| Learning Objective #1: Identify major environmental and organizational factors which have influenced rural hospital nursing since 1995 | |||
| Learning Objective #2: Describe the unique challenges faced by rural hospital nurse executives |
Background: Rural hospitals have faced decreasing financial margins, resulting in economic pressure for rural hospitals. This dynamic presents a challenge for Nurse Executives who are responsible for assuring quality of nursing care. Nursing care affects patient outcomes. The impact of legislative, economic and strategy decisions on nursing in rural hospitals is unknown.
Methods: A focus group was conducted with eleven Nurse Executives from rural hospitals who attend the American Organization of Nurse Executives Annual Meeting on April 20th, 2004.
Results: Themes from the content analysis were grouped into three major categories: external environmental (physical isolation, patient population, services needed, legislation), internal organizational (patient acuity, volume, services, technology, financial margin and strategy, staffing, leadership, culture, and resources), and nursing infrastructure (staffing, salary, Registered Nurse (RN)- Physician (MD) conflict, continuity of care, competency, culture, politics and leadership).
Conclusions: Nurse Executives in rural hospitals face distinctive issues and challenges then their urban counterparts. Further study of the impact of policy and strategy decisions on rural nursing is needed.