BE A HERO:
Be a Nurse in Rural America
By Sandie Nadelson
“ I can’ t decide on a specialty area.” As a nursing faculty member, I hear this frequently from graduating nursing students. Picking one specialty area from so many possibilities is a decision many nursing students find difficult. Often the choice is overwhelming because of students’ concerns that if they start in the wrong area, they may end up being unhappy with their choice and be stuck with it, unable to easily find other options.
I have good news! New graduates do not have to decide whether a focus on obstetrics( or some other area) is a better choice for them than cardiac or med-surg nursing if they choose to begin their careers working as rural nurses. It is not uncommon for nurses in rural community hospitals to help women give birth the same day that they care for people with cardiac problems. Typically, rural nurses stretch themselves and use multiple skills and an array of knowledge by providing care to many different types of patients— all in the same shift. They are truly super nurses.
In rural areas, new graduates have many job opportunities. Hospitals and home health agencies in small towns seek nurses who want a wide range of experiences. Most nurses in rural areas work in what are called Critical Access Hospitals. The Centers for Medicare and Medicaid Services( CMS) designates non-profit facilities that are open 24 / 7, have an emergency room, and no more than 25 beds as Critical Access Hospitals( Rural Health Information Hub, 2018). The nurses working in Critical Access Hospitals need to be prepared to expect the unexpected, as there is likely to be a diversity of patient needs in the small care facilities. The conditions in these hospitals allow nurses to develop and use a wide range of skills and knowledge.
Home Care in Rural Oregon
Not all rural nurses work in hospitals. Home care nurses are also in short supply in many areas of the country. I have worked as an RN making home visits in small communities and loved it. In Oregon, I worked for the Visiting Nurses Association. As part of my job, I visited people who lived in areas without healthcare clinics. My trips to their homes saved people from driving many miles to Portland to see their care providers. I was able to be the physicians’ and nurse practitioners’ eyes and ears. In addition, I had the privilege of entering people’ s homes and helping them make their homes safer. I also connected these individuals and families to local resources to help with medication and food delivery.
I will never forget one elderly widower who lived alone in a house with electricity, but no indoor plumbing or phone service. Let’ s call him“ Stanley.” His congestive heart failure was an ongoing serious issue, so I often needed to contact his cardiologist to make changes in his cardiac medications. Cell phone reception was horrible on Stanley’ s farm, but I found one place in the front yard where I could make calls. I had to stand very still or the calls were dropped. I recall many times standing in the sun, smelling the country air while waiting for Stanley’ s cardi-
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