Rural and Remote Nursing

Why Rural and Remote Nursing?

• Rural communities make up 95% of the country’s land mass, most in northern Canada.
  
  
• Two thirds of northern residents live more than one hundred kilometres from the nearest health care facility.
  
  
• Northern communities have been subjected to major cuts in health services to the communities (Canadian Nursing Association, 2004)

To further provide you with insight into the realities of Rural and Remote Nursing, NurseONE enlisted the assistance and relied on the expertise of Roberta Gates-Thompson, Faculty for the Rural Nursing Program (RNP) & Rebecca Mugford from the Registered Nurses Professional Development Centre "RNPDC" in Halifax, Nova Scotia; and the executive of the Canadian Association of Rural & Remote Nurses (CARRN) . The NurseONE team is thankful for their work and dedication in the development of this feature object.

What is Rural and Remote Nursing?

Many groups of people referred to as underserved populations live within this land mass which is most of Canada. Those populations include; racial minorities, those of alternate sexual lifestyles, official language minorities, refugees, immigrants and Canada’s aboriginal populations. These underserved populations are at an even greater disadvantage if they make their home in an underserved area. (Equity in Access to Healthcare & Access to Health Services for Underserved Populations in Canada, Health Canada, 2001).

The Canada Health Act (1984) is based on the five principles of; portability, public administration, comprehensiveness, universality and accessibility. The act states that in order for Canadians to improve and maintain health that “the primary objective is to protect, promote, and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers” (Health Canada, 2001, p.1).

Nurses work toward meeting the goals of the Canada Health Act. Nurses working in rural and remote areas are generalists who are expected to have a broad knowledge of health problems across the lifespan. The rural nurse working to full scope of practice offers excellent acute care and overall community wellness. These nurses, often the first to see patients upon arrival in any rural or remote healthcare setting are pivotal to improving access to care. Their assessment skills, for instance, expedite immediate referral to the needed health professional in a collaborative inter-professional primary healthcare practice setting or to one outside of that setting if required.

In 1998, MacLeod, Browne and Leipert described rural and remote practice as; “based on the skills and expertise needed by practitioners who work in areas where distance, weather, limited resources and little back up shape the character of their lives and professional practice” (p.72). Bushy (2000) stated that, “Moreover, rural nurses are likely to provide care to clients across a broad age range and a variety of health problems. Nurses are usually well known and highly regarded by the community” (p.13). Rural and remote nurses work in various settings, some small and some larger. Other authors have described the fact that; rural and remote nurses are required to be able to work in any area of the hospital, work autonomously and adjust quickly to change (Bauman, Hunsberger, Blythe &Crea, 2006).

The Toward 2020: visions for Nursing report addresses the need for most health care services to be provided in the form of primary healthcare within the communities (Villeneuve & MacDonald, 2006). Evidently, the skills of the generalist practicing nurse will be very much in demand in the future as the nurses who care for these patients must be knowledgeable of healthcare problems across the lifespan.

Interest in the exciting and unique role of the rural and remote generalist nurse will be promoted with support from those responsible for the provision of healthcare, public recognition of the unique practice and the nurse’s ability to obtain adequate and ongoing continued education.