliminating a daily commute.
Private Home Health Agencies
According to the U.S. Bureau of Labor Statistics online Occupational Outlook Handbooks, five percent of the 2.7 million practicing registered nurses worked for public and private home health agencies in 2010. Nurses employed by private home health care agencies in rural areas often travel long distances out of necessity. The increased amount of required travel compared with the smaller number of patients who can be seen daily often requires salary adjustments, with higher pay per patient rates offered to nurses than those rates provided to agency nurses.
County Health Departments
County health departments are state agencies that monitor health issues and provide home health nursing to patients in areas unsupported by private home care agencies. Available openings are limited due to the attractive state benefits and satisfactory pay that often accompany employment.
Nursing Homes or Extended Care Facilities
In those rural areas capable of supporting a nursing home or other extended care facilities, area nurses may have the limited option of employment within these institutions. Registered nursing (RN) positions are usually few and consist of supervisory roles as most patient care can be provided by Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs).
Native American Reservations
Native American reservations may offer clinic or hospital employment, depending upon the tribe and resources.
A limited number of rural nursing positions are usually available at town jails and state or Federal prisons. These positions require additional training for staff safety and security and are often more stressful than other nursing specialties.
Elementary and secondary school nurse positions are available in rural counties, although in limited numbers. School nurses in rural areas often rotate throughout the schools at which they work on a daily basis as compared to an urban school nurse’s assignment to a single school.
Temporary rural nursing positions may be available at some summer camps and other recreational programs designed for children. The work is seasonal, and openings for employment are limited.
Primary Care Practice
Nurse practitioners with training as primary care providers (PCPs) and prescribing authority may be able to open clinics serving as PCPs to rural communities.
There are many options for nursing careers in rural areas, although actual openings may be limited and competition fierce to win a position. Prior experience in the field, advanced education and certifications may give applicants additional opportunities for employment.