Perceived Facilitators and Barriers to Rural Nursing Practice
Regardless of the type of work they are engaged in (ambulatory care practice versus other settings) or the geography of the facility in which they practice (rural, suburban, or urban), nurses are in general satisfied with their work. A majority of responding nurses reported that it was "not at all likely" they would leave their current job within the next year (73.3%), and nearly all reported that it was "not at all likely" they would "leave nursing altogether" in the next year (94.2%). Ambulatory nurses responded similarly with 74.0% indicating that they were "not at all likely" to leave their current job within the next year and 94.2% indicating that it was "not at all likely" they would "leave nursing altogether" in the next year. Nurses perceive that their jobs offer them respect from colleagues (83.0% all nurses, 82.2% ambulatory practice nurses) and a chance to use their personal initiative (87.3% all nurses, 89.4% ambulatory practice nurses).
The most crucial finding of the present analysis pertains to rural nurses' perception of their preparation for their practice. Both among the total respondent group and among ambulatory care nurses alone, nurses working in rural settings were more likely to indicate that inadequate training was a barrier to their work performance. Correspondingly, rural nurses in the total group, although not among ambulatory care nurses alone, were less likely to report that their nursing education had equipped them for work. In assessing these findings, it should be noted that while rural nurses were more likely than urban or suburban nurses to have a diploma or associate degree, they were also more likely than urban nurses to have an MSN. In addition, education alone was not associated with perception of educational preparation. When responses are tallied by the respondents' educational attainment, no significant differences are present. Thus, it would appear likely that unique characteristics of the rural practice environment are causing nurses to perceive educational or training gaps.