Third in a Series: "Take Me Home, Country Roads to the Place Where I Belong... and Can Get the Health Care I Need!"

Jun 23, 2011, 2:23 PM, Posted by

The AARP Solutions Forum: “Advancing Health in Rural America: Maximizing Nursing’s Impact,” was held on June 13. This post is the third in a series in which Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars share their thoughts on the ideas presented. The author, Laurie Theeke, Ph.D., R.N., is an assistant professor of nursing at West Virginia University in Morgantown, West Virginia, and her research emphasizes the development of interventions that target loneliness as a psychosocial stressor that impacts overall health. Find out more about the forum or view the archived webcast.

I recently had the opportunity to listen to the AARP Solutions Forum, “Advancing Health in Rural America – Maximizing Nursing’s Impact.” I was thrilled to be able to hear about the continuing emphasis on rural health care. As a native of Appalachia, a long-term resident of West Virginia, and a Clinical Nurse Specialist in Gerontology, I often think about how we could better serve our older adults who are living in poverty with limited resources and complex chronic illness.

As I listened, I thought about how attached many of my patients are to rural living in Appalachia. Nearly everybody in the region knows the words to this popular song, “Take me Home, Country Roads” and I kept thinking that it would be wonderful if health care was available and affordable for all rural residents without having to take the long country road back to a more urban area, particularly in the winter months.

An enhanced national emphasis on understanding that rural residents not only need access to providers, but access to a variety of providers to optimize health, could really impact health outcomes for patients who suffer from multiple chronic illnesses. I can’t tell you how many times I’ve seen frustration on the faces of my patients who need to see multiple specialists or have several tests. They struggle with the thought that scheduling these appointments will mean multiple trips to a tertiary care center unless they can somehow coordinate appointments to minimize travel costs.

Understanding, as Alan Morgan [Chief Executive Officer, National Rural Health Association] said, “rural America is not just a small version of urban” will serve as a good foundation. It is truly important for all providers to understand the unique challenges of older adults living rurally which can include extreme poverty, diminished social contacts, and altered expectations for healthy living.

Listening to the webcast made me wonder why we are not using more Bachelor prepared nurses in rural areas for actual education on topics like nutrition, exercise, parenting, dental hygiene, chronic illness self-management, alternative therapies, preventive screening, immunizations, and substance use disorders. Not only do we need more advanced practice nurses to influence patient outcomes but we also need to make the best use of our Bachelors prepared nurses in rural areas.

It will become truly important, with the limited number of nurses practicing rurally, to work smarter. That will definitely mean that nurses will need to create strategies to have a positive impact. The establishment of more nurse managed health centers, increased use of technology to work directly with patients, development of innovative interventions for chronic illness, and continued emphasis on education for nurses will be important as we work toward our goal of improving access and therefore, outcomes.

Read more about the AARP Solutions Forum: “Advancing Health in Rural America: Maximizing Nursing’s Impact.”

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.