Rural Nursing: Practice and Issues

Angeline Bushy, PhD, RN, FAAN, PHCNS-BC



Of the total United States (U.S.) population, rural residents make up about one-fifth (20%) of the total population. Comparatively, this one-fifth of the [rural] population are dispersed across four-fifths (80%) of the U.S. land area. Further, there is great diversity within and among rural communities in the United States in their economic and socio-cultural characteristics as well as the health status of the people who live there. Hence, it is with utmost importance to stress that any discussion on rural take into consideration this diversity and avoid generalizations! Rural communities and the people who live there are not a homogeneous lot! As for demographic trends, while some rural regions are experiencing a declining population in recent years, there has been a broad economic revival and population growth in many small towns across the 50 states. In respect to delivery of health care services in rural areas there also is great diversity –some communities have a robust health care system while others have very limited services and providers. Of particular concern are regions defined as Health Personnel (Professional) Shortage Areas (HPSAs), characterized by an insufficient numbers of all types of health care providers which have been a national health care delivery priority for several decades. This independent continuing education module focuses on the opportunities and challenges of nursing practice in health care systems located in the more remote and sparsely populated geographical regions of the U.S.

Purpose/Goal: To provide an overview of nursing practice in rural settings.


1. Compare the following terms and their definitions: urban, suburban, rural, frontier, farm, non-farm residency, metropolitan, and non-metropolitan.
2. Interpret the notion of residency "continuum" ranging from farm residency to metropolitan.
3. Describe economic, social, and cultural factors that can impact rural lifestyle.
4. List factors that influence the health of rural residents and their care-seeking behaviors.
5. Discuss barriers that impact accessibility, affordability, availability, and acceptability of health care services.
6. Identify socio-dynamic features often associated with residency in a small and rural community.
7. Characterize health personnel shortage areas (HPSAs).
8. Compare and contrast the role and scope of nursing practice in rural settings compared to that which occurs in more populated settings.
9. Explain challenges, opportunities, and benefits of a health professional who lives and works in a rural setting.
10. Discuss potential legal and ethical considerations for professionals in rural practice.


Angeline Bushy, PhD, RN, FAAN, PHCNS-BC is the Bert Fish Endowed Chair at the University of Central Florida's School of Nursing Regional Campus in Daytona, Florida.

The planners and author of this CNE activity have disclosed no financial relationships with any commercial companies pertaining to this activity.

Contact Hours: 2.75

Expiration Date: 12/31/2013


Member Price: $0.00
Non-Member Price: $20.00

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