Nursing Leadership in Rural Settings: Challenges and Strategies

Monday, 30 October 2017

Carol Boswell, EdD, RN, CNE, ANEF, FAAN
School of Nursing, Texas Tech University Health Sciences Center, Odessa, TX, USA
Minerva Gonzales, DNP
College of Nursing, University of Texas of the Permian Basin, Odessa, TX, USA
Jessica Marquez
Unemployed, Odessa, TX, USA

Purpose: Texas Team Rural Taskforce identified a challenge encountered by Chief Nursing Officers (CNO) functioning in rural hospitals and critical access hospitals related to networking and support. These CNOs, educated at the Associate or Baccalaureate degree levels, are responsible for managing the nursing staff along with staffing the units directly. On top of these challenges, these CNOs are being confronted with the Affordable Care directives and value-based funding challenges. In addition, the lack of a networking system is another challenge regularly identified. Having a network of like-mined individuals is viewed as a beneficial resource to support and mentor rural CNOs resulting in a positive impact concerning patient safety and management issues. Stroth (2010) acknowledged that "the complex issues of rural nursing practice places a high priority on retention of experienced, skilled staff nurses" (p. 33). Challenges undertaken by rural nurses include: reduced networking opportunities, challenges to advance professionally, static communities, lack of resources, lack of support, inadequate recruitment and retention activities, and varying skill mix (Bish et al, 2012; Stroth, 2010). The nursing leadership in these settings must also embrace an expanded role within the health care setting.

Methods: A qualitative project was conducted to identify strategies to be used to establish a mentor/support network for rural CNOs. West Texas rural hospital CNOs were interviewed to gather their recommendations for constructing a Rural CNO Network. A semi-structured set of questions was used for each conversation.

Results: The data from the interviews were compiled and analyzed to determine the recommendations and strategies for supporting and nurturing the CNOs in rural settings. The analysis was submitted to the participating CNOs to ensure that a complete representation of the strategies and recommendations identified were presented within the report.

Conclusion: This presentation will review the project process along with the results analyzed. Challenges and barriers encountered in the implementation of this project will be discussed to allow others to understand these aspects for planning future studies. Recommendations and strategies for use in rural settings for professional nurses assuming the leadership role as the Chief Nursing Officer will be provided. This presentation will address the application of the recommendations and strategies to global communities where collaborative support for nursing leaders is minimal. Nursing leaders in third world countries encounter challenges and barrier in networking with colleagues who can help them to grow as professionals. This presentation will apply the lessons learned during this data collection and analysis to these different challenging leadership settings.