Lack of Anonymity and Secondary Traumatic Stress in Rural Nurses

Purpose: The purpose was to determine the prevalence of lack of anonymity (LA) and secondary traumatic stress (STS) among nurses; determine if nurses’ LA and STS differ by population density and examine the relationship between lack of anonymity and STS. Design and Method: A descriptive correlational study examined LA and STS in a random sample of 271 nurses from counties with differing population densities (rural, micropolitan and metropolitan) of a Midwestern US State. A 3-group design was used to examine the relationship between LA and STS in nurses, living and working in these counties. Data on lack of anonymity, secondary trauma and demographics were collected through online questionnaires. Findings: Rural nurses had a higher prevalence of LA than micropolitan and metropolitan nurses. While the prevalence of STS among rural nurses was higher than either micropolitan or metropolitan nurses; there was no difference in STS among the three population groups. Lack of anonymity and STS were related; however, analysis revealed that LA and STS are inversely correlated, indicating that as LA increases, STS decreases. A majority of rural nurses (90%) reported living in a rural community prior to their 18th birthday. Conclusions: Rural nurses experience STS at similar rates as their metropolitan and micropolitan counterparts, indicating that population density may not be a factor related to the development of STS. LA appears to have a positive effect on reducing STS in rural nurses. Clinical Relevance: The study advanced the understanding of LA and STS among nurses who live and work in different population densities. The social support within rural health care facilities and communities may play a role in mitigating the effects of indirect stress. Keywords: rural, rural nursing, lack of anonymity, traumatic stressDOI: https://doi.org/10.14574/ojrnhc.v21i1.651

Navigating public health clinical placements for rural online RN-BSN students

Purpose: In rural settings scare public health resources potentially limits the opportunities for nursing students living in these areas to participate in traditional one to one precepted experiences with public health agencies. To meet the revised Commission on Collegiate Nursing Education Standards related to direct clinical practice, creative strategies are needed for online degree seeking RN-BSN students who live in rural areas. This article explores an alternative learning experience by partnering students with a nonprofit healthcare institute to work on state health initiatives in the geographic region where the students reside. Process: In the absence of adequate opportunities for one to one precepted clinical experiences, student living in rural areas completing an online RN-BS program were partnered with a non-profit health organization. The students participate in an experiential learning experience to fulfill clinical hours in a public health setting as required by the Commission on Collegiate Nursing Education. In this case a cohort of students worked with a nonprofit healthcare institute on New York State’s T-21 campaign to further advance their knowledge on health initiatives driven by state health reform policy and actively participate community-based education. Conclusion: With a growing focus on population-based care and caring for vulnerable populations, particularly in rural areas, seeking clinical activities through partnerships with non-profit healthcare institute to improve health outcomes at the community level offers an alternative approach to engaging online degree seeking RN-BSN students in experiential clinical learning in communities with limited public health agency placements. Keywords: interprofessional learning, nursing accreditation, rural nursing students, service-learning pedagogy DOI: https://doi.org/10.14574/ojrnhc.v21i1.664