Advancing Nursing Practice Through Postgraduate Education (Part Two)
Deborah Spence, RGON, RM, PhD, Principal Lecturer, Division of Health Care Practice, Auckland University of Technology
Reference: Wilkinson, J., & Huntington, A. (2004). The personal safety of district nurses: A critical analysis. Nursing Praxis in New Zealand, 20(3), 31-44.
A workplace safety study of district nurses in New Zealand was conducted to explore personal safety experiences. A qualitative methodology informed by Critical Social Theory was employed. This paper details the findings and implications derived from data collected from six district nurses in two urban New Zealand Health Services who recalled incidents in which they felt their personal safety was compromised. Data were collected through individual interviews and a focus group discussion with the participants. Data analysis revealed two-fold risks to nurse safety; these were associated with client behaviour as well as risks embedded in the organisational structure. Findings suggest a number of practical issues involving basic security measures require urgent attention and would mitigate the risk arising from high-risk clients. Attention must also be given to the development of institutional policy that prioritises nurse safety, and has in place post-incident plans and support structures. The complex power relationships that shape the experience of nursing in a community impinged on the ability of the nurses in this study to confidently and safely fulfil their role. An organisational commitment to a culture of safety would help address the powerlessness experienced by district nurses.
Community health nursing; personal safety; critical theory; power structures
Concern for district nurse safety arose from the experiences shared by district nursing colleagues and the personal experiences of the principal researcher while working as a district nurse. Situations where safety was compromised were everyday occurrences that engendered a sense of powerlessness to prevent similar incidents happening again. The way nursing work was organised, and attitudes amongst some staff towards personal safety, perpetuated a level of risk that seemed unnecessary and provided the impetus for conducting this study. Although there is extensive international literature about nurses and workplace safety, particularly in relation to violence, prior to this study there has been no formal research about nurses working in the community in New Zealand. This article describes the experiences of six district nurses from two urban Health Services who recalled incidents in which they felt their personal safety was compromised. A brief review of the literature is presented, followed by an exploration of the nurses’ experiences in the context of the literature. The article concludes with recommendations for institutional change.