Hemodialysis Nurse Practitioner Challenges in Rural Areas
Shawona Daniel, RN, PhD, CRNP, ANP-BC & Laura Steadman, Ed.D., CRNP, MSN, RN
Nurse practitioners (NPs) play a crucial role in delivering specialized care to rural patients with chronic kidney disease (CKD), where nephrologist availability is limited (Schreiber, 2020). While NPs have the expertise to fill this gap through patient assessments, complication monitoring, and dialysis prescriptions (Kaiser et al., 2019), hemodialysis NPs in rural areas face several challenges that potentially impacts the quality of care provided to these patients. One of the most significant challenges is scarcity of healthcare resources, such as primary care providers, specialized providers such as nephrologists, and other vital medical resources (Jones & Smith, 2020). Additionally, many patients living in rural areas must travel long distances to reach dialysis centers, resulting in missed or delayed treatments and increasing complications’ risks (Anderson & Roberts, 2021). Lack of public transportation options and financial constraints compound this issue. Insufficient resources and adequate support further hinder the NP’s ability to manage complex cases, making it difficult to provide the highest level of care.
Despite these challenges, hemodialysis NPs in rural areas are key in improving patient outcomes. For example, NPs reduce the need for patients to travel long distances for care, which is particularly beneficial for individuals with limited mobility or financial resources (Ryan & Stone, 2021). NPs offer education related to treatment adherence, diet modifications, and the importance of regular follow-ups, which also significantly improve patient outcomes. Overall, NPs ensure a holistic approach to CKD treatment and support the broader healthcare infrastructure in rural regions, highlighting their importance in the healthcare system. Addressing CKD care barriers through community stakeholders, policy changes, and community, regional, and national resources also significantly enhance care in underserved rural communities.
References
Anderson, L., & Roberts, L. (2021). Transportation barriers for dialysis patients in rural areas: Implications for care. Journal of Rural Health, 37(2), 201-208. https://doi.org/10.1111/jrh.12456
Jones, T., & Smith, D. (2020). Barriers to nephrology care in rural communities: The role of nurse practitioners. Nephrology Nursing Journal, 47(3), 221-228.
Kaiser, M., Jones, T., & Smith, D. (2019). The role of nurse practitioners in managing chronic kidney disease in underserved areas. Journal of Rural Health, 35(3), 357-365. https://doi.org/10.1111/jrh.12345
Ryan, R., & Stone, M. (2021). Addressing healthcare gaps in rural communities: The role of nurse practitioners in dialysis care. Nephrology Nursing Journal, 48(4), 297-305.
Schreiber, M. (2020). The impact of nurse practitioners on rural healthcare: Enhancing dialysis care in underserved populations. Journal of Nephrology, 40(5), 411-418. https://doi.org/10.1016/j.jn.2020.06.017
