Registered nurses' experiences of working with indigenous patients in remote areas in Amazonas, Peru : a qualitative interview study at health clinics in Loreto region

Abstract: Background In remote areas of the Peruvian Amazon there is a high burden of communicable diseases, limited access to health care and a low distribution of registered nurses. Registered nurses are working with indigenous patients in the area, where traditional medicine and practice is common. In order to strengthen the relation between western and traditional practices, intercultural health has been implemented within the public health care. Aim The aim was to describe registered nurses’ experiences of working with indigenous patients in remote health care settings in Loreto region, Peruvian Amazon. Method A qualitative field study with semi-structured interviews was conducted at four health clinics in Maynas and Mariscal Ramón Castilla province. A qualitative content analysis was used when analyzing the data. Findings Three categories were identified in the analysis; Working environment in a remote area, Providing health care for indigenous patients and Including intercultural health in nursing practice. The participants’ daily work with few colleagues and high demand in remote clinics was described. Experiences of working with intercultural health, as well as opportunities and challenges of working with indigenous patients was found. Conclusion The registered nurses work in an area with a high workload, limited resources and geographic isolation. Intercultural implementations were shown to improve intercultural relations, autonomy and health. Challenges between registered nurses and indigenous patients related to communication and different cultures were described. In order to improve the situation and reach the UN Sustainable Development Goals, infrastructural and socio-economic improvements, more resources and health professionals are necessary.