[Nursing practices in primary care in remote rural municipalities]

Practices developed by nurses of family health teams (FHTs) in remote rural municipalities were analyzed. A multiple case study with a qualitative approach was conducted through 52 interviews with nurses from 27 remote rural municipalities distributed across 10 states. With few specificities among the remote rural municipalities, nurses stood out for developing a broad range of skills related to management activities, individual care practices, and actions in the local community. Irrespective of the obstacles to care faced by FHTs, the work of nurses stood out in all remote rural municipalities to overcome adversities, reestablish patient flow, and minimize the lack of care as much as possible. In all remote rural municipalities, nurses sought to reestablish the communication link and enable the continuity of care for individuals who required assistance outside primary care. None of the nurses established dialogue between folk knowledge and the biomedical actions of the practices established in primary care but recognized the cultural and ethnic diversity in the local communities. In summary, nurses in the remote rural municipalities sought to overcome communication difficulties and forged - although in a limited way - practices sensitive to the needs of individuals and the community.