Comparing Urban and Rural Nursing: Key Differences and Similarities

City nurses and rural nurses have the same job, but the healthcare cities in their respective communities typically have many significant differences. Urban hospitals are overflowing with patients. They experience higher instances of violent crime. During times of viral illness, their infection rates are considerably higher.

Rural hospitals aren’t a walk in the park either. They are understaffed, underresourced, and at the center of many serious health problems as well. Rural America has extremely high rates of opiate addiction, even in minors.

It’s never a walk in the park working at a hospital. If you are a nurse considering which path is right for you, read on as we compare and contrast urban and rural nursing.

A Common Ground

First of all, it is important to understand that rural and urban nurses share the same basic background. Regardless of their location, both began their journey by entering into some sort of program that certified them as an RN.

There isn’t a unique credential for working in the country versus the city. It sounds almost obvious to say but it is a meaningful distinction to bear in mind.

Many people on both sides of the cornfield border assume a degree of separation between city and rural people that doesn’t exist in real life. There are, of course, important cultural differences between the two settings.

However, at the end of the day, we’re talking about people. From a health perspective, as well as a social one, people are pretty much the same wherever you go.

Nice speech Ms. America. Doesn’t that sort of undermind the concept of your article?

Ahem. Yes. Well, while the human element of healthcare does remain consistent between settings, there are experiential differences that are worth exploring. Below, we compare and contrast rural/urban healthcare.

Patient Demographics

One of the most obvious differences between rural and city nursing is the patient demographics. Urban nurses will come across people from all parts of the world. The bigger the city, the more diversity there will most likely be.

In rural settings, there certainly can be some diversity, but the overall demographic tends to be more monolithic.

Why does this matter? Interacting with people from different backgrounds can require more social awareness and sensitivity than is usually required when working with people you share a background with.

As a city nurse, you will need to be willing to understand other people’s cultures and treat them with respect accordingly.

The Urban Advantage

Talk to any nurse working in an urban setting, and “advantage,” probably won’t be the first word they reach for when describing their place of work. Still, compared to rural hospitals, city systems do have significantly better access to resources.

Some of these resources are staffing-related. It’s hard for rural hospitals to find people for the simple reason that they have a much smaller candidate pool to choose from.

It goes deeper than that, though. City hospitals have more access to specialists and advanced treatment technologies. In fact, when rural people are diagnosed with a particularly challenging or sensitive illness, they will often be referred to urban hospitals.

Scope

Piggybacking off that last idea, urban healthcare workers have more of an opportunity to specialize than their rural counterparts. Because they typically have access to more people, it becomes possible to designate specialty groups.

A nurse working on the cardiac floor in an urban hospital may not need to abruptly change lanes into respiratory.

Rural hospitals are the opposite. They have fewer people to work with, so everyone needs to be versatile in their skills.

From a purely third-party perspective, it is difficult to say which arrangement is better. On the one hand, skill diversity is definitely a good thing. On the other hand, it can also be nice to be on the receiving end of highly specialized care.

Community Bonds

One thing rural hospitals typically do better than their urban counterparts? Community building. It’s hard to establish bonds when you are offering care to tens, or even hundreds of thousands of people. In rural hospitals, the patient pool is considerably smaller.

What’s more, there are also fewer hospitals to go around. One rural county might be served by a single hospital. That means everyone in the community is going to the same place when they require healthcare.

Common Cause

We talked a lot about what rural hospitals have versus what urban ones have. The truth is that neither setting has enough. Hospitals all over the country, all over the world, in fact, are struggling to meet basic needs.

Part of this problem is staffing-related. Just last spring an ER nurse in Washington had to call 911 and ask for backup support. The hospital wasn’t trying to process the victims of a large accident. They just didn’t have enough people to deal with a typical shift.

That’s a big problem, but not an uncommon one. It’s also an issue that has been going on for a long time. More nurses are leaving than coming in.

The new arrivals are entering a challenging time in the history of healthcare. Costs are rising. Technology is changing the experience in ways that no one can quite predict. And community distrust of healthcare has reached a high point as many people all over the country struggle to embrace vaccines and other forms of preventative care.

In other words, nursing isn’t easy, regardless of where you find yourself in the world.


Image by Yaroslav Danylchenko on Freepik


With a Bachelor’s in Health Science along with an MBA, Sarah Daren has a wealth of knowledge within both the health and business sectors. Her expertise in scaling and identifying ways tech can improve the lives of others has led Sarah to be a consultant for a number of startup businesses, most prominently in the wellness industry, wearable technology and health education. She implements her health knowledge into every aspect of her life with a focus on making America a healthier and safer place for future generations to come.


Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.