Highlanders: a qualitative study to explore the experiences of home care nurses in rural areas in Italy.

Abstract Introduction and aim: Home care in rural areas is characterised by peculiarities linked to both the type of care of the patient and his/her family and the context in which it is provided. International studies have highlighted the need for specialised training and advanced clinical skills to work in this feld. Currently, there are no studies in the literature that explore the experiential feelings of Italian nurses who provide home care in rural areas. Setting: Rural areas in Italian Apennine District. Participants: Italian home care nurses in the selected areas. Design: Qualitative study using a transcendental phenomenological approach. Semi-structured interviews were conducted face-to-face, and audio was recorded with home care nurses. Results: Eleven nurses (mean age, 53 years) were interviewed. Four themes supported by nine codes emerged: "Entering your homes" (Stepping lightly; a matter of trust; key professional); "Being home care nurses in rural areas" (Working alone, autonomy, responsibility and gratifcations; ideal characteristics of home care nurse); "Love and hate toward doctors" (Family doctors; ANT doctors); "The territory: the Apennines and mountainous areas" (working in rural areas; healthcare professionals). Discussion and conclusions: The risks for home careers in rural areas are related to the vastness of the territory, long car journeys, the harsh climate in winter, and pets in the homes. The beauty of the area, the close relationship established with the families in charge, and daytime working hours are reasons for great professional and personal satisfaction. Some modalities and forms of collaboration with general practitioners can be improved.