Nursing 320 chronic illness in rural settings

NURS 320: Module 2: Rural Dwellers

This module introduces some common characteristics of rural dwellers as they relate to healthcare. It is very important to remember that rural dwellers are not all the same! Yet it is important to appreciate some characteristics that may be more prevalent in rural areas so care can be adapted to meet unique needs and preferences.

Module Objectives:

1) Consider approaches nurses should take in adapting care to meet the needs of unique individuals.

2) Explore the significance of the Symptom- Action – Timeline Process as it relates to rural dwellers.

4) Choose approaches that would facilitate positive outcomes when caring for those who delay care.

5) Appraise factors that contribute to the use of complementary and alternative approaches to care in rural dwellers.

Assigned readings:

Buehler, J.A., Malone, M., Mjerus-Wegerhoff, J.M. (2013). Patterns of Responses to Symptoms in Rural Residents: The Symptom-Action-Timeline Process. In C.A. Winters (Ed.), Rural nursing: Concepts,theory, and practice (pp. 131 – 139). New York: Springer.

This is chapter nine in the online text Rural nursing: Concepts, theory and practice. http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sww&AN=547705&scope=site

National Council of State Boards of Nursing (2018). A nurse’s guide to professional boundaries. https://www.ncsbn.org/ProfessionalBoundaries_Complete.pdf

Shreffler-Grant, J.M., Nichols, E., Weinert, C., & Ide, B. (2013). Complementary Therapy and Health Literacy in rural Dwellers. In C.A. Winters (Ed.), Rural nursing: Concepts, theory, and practice (pp.205 – 214). New York: Springer.

This is chapter 13 in the online text Rural nursing: Concepts, theory and practice. http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sww&AN=547705&scope=site

Swan, M. A., & Hobbs, B. B. (2021). Lack of Anonymity and Secondary Traumatic Stress in Rural Nurses. Online Journal of Rural Nursing & Health Care, 21(1), 183–201. https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150428679&scope=site

Key Points

• Since rural dwellers have different definitions of health, it is important that healthcare professionals respect values and approach care from the client’s unique perspective.

• It is important to remember that rural dwellers and rural communities are not all alike. There is much diversity (client, family, nurse, and healthcare system) in rural areas.

• It is not uncommon for rural dwellers to delay seeking professional healthcare for a variety of It is important that healthcare professionals are sensitive to issues surrounding the healthcare experience of rural dwellers.

• The Symptom-Action-Timeline (SATL) process is explored in relationship to rural dwellers.

• Chronic illness impacts many. It is not uncommon for rural and urban dwellers experience and manage chronic illness in different ways.

• Rural dwellers may be drawn to use complementary and alternative therapies for unique reasons.

• Caring for individuals the nurse knows on a personal level can be beneficial or detrimental.

Graded Assignment:

You will complete your first synthesis and application assignment. Synthesis and Application assignments have two separate components. Please see the information in the Synthesis and Application Assignment folder for a video and more detailed direction. Refer to the grading rubric (Appendix B in your syllabus or at the end of this document) for how points can be earned. Carefully note the criteria for a professional nursing journal as found in the course syllabus (p. 9).

Part 1: Choose one of the situations below. You will need to refer back to information from your assigned readings in Module One in addition to the readings assigned for this module. Respond to the situation you choose in the discussion forum adhering to the grading rubric in Appendix B. Note that all parts of the discussion question/topic must be addressed to earn full points. You can earn up to 15 points for your initial post.

Part 2: There is an opportunity to review what your peers have posted and build on their knowledge and insights by the date included on the course schedule. You will post a substantive addition to one of your peers’ post. Your substantive addition must address the topic/situation other than the topic/ situation addressed in your original synthesis and application post. You can earn up to 10 points for a substantive addition that meets rubric criteria.

As you search for articles the first weeks of this course, two journals that may be especially helpful are the Online Journal of Rural Nursing and Health Care and the Journal of Rural Health. Both are readily accessible via the SMSU library. There are many other articles and journals that will be helpful as well.

Situation One: Please post your primary post in both the discussion forum and the assignment box. Thanks.

You are the nurse working in a rural hospital. Joe is a 64 year old gentleman, who has been working as a farmer for the last 40 years. Joe’s wife Ann brings him to the emergency department after he complained of chest pain, became short of breath, and his skin was cool and clammy. Joe says this has happened before, that he feels fine now and this isn’t bad enough to keep him from getting back home and tending to his cattle. Ann insists that since he is here now (they live 30 miles from the hospital) he should have this checked out Explore at least two concepts of Rural Nursing Theory (from those addressed in Chapter 1 in your text by Winters, i.e. work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer). Discuss how these two concepts are relevant to this nursing situation.

2. As the nurse, explain how would you approach this situation to achieve the best outcome? (be sure to consider concepts of Rural Nursing Theory). Note: the implications for nursing practice section (pages 11-12) of chapter 1 in your Rural Nursing text maybe helpful as you discuss nursing approaches.

Joe stays in the Emergency Department (at his wife’s insistence). As you complete your assessment, you learn that Joe has a strong family history or coronary artery disease, has experienced these symptoms before, has not seen a physician for over 20 years, has tried over the counter remedies, and even asked his neighbor (a retired nurse) for some advice.

3. Consider the Symptom- Action –Timeline (SATL). How does it relate to Joe’s situation? How can the nurse be the most effective in this type of situation?

Situation 2

You are the nurse working in a primary care clinic in a rural community. One of your neighbors comes to the clinic but is very hesitant to share her mental health challenges. Please respond to demonstrate synthesis and application of the assigned readings.

1. Compare and contrast probable lack of anonymity in rural vs. urban settings What are at least two positive and two negative factors related to knowing those you care for on a personal level?

3. Consider the Code of Ethics for Nurses, particularly as it relates to professional boundaries. As the nurse, what could you do to help the person seeking care for sensitive concerns share more openly?

Appendix B: Synthesis and Application Assignment

Remember that integrating your own thoughts with evidence from the literature is an effective to demonstrate synthesis and critical analysis. Sometimes a few short direct quotes add value to your work. But remember that long quotes generally serve to share someone else’s thoughts, rather than your analysis. Please refer to the Synthesis and Application folder for a more detail and guidance. 

Criterion

Excellent

Competent

Not satisfactory

Complete

All questions from one chosen scenario/topic addressed in a clear, focused manner. All responses demonstrate critical analysis. (3 points)

Not all questions addressed OR responses not clear and focused

(2 points)

Not all required questions addressed.

(0 points)

Demonstrates

Post demonstrates that the assigned content was appropriately reviewed,

Demonstrates limited familiarity and synthesis

Not all questions addressed. Responses do not synthesis of assigned readings

understood, and synthesized. Minimal direct quotations. (points) (6 points)

of assigned content. (3 points)

demonstrate synthesis of assigned readings

(0 points)

Evidence based

At least two professional resources support post. Resources must be integrated, cited, and referenced per APA style. See criteria for professional references on p. 7

of syllabus. Rare APA style errors. (3 pts)

Supported by fewer than two professional references. Or provides evidence-based, scholarly references using incorrect APA format. Or provides non-scholarly references with correct APA format in-text. (1.5 points)

Provides no scholarly reference to support position/ideas in postings/discussion and /or uses no APA format

(0 points)

Writing quality

Punctuation, spelling, spacing, capitalization, and writing mechanics errors are rare. Writing is clear, succinct, focused, organized, Easy to understand main ideas. (2 points)

Fewer than six total writing mechanics

Writing is focused and organized. (1 point)

Six or more writing mechanics errors; run-on sentences. Writing lacks organization or focus (0 points)

Posted

Posted in both the discussion forum and the assignment box.

(1 point)

Not posted in both the discussion forum and the assignment box (0 points)

Not posted as directed.

(0 points)

Substantive addition – addition must address the topic/situation other than the topic/ situation addressed in your original synthesis and application post to earn any points.

Criterion

Excellent

Competent

Not satisfactory

Addition relevant and valuable to nursing practice

Substantive addition demonstrates thorough review of post. Adds at least one new perspective that would be relevant and valuable in nursing practice situations. (3 points)

Addition accurate, but application to nursing practice limited.

(1.5 points)

Relevance to nursing practice not included.

(0 points)

Demonstrates critical analysis

Offered a critical analysis of an existing posted. Demonstrates that the assigned content was appropriately reviewed, understood, and synthesized.

(3 points)

Addition demonstrates limited synthesis of assigned content related to the situation/topic. Agreed or disagreed, but did not provide justification.

(1.5 points)

Response not applicable to the situation/topic.

(0 points) Supported by evidence

At least one professional resource supports post. Resources must be integrated, cited, and referenced per APA style. See criteria for professional references on p. 9

Supported by at least one professional resource. Provides evidence-based, scholarly reference using incorrect APA format Or provides non-scholarly references with fewer

Provides no scholarly reference to support position/ideas in postings/discussion and /or uses no of syllabus. Rare APA style errors. (3 pts)

than four APA format errors. (1.5 points)

APA format (0 points)

writing quality

Punctuation, spelling, spacing, capitalization and writing mechanics errors are rare. Writing is clear, succinct, focused, organized, Easy to understand main ideas.

(1 point)

Fewer than 6 total writing mechanics

Writing is focused and organized. (0.5 points)

Six or more writing mechanics errors; run-on sentences. Writing lacks organization or focus (0 points