Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems.