Page 489 - Encyclopedia of Nursing Research

456 n RURAl HEAlTH

The problems and disadvantages that Knowledge generation and acquisi-
rural areas experience may contribute to the tion are needed for rural nursing practice.
R often strong sense of a unique rural culture Although the knowledge base is growing,
and community connectedness among rural there continues to be a limited number of
residents. The value and beliefs in a rural cul- data-based articles in the rural nursing liter-
ture play key roles in how rural people define ature. Continuing shortfalls in the literature
health and from whom they seek advice, include small sample sizes, lack of random
treatment, and care. The culture combined sampling, cross-sectional designs, problems
with realities of rural living, such as weather, with operationalization and measurement
distance, and isolation, affects the practice of of rurality, and small specific populations.
nursing in rural areas. Knowledge of the rural Studies lack clear descriptions of comparison
culture is a basic requirement if a nurse wants groups and often fail to adequately account
to work effectively in a rural community, for key variables (Merwin, 2008).
but also a strong influence on the individu- Positive signs of the growth of rural
al’s health (Baernholdt, Jennings, Merwin, & nursing science are appearing. Among these
Thornlow, 2010; leipert & George, 2008). The are more articles about rural nursing in jour-
community connectedness where nurses and nals of rural health, the creation of the Online
patients know one another outside the health Journal of Rural Nursing and Health Care, a
care setting can create boundary-related eth- whole issue of the Annual Review of Nursing
ical conflicts (Nelson, Pomerantz, Howard, & Research focused on rural health, programs
Bushy, 2007). Such situations are challenging of rural nursing research (including multi-
because they bring into play competing roles site projects), National Institute of Nursing
of values, duties, and community expecta- Research (NINR)–funded research centers
tions to the classic ethical understanding of focused on rural health, new graduate pro-
the nurse–patient relationship. However, the grams (including at the doctoral level for
community connectedness can also translate preparation in rural health), and use of new
into the nurses’ commitment to give quality technologies for education and in nursing
care and attempts to break unhealthy family research.
histories of obesity-related diabetes or teen The Online Journal of Rural Nursing and
pregnancy (Baernholdt et al., 2010). Rural Health Care, which focuses on dissemination
nurses also have to be a “Jack-of-all trades.” of rural nursing research and health care
They have to take on nonnursing roles, such information, is a sign of progress. In the
as transporting patients, cleaning, and secre- first decade of the journal, there have been
tarial duties in hospitals when nobody else is a cluster of projects published addressing
available on the off-hours. Their nursing prac- some of the pressing health issues, such as
tice also has to be very broad (Scharff, 2010). women’s health, children and adolescents,
They are advanced generalist nurses who the elderly, caregiving, and issues associated
are able to care for a great variety of patients with managing cancer, stroke, Alzheimer’s
beyond a regular nurse’s scope of practice. disease, and end-of-life care in the rural set-
In addition, they often have to do so with ting. Programs of rural nursing research
limited resources and support systems. yet are developing: Fahs and colleagues at
the rural nurses face challenges keeping up Binghamton University, on cardiovascu-
with their professional knowledge and skills lar disease and rural women; Hauenstein
because of limited educational opportunities and colleagues at University of Virginia, on
(Newhouse, 2005). Despite these shortcom- rural women’s mental health; Magilvy and
ings, rural nurses are not less satisfied with colleagues, at the University of Colorado,
their jobs compared with their urban coun- on the community health needs of elderly
terparts (Baernholdt & Mark, 2009). rural populations; Utz and colleagues at the