To meet both current and future competence needs, improved and updated understanding of nurses’ scope of practice when working in remote communities is needed. The aim was to describe and analyze the characteristics of nursing encounters in primary healthcare in remote areas. The setting for the study was an island community in Finland. Nurses’ patient record documentation and self-reports on patient encounters were surveyed ( n = 1062). Patients aged ≥65 years accounted for most encounters. Great variety in the encounters was seen, though some nursing tasks and patient conditions were overrepresented. For patient safety reasons, it is important to review how nurses maintain competence regarding those tasks and conditions encountered less often. Primary healthcare services should focus on the broader determinants of health. However, a more disease-oriented focus was seen. To ensure quality of care in primary healthcare in remote areas, there is a need for standardized routines for monitoring patients and documenting findings and performed interventions.

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AimThe aim of this study was to illuminate the meaning of being a nurse in the archipelago.Methodological Design and JustificationA phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago.Ethical Issues and ApprovalApproval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate.Research MethodIndividual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method.ResultsThe analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub‐themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub‐themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub‐themes: Having responsibility for the islanders and Having an intertwined private and work life.Study LimitationsThe interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others.ConclusionBeing a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.

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