Oral Presentation The 26th International Nursing Philosophy Conference 2023

What is different about rural health nursing: A philosophical exploration (#35)

Jessica G Smith 1 , Sharon Laver 2
  1. University of Texas at Arlington College of Nursing and Health Innovation, Arlington, TX, United States
  2. Charles Sturt University School of Nursing, Paramedicine and Healthcare Sciences, Bathurst, New South Wales, Australia

Rural nursing is not spot treatment of diseases separate from the mind, body, and spirit. It is critical for nursing students to appreciate that nursing care in small rural communities cannot be provided from a “buffet” approach. Rural nurses committed to their communities understand that choosing who is cared for based on personal care provision preferences does not meet a moral and ethical standard of practice. Further, holding a classist view of rural residents as “less than” based on characteristics such as limited educational attainment reinforces a lack of cultural humility.

Structural factors within nursing education programs, such as curriculum biases towards high-end acute care, and a focus on specialisation, could deter undergraduate nursing students in desiring to learn about the unique role of a rural nurse generalist.

Rural nursing requires a paradigm shift to caring for people and communities from cradle-to-grave—true person-cantered care.

Professional culture change is needed from individualist approaches of specialist service provision to embracing the value of being a generalist, building on marketable ‘soft skills’ such as flexibility, collaboration, communication, integrity, and acceptance. Rural nurses are adept at overcoming care challenges as partners and members of communities dedicated to serving and improving population health. Building a stronger philosophical care basis inclusive of all people, honouring their age, gender, ethnicity, and other characteristics that distinguish them as human beings, is long overdue.

The purpose of this panel session is to facilitate an exploratory discussion about the philosophical underpinnings of rural health nursing. The starting point of this exploration will be the poem, “The Ambulance Down in the Valley”, (Joseph Malins, 1895), which illustrates the tension between focusing on treatment after the fact and prevention in the first instance. Attendees will contribute to an open dialogue about including a rural nursing philosophical focus in undergraduate nursing curriculum.

  1. Malins, J. (1895). The Ambulance Down in the Valley. https://tonycooke.org/stories-and-illustrations/ambulance-valley/