As technology advances and access to smart devices and the internet increases, remote nursing is becoming increasingly popular. According to Future Market Insights Inc., the remote healthcare market is expected to grow from $13 million in 2025 to $84 million by 2035. This rise is primarily driven by a need for more access to care in rural communities.
Related CE course for nurses: Fundamentals of Telehealth: Registered Nursing Practice in the Virtual Care Environment
Health and healthcare in rural settings
Nurses working remotely or providing virtual consultations should be aware of the unique challenges facing patients living in rural communities. Patients in rural areas may have difficulty accessing specialty care and limited access to pharmacies. In addition, financial challenges, poverty, and lack of insurance coverage are more common in these communities.
Inequities in rural healthcare
The Rural Healthcare Information Hub identifies several inequities in rural healthcare compared to larger urban areas. These include:
Fewer healthcare providers per capita. Research shows that health outcomes improve when a community has at least 10 primary care physicians per 100,000 population. This ratio is rarely met in rural communities. The Association of American Medical Colleges estimates that there will be a shortage of up to 40,000 primary care physicians by 2036. These shortages most often occur in rural communities.
Limited access to specialists. Patients needing specialty care or high-acuity hospital care often have to travel long distances to receive services. For example, in the mountain west region in the United States, there is only one trauma one pediatric center to cover Utah, Nevada, Wyoming, Idaho, Montana, and Colorado. Critically ill children often need to be flown to a different state to receive the care they need.
Patients in need of frequent specialty care such as dialysis, wound debridement, or chemotherapy may even have to move away from their homes or communities to receive care.
Related CE course for nurses: Recognizing and Mitigating Implicit Biases in Healthcare
Additional challenges for rural populations
Increased poverty rates. In 2023, about 11% of people living in rural communities did not have any insurance coverage, compared to just 8% of the general population. In addition, 13.6% of the rural population has an income below the national poverty level. Counties with known persistent poverty are almost exclusively rural. Cuts to Medicare and Medicaid are sure to further increase challenges for people living in rural communities.
Health behavior. Rural communities have higher rates of smoking, obesity, alcohol use, and illicit drug use. Those living in these areas are also less likely to see a physician for well-check visits, preventative care, and health screenings.
Increased incidence of disease. All these risk factors combined lead to higher rates of disease and death in rural communities. Rural populations also have significantly higher rates of:
- Heart disease
- Cancer
- Unintentional injuries
- Chronic lower respiratory disease
- Stroke
- Alzheimer disease
- Diabetes
- Kidney disease
- Influenza and pneumonia
- Suicide
Quality and Safety Education for Nurses (QSEN)
Nurses can have a large impact on outcomes for patients in rural communities by following the 6 core competencies of QSEN. These include the following:
Patient-centered care
Focusing on patient-centered care means understanding the barriers faced by the patient and finding ways to help them reach their highest level of health. A remote nurse can do this by using active listening, gaining a good understanding of the patient’s health goals, and exploring more than one solution to the patient’s concerns.
Teamwork and collaboration
Complex and chronically ill patients almost always need more than one caregiver to support them in their healthcare journey. Virtual caregivers especially must collaborate with case managers and community services to coordinate things like medication delivery or transportation to and from appointments.
Evidence-based practice
Evidence-based practice means staying up to date on the latest healthcare research and recommendations. Many patients may have questions, and some may even harbor a mistrust of healthcare providers. Being able to answer questions and ensure that the team is following best practice can help calm the patients’ fears and re-establish trust.
Quality improvement
Advances in technology such as artificial intelligence and health tracking devices have made providing virtual care much more convenient. When it comes to remote nursing, it’s important that practitioners understand the technology well enough to help their patients troubleshoot equipment and ensure accuracy from a distance. It takes special skill to deliver high-quality care virtually, but it can be done.
Safety
Keeping patients safe should always be a priority, whether in person or virtually. In a virtual setting, solid cybersecurity is vital for protecting patient information. In addition, nurses can keep patients safe by helping them identify where to find accurate medical information online.
Informatics
Informatics is a computer science that involves collecting and interpreting information to help patients, organizations, and the community. Rural and virtual nurses can use informatics to improve care for communities with unique needs.
Virtual care, telehealth, remote patient monitoring systems, and artificial intelligence have made an enormous impact on remote nursing. While healthcare is rapidly evolving, nurses must keep these core competencies in mind. They help nurses provide quality care to patients across all settings but become especially important when caring for underserved populations.
