Nurses’ Views of Family Nursing in Community Contexts: An Exploratory Study
Judy Yarwood, RN, MA, Principal Lecturer, School of Nursing, Christchurch Polytechnic Institute of Technology, Christchurch
Reference: Yarwood, J. (2008). Nurses’ views of family nursing in community contexts: An exploratory study. Nursing Praxis in New Zealand, 24(2), 41-51.
In their day to day practice nurses interact with ‘family’ as a whole in a variety of community locations. Public health, Practice, District, Well child health and Rural nurses participated in a qualitative study in which four focus groups were used to explore the ways in which each nurse integrated ‘family’ into their practice. Thematic analysis of the data revealed four related themes: the labyrinth of family nursing, relational webs, personal and professional knowing, and contextual determinants. It was found that ‘family’ was integrated into participants’ community practice in a “narrative, dialogical, relational and contextual” manner (Doane Hartrick, 2002, p. 623). Each family/nurse interaction had its own story exemplifying the contextual complexity and uncertainty, while at the same time showing the deep satisfaction inherent in working with families. Paramount in this practice was dialogue and building relationships, not only with families, but also with colleagues, health and other professionals. While it is apparent a family/family health nursing role has yet to be established, the possibilities of such a role have been recognised in this study. Yet considerable work still remains to be done before this nursing role is seen as an imperative in improving family health and wellbeing.
Family, family nursing, community nurses, relationships
In the delivery of health care Public health nurses were among the first to regard the family as a whole, rather than the individual, as the focus of their practice (Whall, 1986). Variations of family nursing are now seen as a crucial dimension of contemporary nursing practice (Doane & Varcoe, 2005; Litchfield, 2005; Parfitt, 2007). While it is acknowledged that many nurses interact with family members of a person for whom they are caring, the focus of this study was to obtain a clearer understanding of how present day community nurses in one geographical region within New Zealand integrate ‘family’ as a whole into their practice. A variety of terms describe family nursing as a method of care provision in both institutional and community settings. These include family nursing, (Doane, 2005; Friedman, 1998) family health nursing, (Denham, 2003; Hanson & Boyd, 1996; Parfitt, Cornish, Whyte & Van Hooren, 2006) nursing of families or family systems nursing (Wright & Leahey, 2000) and family centred care (Darbyshire, 1995). Little consensus exists as to what is encompassed by any or all of these roles.