Opportunities to pursue bachelor's degrees may be limited for nurses in rural hospitals
Research Activities, August 2011, No. 372
When quality professionals look at hospitals across the Nation, they tend to lump all rural hospitals into one category. A new study finds that nursing characteristics vary among large and small rural hospitals. Most nurses in both types of rural hospitals graduate from associate degree programs.
Robin P. Newhouse, Ph.D., R.N., NEA-BC, of the University of Maryland School of Nursing surveyed 280 nurse executives from small (25 beds or fewer or a critical access hospital) and large (more than 25 beds) rural hospitals. For both large and small hospitals, 77 percent of the registered nurses hold associate degrees. Of the nurses who have bachelor's degrees, more work in larger rural hospitals (20.8 percent) than small rural hospitals (17.1 percent). The authors suggest this is likely a result of the proximity of the rural hospital to colleges and universities.
Because of their rural locations, the average distance to any educational institution from a hospital was 43 miles. Distance from a university may hamper nurses who are interested in completing a bachelor's degree. The authors stress the need for policymakers to explore ways to bring educational opportunities to rural settings for nurses who want to pursue baccalaureate degrees, either by fostering partnerships with local colleges or through distance education.
Large rural hospitals are also more likely to have clinical ladders that structure nursing roles according to expertise; that is, higher levels indicate expanded roles and responsibilities. These ladders are associated with nurse retention and better patient outcomes. The authors recommend that nurse executives, particularly from small rural hospitals, explore how to institute career ladders in their hospitals as a way to improve care. This study was funded in part by the Agency for Healthcare Research and Quality (HS15548).
See "Rural hospital nursing: Results of a national survey of nurse executives," by Dr. Newhouse, Laura Morlock, Ph.D., Peter Pronovost, M.D., Ph.D., and Sara Breckenridge Sproat, Ph.D., R.N. in the March 2011 Journal of Nursing Administration 41(3), pp. 129-137.