An Exploration of Rural Nurses in Decision Making of Academic Progression


academic progression, associate degree, bachelor degree, nursing education, role transition, rural health, rural nursing, rural RN workforce


Purpose: To explore the meaning that academic progression has for rural RNs and their decision to pursue or not pursue a BSN or higher levels of education.

Background:  Mounting evidence has linked a higher educated nurse with improved patient outcomes and decreased patient mortality prompting leaders in healthcare to call for a bachelor of Science (BSN) degree as baseline preparation for nursing practice Yet, the majority of the nation’s registered nurses (RNs) continues to be educated at the associate degree (AD) level. These numbers are even higher in rural areas of the country, where social determinants of health for rural populations places higher demands on rural nurses to provide quality of care.

Sample: Nine (n=9) AD RNs from a rural community hospital in Pennsylvania who met inclusion criteria were selected.

Methods: A qualitative phenomenological approach was the research design choice which captured the lived experiences of how rural RNs think and feel about pursuing a BSN or higher degree.

Findings:  Findings from this study revealed that rural RNs are motivated by the need for a BSN specifically in regard to job security, professional identity, professional development, personal enrichment, and career mobility and feeling prepared for the demands of 21st century nursing practice. The participants conveyed they want their voices to be heard regarding the unique challenges that rural nurses face in pursuit of a BSN.

Conclusion: Higher education in nursing is now a key imperative. Understanding academic progression in relation to RNs practicing in rural healthcare institutions should serve to disseminate the identified gaps of knowledge in rural nursing education. This study has direct implications for curriculum development and educational strategies focused on producing a more educated rural nursing workforce to meet the growing needs of rural populations.


Keywords: academic progression, associate degree, bachelor degree, nursing education, role transition, rural health, rural nursing, rural RN workforce.

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