Rural Nursing: Concepts, Theory, and Practice is the fourth edition in a series of texts focusing on the health of rural dwellers; the provision of health care in rural settings; and the requirements for effective nursing practice, education, and research in this context. As with the previous editions, this text builds on the foundation provided by numerous faculty and graduate students from Montana State University College of Nursing and now includes work from researchers from across the United States, Canada, and Australia. In addition to seminal chapters on rural nursing theory and rural nursing practice, there are thirteen new chapters which expand our understanding of what it means to “be rural.”

The genesis of my interest in “being rural” can be attributed to several events; however, three specific events stand out in my mind. The first was a childhood trip to Ohio farm country with my parents and brother to visit my dad’s boyhood home. I was struck by the warm welcome we received from the “old timers” we saw that remembered my dad as a boy and invited us to stay with them. I had the privilege of staying on the farms of two of my dad’s long-time friends, eating fresh vegetables from their immense gardens, helping with the daily chores, and driving a tractor for the first time. I was struck by their hardiness, work ethic, and sense of community even though the nearest neighbors were miles away.

The second event was my move to Montana with my husband and two small sons. My husband had childhood experiences similar to mine since he had visited family who ranched and farmed in Colorado and Texas. We both knew that we wanted to live in a place that had a small town atmosphere and had wide-open spaces. I was lucky enough to land a faculty position at Montana State University. We purchased a log home on a small piece of land and dove into gardening and raising animals for our own consumption (beef cattle, pigs, turkeys, hens, and meat chickens). We relied on books, our fathers, and our neighbors for answers to our questions about farm living. Our boys played in the creek at the end of our dirt road, learned to fish and hunt, and play sports; the usual activities that dominate rural life.

The third event was my assignment to teach a graduate course, Rural Nursing, with Dr. Helen Lee at Montana State University. Helen had been instrumental in the development of a rural nursing theory interest group in the College of Nursing and was the editor of the first edition of the rural text, named Conceptual Basis for Rural Nursing.  We asked the students enrolled in the rural course to interview rural residents to determine their perceptions of and needs for health care. Years earlier, students assigned to a similar course had collected data from rural residents engaged in extractive industries (farming, ranching, and logging) that led to the initial rural nursing theory development. We decided it was time to recheck perceptions of rural residents, only this time from those who were employed in other industries. Thus began more than a decade of collaborative research with our graduate students and others interested in rural nursing theory. Along the way, Dr. Lee and I edited two more editions of the rural text.

The fourth edition of Rural Nursing: Concepts, Theory, and Practice continues to expand our understanding of the rural health care environment. New chapters have been added on topics important to rural providers, educators, and researchers including: A review of literature on rural nursing theory; U.S. – Mexico border health issues; occupational health and safety in agricultural communities; and rural nursing workforce development.

More than four decades have passed since the College of Nursing developed a graduate program that focused on the care of individuals living in a rural/remote environment. The published editions have recorded the progress of our work and the expansion of content beyond Montana to the U.S. and to countries beyond our borders. The extension of the content areas and the countries represented demonstrate the book’s importance to nurse educators, researchers, clinicians, and policy makers.