Rural Nursing in America

Posted on: 29th May 2023


NURS 3333 Nursing in Rural America

  Rural Scholarly Paper | Week 4 


The purpose of the paper is to define and describe rural and identify health concerns for those living in rural areas. This is a scholarly paper and should be written as such. This means proper grammar, spelling, punctuation, and the use of APA formatting is required.  The body of the paper (not including title page and reference page) should be 6-7 pages in length. 

When your paper is turned into the assignment tab, it will automatically be submitted to Turn-It-In.  Turn-It-In is a program designed to assist a student with possible concerns regarding plagiarism.  Once Turn-It-In examines your paper, you will receive a “score” next to your assignment submission.  Any papers that are over 30% matching will not be graded and will receive a grade of zero.  Students can have multiple submissions and are highly encouraged to review submissions and re-submit.

The paper is due at the end of Week 4. Late papers will not be accepted.  Please utilize the Rural Paper Template for assistance with formatting your title page, header, and headings 



The title page should be formatted according to APA formatting guidelines.


Include an introduction to the paper.  The introduction provides an overview of the paper. The reader should have a clear idea of the purpose and topic(s) of the paper after reading the introduction. General facts and supportive information should be included.

 SECTION 1: 42 pts (14 points per bullet point)

This section of the paper identifies and defines “rural”. This section must include the following:

· Describe and define rural and urban as noted in your book and other course information

· Describe your own definition of rural and urban.  APA papers do not include the words I, me, my, you, we.  This is the only paragraph that these words can be used.

· Describe the rural populations located in your area of employment or community in which you live.

 SECTION 2: 42 pts (14 points per health topic)

Utilizing the Centers for Disease Control and Preventions’ Rural Health section (You may utilize another reference as long as the reference is peer-reviewed, scholarly, or relevant and current.  Wikipedia and WebMD are not appropriate references). 

·  State, describe, and explain 3 different health topics impacting rural Americans. 

·  Relate your chosen health topics to rural populations located in your area of employment or community in which you live.

 SECTION 3: 42 pts (14 points per intervention)

Choose one of the three identified health topics in Section 2.  Include in this section:

· Discuss 3 interventions you could implement for rural patients.  Provide clear identification and detailed overview of the intervention and related topic. 

· Rationale demonstrating understanding of how the intervention is pertinent to rural nursing

· Example- A topic and objective chosen in Section 2 is Family Planning. An intervention is Teen Pregnancy Prevention. The paper would include clear identification of the intervention, an overview of the intervention, and discussion of how this chosen intervention applies to rural nursing.

 CONCLUSION:  12 pts

The conclusion of the paper should be concise and reiterate the main topic(s). Do not introduce new material in the conclusion of the paper.

QUOTES:  5 pts
You may only have one long quote (longer than 40 words) or 2 short quotes (39 words or less) in the paper. 

HEADINGS:  5 pts

Each subheading or section listed above should be used as the Level One headings for the paper and formatted according to APA guidelines. Please refer to your APA resources for assistance.


APA papers require the use of in-text citations to validate the information in your paper.  In-text citations must be used after sentences that are not your own thought or idea.  Utilize your APA resources to assist in proper formatting. 


Use a minimum of 3 scholarly and current (less than 5 years old) sources.  You may use your textbook as a reference.  Peer-reviewed journal articles are recommended for the other sources. Peer-reviewed journals are accessible through the McKee Library.  Library staff are available to assist with searches for information if this is a new skill.


The reference page must be formatted according to APA formatting guidelines. Please refer to your APA resources. 

 Spelling and Grammar:  10 pts

Proper spelling and grammar usage is required for APA papers.  APA papers do not use I, me, we, you, they.

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Rural Nursing in America

In the US, there are health disparities between rural and urban populations. About 15 percent of the population of the United States lives in rural regions, as defined by the U.S. Census Bureau (CDC, 2020). Recent CDC research has shown a growing discrepancy in medical status both rural and urban Americans. Cancer, heart disease, accidents, chronic lower respiratory diseases, and stroke are the main killers of rural Americans. Rural locations experience a 50% greater rate of accidental injury mortality than urban areas due to the increased risk of deadly car accidents and opiate overdoses (CDC, 2020).Furthermore, residents in rural areas are typically older and ill compared to urban ones. This paper aims to describe rural and analyze health issues for rural residents. Three components comprise this paper—an analysis of rural and urban distinctions and first describing my community's rural population. The second segment will analyze rural patients' various health issues and how those issues relate to my community. The third section examines possible rural-specific treatments based on the issues raised thus far. In rural locations, good patient outcomes depend heavily on the availability of quality treatment.

Rural Vs. Urban

The United States Census Bureau defines rural as all land not part of an urban area. At least 2,500 persons and 1,500 occupants of non-institutional structures are required for a place to be considered an urban area. More than 50,000 people live in an urbanized area, while 2,500 to 50,000 live in an urban cluster (Surbhi, 2017).

There is a stark contrast between rural and urban places. Low population density and extensive tracts of undeveloped terrain characterize rural areas, sometimes called "the country." The distinction between rural and urban areas is usually evident. Urban areas in the United States have at least 2,500 residents. As a result of Japan's high population, only areas with a population of at least 30,000 are deemed urban (Surbhi, 2017).

My definition

A rural area is a geographical location that is sparsely populated and contains few dwellings or other buildings. There are few people around because their residences and businesses are tucked away in a quiet neighborhood. Most rural communities rely on agriculture as their primary source of income. However, because of its high population density and superior built environment infrastructure, an urban region can be a desirable place to live for many people.

Description of the community's rural population

I live in a town in Texas's Kent County known as Clairemont. In 1892, Clairemont was founded to coincide with Kent County's formation and serve as the county government's seat. R.L. Rhomberg, a nearby rancher, donated the property for the new town, which he named for his niece Claire Becker. The population of Clairemont now stands at 16,848 people, with a median age of 33.6. This group has 47.7% males and 52.3% females (Places, 2022). The population of Clairemont Place is 73.68 percent American-born, while the population of non-American-born residents is 7.83 percent. Additionally, 18.48 % is made up of noncitizens. In Clairemont Place, 14,334 people still reside in the same home they did a year ago. Clairemont Place is home to 5,268 families with an average of three members. 68.58 percent of these Clairemont Place households are family-owned, while the remaining 31.42 percent are non-family-owned. Families with children make up 33.71 percent of households, while families without children make up 66.29 percent of households. Nearly 40 percent of Clairemont Place's population holds a high school diploma, 22.83 percent have completed some form of post-secondary education, and 10.68 percent have a bachelor's degree (Places, 2022).

Section 2

One of rural Americans' biggest health issues is the misuse of antibiotics. Patient outcomes can be improved by increasing the use of antibiotics in hospitals. According to several recent studies, hospitals prescribe an estimated one in three unnecessary or incorrectly prescribed antibiotics. One of the antibiotic use's most serious side effects is Clostridium difficile infection (C. difficile) (CDC, 2020). Because of the overuse of antibiotics, the U.S. is facing an increasing antibiotic resistance crisis. Many antibiotic-related side effects, such as Clostridium difficile infections, are preventable and curable through antibiotic stewardship programs, which aim to improve the prescribing and use of these drugs. In addition, they save money on all of these benefits. Small or "critical access" hospitals (fewer than 25 beds) use antibiotics just as frequently as larger hospitals in rural locations. C. difficile and antibiotic resistance pose similar problems to more extensive facilities. Due to a lack of resources, smaller hospitals generally cannot effectively implement stewardship programs. New guidelines for the use of antibiotics at critical access hospitals and small community hospitals are available.

A urinary tract infection (UTI) is the most common reason for using antibiotics in Clairemont. Despite this, most patients treated for a urinary tract infection (UTI) do not display symptoms specific to the urinary tract. Besides, most residents are treated with antibiotics even when at an asymptomatic stage. According to research, an asymptomatic urinary tract infection is rather frequent, but it usually has no negative implications for the patient and is not helped by antibiotic treatment in most cases. Malaise or falls are frequently cited as a reason to collect urine samples from patients with no apparent connection to the urinary tract. UTI and asymptomatic bacteriuria cannot be distinguished by urine diagnostic tests like the dipstick (urinalysis), urinalysis, or urine culture. Positive results from a urine test play a role in the decision to start an antibiotic; however, this is well-documented. Only after the results of urine cultures are available can 60–90% of antibiotics prescribed in Clairemont for UTIs be started. To further reduce the number of antibiotic prescriptions in hospitals, urine culture results should be withheld unless specifically requested by the provider.

Due to the increased obesity rates in rural areas, these patients have a higher chance of acquiring diabetes. Consuming healthy foods like fruits and vegetables becomes more challenging in rural locations due to environmental considerations as well as access limitations. In rural areas, diabetes prevalence is roughly 17% higher than in urban areas, with prior studies finding that rural persons were more likely to report a diagnosis of diabetes than urban adults (CDC, 2020). According to the CDC's 2018 National Diabetes Statistics Report, 8.2 percent of the population, or 26.9 million Americans, have diabetes (CDC, 2020). Due to the prevalence of risk factors and the lack of access to a wider range of services, rural areas have a higher risk of developing diabetes than urban areas.

The third impact is when a vehicle is involved in an accident. Depending on the region, the number of people killed in car accidents is three to ten times higher in rural America than in urban areas. The use of seat belts has decreased in rural areas. In rural U.S. areas where there were fatal collisions, more than 60% of the drivers and passengers weren't wearing seat belts. States with primary enforcement, where a ticket can be issued for not wearing a seatbelt, have far higher rates of seatbelt use than those with secondary enforcement, where a citation can only be issued for not wearing a seatbelt after another traffic infraction has occurred (CDC, 2020).At least 28% of accidents are thought to be the result of rear-end collisions. The National Safety Council estimates that at least 2.5 million rear-end collisions occur yearly. Many people mistakenly believe these mishaps are "no big deal" because they frequently occur. However, victims of a rear-end collision may suffer long-term effects. Whiplash is a common injury following a rear-end collision. In a rear-end collision, about 20% of people suffer some degree of whiplash. Whiplash can cause headaches, neck, shoulder, and back pain, as well as the inability to move the neck without experiencing discomfort. Whiplash treatment can last for months or even years, and some patients never fully recover from their injuries.

Section 3

Antibiotic Use

Antibiotic prescriptions for urinary tract infections (UTIs) may be curtailed through strategies to reduce the frequency with which residents' urine samples are over-tested. Patients with fever and localized urinary symptoms were excluded from urine tests and antibiotic administration in the first large-scale investigation to test this theory (Schwartz et al., 2007). While antibiotic prescriptions for UTIs were reduced in 24 nursing homes in the United States and Canada, the effects faded over time, and there was no substantial influence on orders for urine cultures, which suggests that the intervention's sustainability and integrity are in question (Spector et al., 2006). Nevertheless, subsequent research in a single Veterans Affairs (V.A.) nursing home reported a substantial reduction in urine cultures, treatment of asymptomatic and overall days of antibiotic administration following implementation of the same intervention (Schwartz et al., 2007). (Schwartz et al., 2007). Similarly, treatment of asymptomatic bacteriuria was reduced from 52 to 10 percent following the introduction of a cognitive intervention (Trautner et al., 2013) focused on restricting urine cultures in patients with guideline conflicting symptoms (e.g., foul-smelling urine) (e.g., foul-smelling urine). Finally, a quality improvement collaborative concentrating on improving urine testing in 17 Massachusetts nursing institutions resulted in significant reductions in urine cultures and antibiotic treatment for UTIs.


Diabetes management interventions that involve community health workers aim to improve patient care and self-management behaviors. Education, coaching, and social support help people with diabetes manage their condition and weight. These interactive and playful illustrations and everyday situations that people with diabetes experience are among educational strategies aimed at D.M. patients. There are many ways that the Diabetes Conversation Maps can be used to help people better understand and use the information in their daily lives, as well as to encourage behavioral changes that are necessary to manage the disease and interact with health care providers. Using the tool in a group allows for sharing knowledge and experiences, which in turn aids learning (Dwyer et al., 2013). SCT, also known as Social Learning Theory, was applied to the Diabetes Conversation Maps to aid and facilitate student learning. Modeling, one of the SCT constructs, is a process that allows people to develop their behavioral and cultural standards, as well as their beliefs and values, as a result of a continuous interaction process with their surroundings. This theory views man as a socially embedded individual who must adapt and change in response to the social context in which he lives.

Motor Vehicle Accidents

As the primary intervention, people should be educated about road safety measures such as seatbelts. Drivers and passengers alike should use seat belts for a variety of reasons. In a skid or spin, a seat belt keeps a person in the best possible position to avoid injury. Unbuckled drivers are more prone to losing control of their vehicles and crashing. In addition, the force of impact will be dispersed. The body's strongest parts will take the brunt of the force, thanks to the lap and shoulder belts. An unrestrained person is more likely to suffer an injury from a concentrated blow to the head or chest, which is more likely if the individual does not have proper restraint. A safety belt is an essential piece of equipment to help keep your body in sync with your vehicle's speed. After a collision, if a person is not adequately restrained, their body will continue to move at the same rate as the vehicle. If the occupant is not properly restrained, they risk colliding with the steering wheel, dashboard, or a side window.


Rural areas include open country and communities with fewer than 2,500 persons. Urban areas comprise larger places and highly occupied areas around them. Urban areas may not usually follow municipal boundaries. Various health issues impact the rural population. Diabetes is an increasing issue for rural areas compared to urban populations because of risk factors that are widespread in rural regions and access to a variety of services. Rural communities have more excellent rates of obesity, putting them at an increased probability of developing diabetes. Some rural community factors contributing to this risk include environmental characteristics and access hurdles, which can make it tougher to consume nutritious foods, such as fruits and vegetables. Furthermore, the issue of antibiotic use and motor vehicle accidents are increasingly affecting the rural population. Therefore, concrete interventions must be utilized to realize a healthy community.


CDC. (2020). National Diabetes Statistics Report. Centers for Disease Control and Prevention. Retrieved July 17, 2022, from

CDC. (2020, March 25). About rural health. Centers for Disease Control and Prevention. Retrieved July 17, 2022, from

CDC. (2020, March 25). Antibiotic use in rural hospitals. Centers for Disease Control and Prevention. Retrieved July 17, 2022, from

Dwyer, L. L., Harris-Kojetin, L. D., Valverde, R. H., Frazier, J. M., Simon, A. E., Stone, N. D., & Thompson, N. D. (2013). Infections in long-term care populations in the United States. Journal of the American Geriatrics Society, 61(3), 341-349.

Places. (2022, May 24). Clairemont. Retrieved July 17, 2022, from

Schwartz, D. N., Abiad, H., DeMarais, P. L., Armeanu, E., Trick, W. E., Wang, Y., & Weinstein, R. A. (2007). An Educational Intervention to Improve Antimicrobial Use in a Hospital-Based Long-Term Care Facility. Journal of the American Geriatrics Society, 55(8), 1236–1242.

Spector, P. E., Fox, S., Penney, L. M., Bruursema, K., Goh, A., & Kessler, S. (2006). The dimensionality of counterproductivity: Are all counterproductive behaviors created equal? Journal of Vocational Behavior, 68(3), 446–460.

Surbhi S. (2017, August 12). Difference between urban and rural. Key Differences. Retrieved July 17, 2022, from

Trautner, B. W., Bhimani, R. D., Amspoker, A. B., Hysong, S. J., Garza, A., Kelly, P. A., Payne, V. L., & Naik, A. D. (2013). Development and validation of an algorithm to recalibrate mental models and reduce diagnostic errors associated with catheter-associated bacteriuria. BMC Medical Informatics and Decision Making, 13(1).

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