title: The nature of nursing practice in rural and remote areas of Greenland.
abstract: BACKGROUND
  The Greenlandic Healthcare Reform (2010) required improved quality of services for health promotion, prevention of infectious and lifestyle diseases, family nursing and evidence-based clinical nursing.
  
  
  OBJECTIVE
  To investigate current nursing practice in Greenland and to identify whether it meets the requirements of healthcare reform.
  
  
  METHODS
  This ethnographic study utilised documentary analysis, participant observation and qualitative interviewing carried out in remote areas of Greenland during 2011-2012. Eight registered nurses, four women and four men, aged between 35 and 55, participated in this study. Four were working at healthcare centres in towns and four were working at nursing stations in villages. The nurses were educated in Greenland or a Nordic country and had been practicing nursing for at least 2 years in an Arctic region. They were observed for 1-5 days, and subsequently interviewed. Interviews included in-depth questioning, based on emerging outcomes from observation. Interviews were recorded and transcribed; they were analysed within a phenomenological-hermeneutic approach.
  
  
  RESULTS
  Nurses in rural and remote areas navigate their health promotion and preventive work with conflict between health strategies and everyday realities, where unpredictable tasks often lead to prioritisation of urgent, acute work. There is interaction between personal and professional skills. Everyday life is characterised by opportunities and challenges in the grey areas, namely nursing, medical and social work.
  
  
  CONCLUSIONS
  The nature of nursing practice in rural and remote Greenland is characterised by a high degree of variability and complexity, with a requirement for a wide range of knowledge and skills. Nurses need to be better prepared with regard to acute medical care, preventive care, social work, humanistic approaches and information technology to implement the ideology of health strategies.
authors.affiliation: Institute of Nursing and Health Science, University of Greenland, Nuuk, Greenland. lhounsgaard@health.sdu.dk
authors.forename: Lise
authors.initials: L
authors.lastname: Hounsgaard
authors.forename: Anne Birgitte
authors.initials: AB
authors.lastname: Jensen
authors.forename: Julie Præst
authors.initials: JP
authors.lastname: Wilche
authors.forename: Ilone
authors.initials: I
authors.lastname: Dolmer
mesh_terms: D000328:Adult; D005260:Female; D006116:Greenland; D018166:Health Care Reform; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009739:Nursing Services / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*
keywords: Ethnographic study; Greenland; nursing practice; remote and rural areas