Introduction: The health workforce is crucial to reduce inequalities in health and health care in rural areas, and nurses, although it is still a scarce category, stand out in this work when compared to other professionals. There are few studies addressing nurses' work in the rural context. This study aimed to investigate the satisfaction and difficulties of the work of primary health care nurses in rural areas.

Method: This is a case study with a qualitative approach, whose scenario were the health units in the rural area of a large city in the state of Paraíba, Brazil, with Family Health Strategy teams. Eleven nurses working in rural areas participated in the study. Data were collected through interviews with semi-structured script and submitted to content analysis.

Results: The study revealed that nurses working in rural areas have experienced job satisfaction with the recognition and gratitude of families, one of the major motivations for professionals interviewed. The nurses are committed and have adequate training in the area of activity. The working conditions, infrastructure, forms of access to the workplace and distance from the decision center are factors that stand out as difficulties of work.

Conclusions: The nurses appreciate each other in their work, establish good relations with the population and work as a team despite the difficulties. The study reveals that nurses and the population experience isolation in the rural area as well as difficulty in accessing the workplace, in the case of practitioners, and in consolidating policies maintained in the urban area. It evidences the nurse as an essential element for Primary Health Care in the rural setting, which can make the difference in the care of populations often in the sideline of health services.