What to Know About Rural Nursing

Content creator standing in front of green trees smiling for camera
Written by Morganne Skinner, BSN, RN Content Writer, IntelyCare
A nurse in blue scrubs smiles at a patient in a rural nursing setting.

Imagine living over a half hour away from the nearest hospital and over an hour from the nearest speciality clinic. This is the reality for a quarter of Americans living in rural areas. Would you keep all of your appointments? Would you investigate a health concern at the first sign or symptom?

Now imagine you are a nurse working in a rural hospital. What would you do if a child presented to the emergency room, and the nearest children’s hospital was an hour away? You’d need the tools and skills necessary to attend to them, right? That is the reality of rural nursing.

What Is Rural Nursing?

The term rural nursing refers to nurses working in geographically isolated areas with small populations. Often, the patients these nurses care for have limited access to healthcare services. Consequently, rural nurses care for patients of all ages, health conditions, and levels of acuity.

These nurses may work in small hospitals, community health centers, clinics, or doctors’ offices. Due to the limited available healthcare services, rural nurses must have a broad array of skills to adequately care for all community members.

What Does a Rural Nurse Do?

The role of rural nurses is similar to other nurses — they still assess patients, implement nursing interventions, plan patient care, and evaluate patients. Depending on where the nurse is working, their day-to-day tasks may look different.

Since there are fewer specialty clinics in rural areas, rural nursing services include both general care and specialty care. For example, a nurse working as a maternal and child health home visitor may need to be familiar with child growth and development and infant tube feeding.

Examples of rural health nurse duties and responsibilities include:

  • Assessing and providing wound care
  • Providing home health visits
  • Educating patients on checking blood sugar at home
  • Assisting patients in accessing community resources (like transportation or financial assistance)

Working in a Rural Hospital

Nurses who work in a rural hospital must have excellent critical thinking and problem-solving skills. Because they work with limited resources, they need to think quickly, be flexible, and adaptable.

Nurses working in rural areas face these challenges:

  • Limited resources: Hospitals or facilities may lack funding, equipment may be outdated or malfunctioning, and they may work short-staffed.
  • Long distances from specialty facilities: The closest specialty clinic could be hours away. Rural nurses learn a broad scope of skills to care for their patients.
  • Lower household income: Patients may not be able to afford healthcare, childcare for appointments, or transportation to attend appointments.
  • Provider shortages: Nurses may not work in proximity to doctors or other providers.

Not sure rural nursing is the right fit for you? Consider taking some per diem shifts to get a feel for the environment, pace, and people in a particular facility. Some rural areas to consider for per diem nursing work include:

Rural vs. Urban Nursing

Nursing roles in rural and urban settings are directly influenced by their respective populations. For example, a rural nurse may spend a great deal of time assisting patients with housing applications, faxing documentation to the social security office, and coordinating public transportation to take them to their doctor appointments.

Nurses in urban areas, however, have more resources and may rely on social workers or care coordinators for these tasks. They tend to be more specialized and have a variety of workplaces to choose from.

Health Concerns in Rural Areas

Patients in rural areas face a multitude of health disparities compared to those living in urban areas. Examples include:

  • More likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke
  • Higher rates of blood pressure and obesity
  • Children with mental, behavioral, and developmental disorders face greater social and family challenges

Is There a Nursing Shortage in Rural Areas?

Across the country, nurses are in short supply, resulting in adverse impacts on rural areas. Over 90% of nurses report staffing shortages in hospitals and 40% report their hospital has closed beds due to inability to staff them.

Recruiting and retaining nursing staff is a challenge in rural areas. Nurses may have concerns working in these areas, such as:

  • Lower density of nursing professionals: They may have difficulty taking time off, have a heavy workload, or have to be on call often.
  • Lower pay: Rural nurses earn about $4,500 less per year than urban nurses.
  • Family concerns: There may be limited job options for nurses’ partners, long travel distances to school for children, and lack of childcare.

Provider Shortage in Rural Areas

A quarter of Americans living in rural areas say that access to good doctors and hospitals is a major problem. Adding to it, rural Americans report problems with the following issues:

  • Access to public transportation (43% reported)
  • Availability of jobs (42% reported)
  • Access to high-speed internet (24% reported)
  • Poverty (32% reported)

These factors further exacerbate the provider shortage in rural areas, as people may not have the necessary resources to attend their doctor’s appointments, even if providers are available. In addition, limited transportation options and finances pose barriers to accessing providers outside the community.

What Does a Rural Nurse Make?

The Bureau of Labor Statistics does not report the average rural nurse salary, but they do report salaries for RNs in nonmetropolitan areas. For comparison, the average registered nurse salary is $89,010 per year.

Here are the salaries for the top five nonmetropolitan areas with the highest RN employment:

  1. Kansas: $65,350
  2. Northeastern Ohio: $70,620
  3. Piedmont North Carolina: $73,740
  4. Northeast Mississippi: $65,680
  5. Southern Ohio: $73,680

What Are the Benefits of Being a Rural Nurse?

Working in underserved, impoverished communities can create a sense of accomplishment and fulfillment. Strong relationships are built between nurses and patients, who often work closely together for many years. Rural nurses also typically get to work with a great deal of autonomy and independence.

There may be financial incentives for working in rural areas, such as loan forgiveness programs. Additionally, you may find you have greater access to nature and live life at a slower pace.

Ready to Serve Your Community?

After reading about rural nursing, are you feeling inspired to join them? Get started today! IntelyCare can help you the right job in the right place for you.