RURAL HEALTH Flashcards
Define:
Rural Health
difficult to define d/t range of different definitions
* population of less than 1000 people
* more than 30% of people commute to an urban area for work
* less than 150 people per square km
* Postal code has second digit 0 indicating there are no mail carriers
23-38% of Canadians live in rural settings depending on what definition is used
Describe:
Rural Health Issues
- rural areas are at general health disadvantage
- higher negative lifestyle choices, lower physical activity
- lower life expectancy rates
- higher mortality rates especially for MVA
- lower cancer mortality rates
- respiratory disease mortality risks were generally significantly higher in rural areas
- higher incidence of diabetes
- higher prevalence of arthritis/rheumatism than those in urban areas
List
Recommendations to improve rural health outcomes
- health initiatives should focus on occupational health and safety issues
- improving rural road conditions and road safety awareness
- develop variations of activities in rural areas to takle prevalence of lifestyle influencing health risks such as smoking, low consumption of fruit and veg, low physical activity, and obesity - what works for urban may not work for rural
T/F
Rural communities are heterogenous and there is great variety and difference between different communities - makes health implementation difficult to do
True
T/F
Rural communities are heterogenous and there is great variety and difference between different communities - makes health implementation difficult to do
True
T/F
There are little differences between sexes in rural areas
False
Location and Demographics of Rural Nurses
- territories
- female
Name the work settings for rural RNs in Canada
- hospitals
- community
- nursing home/LTC
- other
What is the scope of RN practice in Rural Canada?
- a distinct characteristic of rural nursing is its broad scope of practice
- closely related to the rural context of each community and limited access to healthcare resources
Review (greatest to least)
Reason for RNs to work in their primary rural communities
- interest in the practice setting
- location of the community
- lifestyle
- income
- family or friends
- flexibility of the work
- benefits
- advanced practice opportunities
- spouse employment/transfer
- career advancement
Representation of Indigenous RNs
underrepresented in rural and remote areas, especially in northern areas where the proportion of Indigenous peoples is higher
Satisfaction of RNs in Rural Canada
- satisfied with both where they work and where they live
- may suggest resiliency against the unique challenges of living and working rural
- concern that many RNs expereine and witness emotional abuse, physical violence, and threats of violence
Describe
Rural RN’s Perception of Scope
- majority of rural RNs in Canada report working within scope of practice
- 10% perceived themselves as working above their scope of practice
List:
Guiding principles for a framework for nursing practice in rural and remote canada
- holistic, patient-centered care
- community empowerment
- philosophy of primary health care
- cooperation and collaboration
- the influence of the determinants of health
- the professional practice of all regulated nurses in Canada
Review:
Rural-Urban Disparities
- mortality form innjury and poisoning substantially higher in rural Canada
- higher proportions of rural and remote residents reported fair or poor health status
- greater proportions of rural Canadians report being overweight compared to urban counterparts
- men living in the most remote parts of Canada are at increased risk of suicide
- level of education is a major correlate to variation in earnings between rural and urban workers
- income earnings of rural people are 25% lower than those in large metropolitan areas
- many Indigenous people live on reserves
- labor participation rate for Indigenous people in urban centres is higher than Indigenous poeple on reserve
- less Indigenous peoples on-reserve receive post-secondary education compared to indigenous people off reserve –>indigenous people in urban centres less likely to receive post-secondary education than non-Indigenous Canadians
Describe
Rural and Remote Nursing Interactions
- understanding rural and northern contexts
- being part of a community
- care at centre of practice
- interprofessional, collaborative teamwork
- complex, generalist role
- multiple skills, expanded practice
- being versatile
- being prepared
- culturally sensitive care
- maintaining confidentiality
- blurring of professional boundaries
Kim English:
Issues with Rurality
- Access
- urban centric approaches to planning and decision making
- urban centric approaches to finances
- urban centric approaches to nursing practice
- lack of political will
- lack of value
- 20+ years of lack of attention to rural and remote health infrastructure
Kim English
Examples of lack of access in rural communities
- closure of health services
- closure of other services like banks
- greyhound services closing - smaller communities cannot use these transportation services to access urban areas for medical services
Kim English:
Impact of Geography on Health
- delayed diagnosis
- delayed treatment
- medical adherance or access
- access to food to sustain nutritional diets
- trauma care - no access in remote and rural areas themselves, but sometimes even helicopters and other services cannot access in circumstances of bad weather
Kim English:
Impact of Geography on Health
- delayed diagnosis
- delayed treatment
- medical adherance or access
- access to food to sustain nutritional diets
- trauma care - no access in remote and rural areas themselves, but sometimes even helicopters and other services cannot access in circumstances of bad weather
Kim English:
Health Concerns in Rural Populations
- agricultural - dust, debris, farming injuries, work load (unlikely to seek care during harvest season)
- tourism related health issues
- maternal/child care - no doctors, liability issues, hard to maintain competent care when there is only one delivery a year in the region
- chronic diseases - management
Kim English
Commonalities in Health Issues between Urban and Remote
- mental health and addictions - cannot have safe consumption sites in rural and remote areas because there are no resources
- HIV - less access to resources and prevention methods and education
- LGBTQ+ - issues with stigma and discrimination; no acceptance
- homelessness and less than adequately housed - looks different, people living in barns, sheds, couch surfing
- intimate partner violence - harder for victims to seek help, limited transportation and communication
Kim English:
How to Address Rural Health Issues
Rural Road Map - report card on access to health care in rural Canada
Kim English
T/F: Nurses are leaders and innovators in rural and remote practice
True
Kim English:
How has the nursing shortage impacted rural and remote Canada?
- in summer 2022, 11 nursing stations closed in rural and remote areas
- hospital ERs had to close especially overnight from staffing shortages
