Advancing Nursing Practice Through Postgraduate Education (Part Two)    

Abstract
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.     

Keywords
Community health nursing; personal safety; critical theory; power structures     

Introduction
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.