Training for rural nurses helps keep farmers healthy

Nursing and agriculture go hand in hand for Lauren Fields, Nelda Campbell, and Amy Kilcannon. When their nursing shoes come off, their chore boots go on.

Fields has lived in rural Arkansas all her life. She grew up on a farm, married a farmer, and started her journey as a nurse right out of high school. Today, she holds the credentials MBA, BSN, RN, and is the chief nursing officer for ARcare, a federally qualified health center providing affordable care to mostly rural patients in Arkansas, Kentucky, and Mississippi.

Like all nurses, Fields must earn ongoing educational credits to maintain her license. She recently met that criteria by participating in the Nurse Scholar program from AgriSafe, a nonprofit organization that provides agricultural occupational health services. The course is taken online at the nurse's convenience. While there is a fee, scholarships are available.

"We don't learn about ag-specific issues in nursing school," says Charlotte Halverson, BSN, COHN-S, AgriSafe clinical director. "Our Nurse Scholar program helps nurses learn to prevent, identify, and assess health issues related to agricultural work."

Lifelong learning

The course covers topics including personal protective equipment, respiratory disease, hearing protection, dermatologic disorders, pesticide exposure, women's health issues, the opioid crisis, zoonoses, immigrant farmers, safeguarding children, rural behavioral health, musculoskeletal disorders, and aging.

Fields says the program is useful to even experienced nurses. "Mental health was a refresher for me and one of the things I got the most good out of," she says.

The course also taught her about whole body vibration, which can occur when operating tractors or other machinery and can cause injury to the musculoskeletal, circulatory, and nervous systems.

Fields was able to put that knowledge into practice right away by recommending exercises and stretches to a farmworker who complained of back pain after driving a tractor. "That was an evaluation I could make that I never knew existed in all my years of nursing until the course," she says.

Sharing knowledge

Fields says once the 300 nurses on her ARCare team have a chance to catch their breath after COVID and research ongoing credit options, she will recommend they look into the Nurse Scholar program.

"I want them to be able to better connect with the rural population and to understand why farmers often feel like they don't have time for prevention," she says. "They are busy and things have been done a certain way for generations and generations. If those nurses can better understand the dynamics of the culture of farming, then they can take care of the farmer with more empathy."

Teaching preventive care

Nelda Campbell, RN, COHN, CPDM, got her start working in a hospital, then making in-home visits to rural patients as a home health nurse. She now works as a regional nurse case manager for Mars/Wrigley. She grew up on a farm and runs a row crop, forage, and cattle operation with her husband and sons. Her daughter and son-in-law are also engaged in farming.

"Having the course all online and at your own pace was fantastic for me because I work all day and have five grandchildren under the age of 2, including triplets," she says.

Campbell would often start a course late at night. "The courses were so interesting that I wanted to be able to focus, listen, and take notes," she says. "The flexibility was great."

Three of the major takeaways for Campbell were mental health, children's safety, and ergonomics. "The mental health training really resonated with me because many farmers don't ever want to admit something like that, so it's very important we get out there and let them know their mental health matters," she adds.

Campbell is especially interested in teaching young people about proper ergonomics when it comes to lifting and other jobs. "They think their bodies are invincible in their 20s, but if they aren't doing things correctly, over time the wear and tear will catch up with them," she says.

Lessons from the Nurse Scholar program apply to her nursing and farming careers and she's eager to share her knowledge. "I definitely learned some things I can utilize in the day-to-day farming of our own operation plus at work," Campbell says. "My wheels have been turning on how I can get that information out there; I'm excited to use the tools."

Digging deeper into diagnoses

Amy Kincannon, MSN, RN, grew up in Louisiana with a high school teacher/farmer father and nurse mother. She followed in both of their footsteps, farming with her own family today and serving as assistant professor of nursing for the Kitty DeGree School of Nursing at the University of Louisiana Monroe.

She completed the Nurse Scholar program in January and was able to put the things she learned into practice right away by staffing a booth at an agricultural expo. "There were hundreds of ag workers coming through. I asked everyone if they had heard of whole body vibration, and not a single one had," she says. "It was phenomenal to be able to share information I had just learned the day before."

Kincannon says the environmental health lessons in the course were very valuable. "We test for the flu all the time, and it never hit me to go back if it's negative and ask if the person has been around livestock, on a farm, or what environmental things they've been exposed to. We should be doing that. We're pitiful as health care providers for not asking those questions and just saying, 'It's negative for influenza; good luck.' What a shame for the patient. We should always do an environmental health history when there's no clear-cut diagnosis." She says that history should include whether the person uses water from a well and if it has been tested.

Another environmental hazard is anhydrous ammonia. "I am so ashamed to say that I never knew how to treat a patient if they ever came in exposed to that," she says, as it wasn't used on her farm growing up. "I would've never known to douse them with water immediately following an exposure. I didn't know, and I'm supposed to be a professional. How many health care workers with no ag background who see these kind of folks in the community or in the ER are going to know to apply water to decontaminate the victims?"

While the Nurse Scholar program was easy to complete as far as timing and accessibility goes, Kincannon says that doesn't mean the coursework was easy. "It was a challenge; it was not a giveaway even for an old farm girl," she says. "It made me critically think, which is something I stress to my students all the time. I say, 'I can spoon-feed you but that's not going to help you when you're working in a hospital or in the community and I'm not there for you. You need to learn to critically think.' The program did that for me."

Learn More

The AgriSafe website, agrisafe.org, is full of information on a variety of health and safety topics. To learn more about the Nurse Scholar program, apply for scholarships, and register for the course, which provides 20 hours of ongoing education, visit agrisafe.org/courses/nurse-scholar. The deadline for the 2024 class is April 8.