Abstract
AIM: This study aims to explore the experiences and challenges faced by rural nurses in Botswana who manage births outside the hospital environment, providing insights into the impact of these experiences on maternal and neonatal health outcomes. DESIGN: A qualitative descriptive design was employed to gain a comprehensive understanding of the participants' perspectives and experiences. METHODS: Twenty-six registered nurses from four remote health districts in Botswana were selected using a purposive convenience sampling technique. Semi-structured interviews were conducted to gather in-depth data regarding their experiences managing childbirth in rural settings. RESULTS: The analysis revealed that nurses face significant emotional and practical challenges, including feeling unprepared for emergencies, lack of access to resources, and high levels of stress associated with managing complications without specialized training. Many participants reported a strong commitment to their communities despite the hurdles, underscoring their vital roles in maternal healthcare. DISCUSSION: The findings indicate a pressing need for enhanced training programs and support systems for rural nurses to better equip them for the complexities of childbirth management outside hospital settings. Addressing these gaps is essential to improve clinical outcomes for mothers and infants and to minimize the risks associated with unsupervised births. CLINICAL RELEVANCE: This study highlights the crucial role rural nurses play in maternal health and stresses the need for targeted training and policy interventions. By strengthening the capacity of these healthcare providers, we can work toward reducing maternal and neonatal morbidity and mortality rates in Botswana and similar rural settings worldwide.