Impact of rural hospital environments on patients and nurses.

Rural hospitals provide life-saving acute care from a consistent group of care providers. Rural hospitals with financial difficulties operate under tight margins as an attempt to prevent closure, which could contribute to not completing repairs needed to the hospital building. This paper explores an ethical dilemma for rural hospital nurse administrators, which is, "Is it better for a rural hospital building is disrepair to remain open so that it can provide a place for some degree of acute care services to be offered in the rural community-or-if a hospital building has structural problems that could lead to harm, should hospital operations cease until a solution is found?" To illustrate this dilemma, I will discuss the challenges of rural hospital administrators and a first-hand experience I had as a bedside nurse who experienced a dangerous near miss related to the built environment. Rural hospitals operating in a built environment in disrepair might need to consider nontraditional, even unusual, solutions to provide safer care given financial constraints. Rural businesses and institutions could consider sharing their building space to provide a safer built environment for nurses and patients while also not placing hospitals at further risk of financial distress.