Date of Award

Spring 2020

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Frenn, Marilyn

Second Advisor

Haglund, Kristin

Third Advisor

Young-Brice, Amber


Higher levels of nurse education have been associated with improved patient outcomes and lower healthcare costs. Members of rural populations are vulnerable, having poorer outcomes than urban inhabitants on a number of health indicators. Rural nurses are more likely than urban nurses to enter practice with associates degrees. Hence, academic progression is important for rural nurses and for the health of rural patients and communities. Rural nurse leaders work to promote the academic progression of rural nurses. Grounded theory methodology was used in this study to describe the concerns of and the actions taken by nurse leaders in the promotion of rural nurse academic progression. Data were derived from semi-structured interviews with 14 rural nurse leaders who practiced in a variety of nursing educational, organizational, and policy roles in a Midwestern state. The theory of leading through distance emerged from these data. The theory states leaders of rural nurses promote rural nurse academic progression by reconciling resource distance, bridging social distance, working through cultural distance, and lessening profession distance; all through the perspective of their professional practice of delivering rural nursing. Members of all populations should have access to high quality nursing care. Rural nurse academic progression promotes health equity for rural populations. The findings of this study suggest leadership of rural nurse academic progression may be enhanced through minimization of the effects of nurse workforce shortages in rural settings, through resource allocation to rural nurse academic progression, by helping rural nurses to navigate social and cultural challenges related to academic progression, and through strengthening the iterative bonds between rural nurses and the greater nursing profession.

Included in

Nursing Commons