ch 18 Rural Nursing

Question 1

t or f are rural canadians seen as a vulnerable group?

Answer 1

true

Question 2

why are rural canadians seen as a vulnerable group?

Answer 2

have high mortality rates d/t injuries, suicide and circ disease
• travel greater distances to receive all services and have high death rates d/t MVA
• Distance, weather, mountain ranges, coastal hazards are barriers to health service accessand delivery
• Rural Canadians have lower income and education

Question 3

which other diseases than injuries, suicide, circulatory issues are rural pops at risk of

do both males and females have lower life expectancies rurally

Answer 3

incidence of resp disease is higher

yes both are lower

Question 4

why is it important to define rural

below what population is the definition of rural generally

Answer 4

this affects funding

<10,000

Question 5

nurses working in what area eg public health form the largest cohort of rural nurses

Answer 5

hospital nurses

Question 6

are rural nurses often specialists

Answer 6

they are multi-specialists (they are usually generalists and they have to know lots of different things) so they are also expert generlists

Question 7

does a large proportion of canadians live rurally

Answer 7

21-30% of them

Question 8

rural nurses are expected to do what kind of duties/roles outside of their own

Answer 8

they are expected to do the work of nonprofessionals often eg housekeeping and alos the work of other professionals eg physio and pharmacy esp at night

Question 9

do most rural nurses see it detrimental or useful that everyone in the community knows them. why or how?

Answer 9

sometimes privacy is an issue but knowing people is seen as a strength
this requires good professional boundaries
• The rural nurses need to know who lives in their community, what their skills are and whether theyre avail to address loack health needs/respond to emerge g might want to know who has first aid and could respond to major event
when you know the community its easier to mobilize community strengths to mae local programs and health services

Question 10

mobilizing community strengths and making local programs and health services is what Feminist researchers described as

Answer 10

“relationship work”an imp and invisible work done by women.

Question 11

which care areas/specialties are most challenging for rural hospital nurses

Answer 11

emer
maternity
complex mental health

Question 12

how do rural nurses feel that their urban counterparts view them?
what about the opinion of educators

Answer 12

• Some nurses feel marginalization or lack of understanding of rural nursing issues from those in urban settings and educators

Question 13

t or f healthcare is increasingly regionalized

T OR F there are increasing numbers of RNs who want to work rurally

Answer 13

tru there is inc regionalization

false there is inc shortage of HCP to work in rural, northern communities

Question 14

what are some factors that affect the recruitment and retention of rural nurses

Answer 14

challenges w job opportunities for partners
• Many rural communities are having job losses d/t dec natural resources eg mill closures, dec fish and consolidation of sevices in lg urban centres
• Touris is challenging as it makes demand for healthcare flucturate
• Maternity care avail is a factor in families willingness to reloacate

Question 15

which organization made the connection tat the lack of healthcare for pioneer women inc anada was adding to high mat and infant mortality rate

Answer 15

o Victoria order of nursing, founded in 1897 by national council of women of Canada

Question 16

what did the victoria order of nursing do to inc care for women

Answer 16

o VON began giving pre/postnatal care in small cottage hospitals in Ont and visiting nurse services were provided in country districts
o Rural program was d/cd d/t funding lack. This showed medical officials that nurses could give health at home and thus inc health of rural families
o VON established training homes in Ottawa, Mtl, Tor, Halifax

Question 17

what kind of things were rural PHNs involved in

Answer 17

they were often generalists that worked in health education, dental, communicable disease, pre and post natal, med surg, delivered babies and even veterinary assistance

Question 18

what signified the shift of graduate nursing work from the community to elsewhere (hospital i guess)

Answer 18

intro of hospitals act and medical care funding, which positioned doctors as gatekeepers to Canadian healthcare system

Question 19

around what time/event were outpost nursing stns set up and what did they establish or demonstrate

Answer 19

o After WWi the red cross et up chain of outpost nursing stns and hospital in remote areas. They showed that public funding was nec to ensure access to essential health services in remote and often poor communities that coultn attract/pay a dr

Question 20

why did the govt put some outpose nurses in arctic and subarctic in 1904

Answer 20

d/t responsibilities for FN healthcare, “for humanitarian reasons and to prevent the spread of disease to the white population”

Question 21

how was midwifery seen in outpost nursing stations by the medical community and what did this necessitate

Answer 21

o Maternity was one of primary reasons for estab of outpost nursing was for mat care but midwifery was illegal so these nurses were often trained in Britain. Some learned on the job or from lay midwives in community

Question 22

how does allocating resources proportionate to populations affect rural communities (good or bad) and why

Answer 22

ural communities are disadvantaged. Because it costs more to live and give health in rural, allocating resources in this way can lead to health inequities and affect willingness of nurses and other HCPs to work in rural and remote communities

Question 23

t or f a rural nurse might be certified to give out Dx and do minor procedures like suturing

Answer 23

true

Question 24

is healthcare increasingly centralized or is there increasing specialties in rural areas

Answer 24

While centralizing specialized services makes sense it has costs to rural pop, esp to remote first nations. They must travel further and there is emotional social etc costs of leaving home community

Question 25

are rural nurses held to the same std of care as urban nurses and is the context of care taken into account for this

Answer 25

o Rural nurses are held to same std of care as urban nurses and context (of less staff, backup, resources) isn’t taken into account

Question 26

are rural residents more or less likely to seek healthcare than their urban counterparts and why

Answer 26

o Rural residents value independence hardiness and self reliance which can dec their willingeness to seek healthcare

Question 27

because of the size of a community a rural nurse may feel that nursing is not just an occupation but a ___

Answer 27

lifestyle

Question 28

job satisfactio rurally is linked to what

Answer 28

For rural nurses predictors of satisfaction are current eqpt and supplies, satisfaction w scheduling and shifts, lower stress and being happy with the community and job satisfaction is linked to retention

Question 29

is leadership equally spread in rural areas compared to urban

Answer 29

no theres inadequate leadership

Question 30

what is one suggested method of providing culturally relevant health services

Answer 30

increasing the proprotion of FN nurses

4% of Canadians are indigenous while onl 1% of nurses are

Question 31

summry of the barriers to rural nursing work

Answer 31

isolation, workload, less social amenities, less spousal employment opportunities, smaller professional networks, les Tx services, inc cost of living
serious shortage of health and HR

Question 32

what is a possible solution to the lack of resources eg staff and continuing education

Answer 32

Recruitment incentives and flexible distance/blended learning opportunitie

Question 33

what ways could they inc retention and recruitment of rural nurses

Answer 33

• Could also provide opportunities to live learn and work in rural ommunity as part of pregistration prof education programs. Some communities endorse this and give housing to students
• Rural preceptors must also be supported
• Could make resources available for learning during work time
• Scholarships/bursaries are useful in rural areas
• Incentives like loan repayment, housing incentives