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Preface
Children, Families and Nursing
Spotlights, Shadows and Places in Between
Philip Darbyshire
Department of Nursing and Midwifery Research and Practice Development, Children, Youth and Women's Health Service, University of South Australia; Flinders University, Adelaide SA
Debra Jackson
Professorial Fellow, School of Nursing, Family and Community Health, University of Western Sydney, NSW
Article Text
Family isn't about whose blood you have. It's about who you care about.
~Trey Parker and Matt Stone, South Park, Ike's Wee Wee, 1998~
The 'family' has been perhaps the most scrutinised of all social institutions. It has been endlessly theorised, philosophised, conceptualised, idealised, demonized, politicised, deconstructed, and reconstructed. As an institution the family has been idealised to the point where adding 'family' as a qualifier to almost anything confers instantaneous virtue. Mere 'values' seem bland compared to 'family values', a friendly hospital pales into insignificance beside a 'family friendly' one and of course at election time the stampede of politicians eager to 'support the family' will be positively Gaderine. Recall George Bush senior's claim that America's families needed to become more like the Walton's and less like the Simpson's and here in Australia John Howard's sudden largesse in ensuring that every new baby arrives with a free gift of $3,000 for its mother. As a social institution, the family has intrigued generations of writers, poets, politicians and assorted 'ologists', but the inner workings and everyday dramas of families fascinate we 'ordinary' people too. Thus 'family life' is a staple of high drama, opera, cinema, 'soapies', books, and the ever-more prurient and voyeuristic 'Reality TV'.
Because of the spotlight that has been shone on the family, there is much that we know about it. However, the glare of the spotlight also casts some long shadows; there are many things that we still do not know and much that remains hidden behind closed doors. The dilemmas for research and social and public policy are obvious. Where is the balance between privacy and state scrutiny, between a family's rights to live according to their values and choices and any greater societal good, between parents' childrearing 'styles' and children's wellbeing, and countless other tensions?
Among the major contributions of feminism and feminist thought was the recognition and acknowledgement of the 'public/private divide' (Hughes 1997:26) that exists between work life and home life. Gatens (1991) suggests that men can achieve what she terms public disembodiment and thus realise a public and private divide. However, this is only attainable because of the gendered nature of social life which permits men to bypass or transcend certain 'natural functions, childrearing, sensuality and so on' (Gatens 1991:6). These, she argues, have become the domain of women, and are relegated to the home - the realm of `private life'. Family life then, and the relationships that constitute them, lie firmly within the domain of the 'private' world (Hughes 1997).
However, changes in workplace culture that affect both men and women may well eclipse such a predominantly gendered understanding. Both men and women are in danger of losing a distinction between work / home and public / private. Technology, which was of course going to liberate us and create endless leisure time, has in fact been instrumental in making us work longer and harder than the most tyrannical, Dickensian boss ever could. For many workers the idea of a 'working week' is at best notional if not absurd. You finish work when the work is finished. The workplace has spread into the home and now we leave 'the office', pack up the laptop and then continue in our 'home offices'.
The instrumental thinking and technological understanding that drives these changes spills over into the place and care of children. The generation of thrusting parents who valorize effectiveness, efficiency and outcomes have created a world where children can't 'just play' - they must have 'structured activities'; where they can't just daydream and fantasise lest they demonstrate 'off-task behaviour'; where a toy shop becomes an 'early learning centre'; where the 'indoor child' is safe, good and responsible and where the 'outdoor child' is an accident waiting to happen or an emblem of social danger. Sociologist Frank Furedi may not be far wrong when he titles his book 'Paranoid Parenting'. We adults have presided over a world where children's childhoods have shrunk to fit the adult-sanctioned confines of a risk-managed 'adventure playgound' that is as much fun as homework or the corporatised theme parks that deliver children into the waiting arms of the advertisers. Ask any adult about the things that they used to do as kids and then ask them to compare that with their own children's breadth of experiences. Watch for the look of regret.
Overworking parents desperately try to schedule in some 'quality time' in the name of 'hyper-parenting' (Rosenfeld & Wise 2001) to be with their equally overscheduled children (Elkins 2003) while convincing themselves that children are 'resilient' and so they will be OK. Alvin Rosenfeld cuts straight to the chase and calls parenting 'America's most competitive adult sport' (Rosenfeld 2004); we have a sense that not too many Australians would disagree. It is of course too easy for older adults to wallow in nostalgia about the 'good old days' of their childhood but there is now a wealth of evidence from childhood studies that children's fun has been supplanted with adult notions of purposeful activity, competitive sport and 'extracurricular activities'. At Massachusetts Institute of Technology in the US, applicants were listing as many as 12 extracurricular activities but couldn't articulate anything that they did 'just for fun' (Young 2004). If you think that we may be overstating a concern, in America a family organisation now feels the need to promote an 'Eat dinner with your children day' as a special event (www.casafamilyday.org). Now, there's a revolutionary concept in parenting and child care!
So, what do we know about the family? We know that the family is often viewed as the 'mainstay of civilization' (Scutt 1990:9). We know that a strong, healthy, supportive, nurturing, encouraging family is the best chance that we have to grow into reasonably healthy, well-adjusted adults. We know that traditional constructions of the family conjured a picture of a heterosexual unit, with a father (the head), mother and children. However this construction differs from what has become the reality for more and more contemporary families. We know that female-headed single parent families are the fastest growing family type - in Australia, the number of single parent families grew by 53% in the 15 years between 1986 and 2001 (Australian Bureau of Statistics 2003). This pattern is not unique to Australia and can also be seen in many other parts of the world. Single parent families have a particular vulnerability in that the onus of responsibility for the welfare of children falls upon the shoulders of a single person - often a single person who is affected by disadvantage, poverty and an associated lack of resources and support.
Female-headed single parent families are subject to criticism and censure, both economically and socially, brought about by the attack on the welfare state that is occurring in many parts of the world (Timpson 1996). In the United States for example, it has been suggested that welfare dependent single mothers have been 'the most visible target of resentment' (Farber & Azar 1999:517) in recent years, and are scapegoated for many of that country's social problems. Farber and Azar (1999) go on to suggest the existence of widespread perceptions that female single parents lack positive qualities and share 'a lack of virtues, abilities, motivation, and socially appropriate values' (Farber & Azar 1999:517). These women are increasingly being blamed for the financial and social problems of their families and communities.
While crude victim-blaming will get us nowhere, there are tough questions to be asked about 'the family' and how to create the most supportive, nurturing and enabling social environment for our children. We must surely have these child and family health debates and discussions if we are not merely to accept and swallow accepted orthodoxies from either polarity of the political spectrum. For example, do we simply accept that all family variants and structures are equally good and that the 'diversity card' trumps all other questions as to whether some family structures and types are better than others? Do we have a sense of a 'preferable', if not for an ideal family structure? Do we have concerns about the increasing number of sole-parent families and their reliance on welfare payments from a system that seems purposely designed with disincentives that trap them in dependence? Is it a worry that increasing numbers of children grow up in families where they may never see a working adult? Is it also a worry that some children may grow up in families where they hardly see their parents because they are always working? Are we concerned that while some progress has been made in raising the social value of motherhood, that similar progress has not been made in establishing that fatherhood may too have some value? Are reproductive choices simply matters of personal 'lifestyle choice' to be supported and funded without question or should social policy seek to influence these? Is 'more money' always the answer to whatever the problem?
So, what else do we know about families? We know that families are idealised as being populated by people who are connected through longstanding associations, many of which are grounded in blood and/or legal ties. Traditional constructions vary from nuclear family to the extended family. However, there is now wide spread acknowledgement of alternative families, including childless families, gay families and other forms of family that are linked neither by blood nor legal ties.
We also know that family life should be characterised by caring and committed relationships. Yet in reality, for many people, family life is anything but the safe and loving place so idealised in many cultures. On the contrary, family life can be a site of violence, abuse, pain and rejection. Some people choose to leave abusive, violence or otherwise damaging family situations, while others are unable or unwilling to do so (Jackson 2003). The idea of the chosen family is a sentiment that is captured in the quote we have placed at the beginning of this editorial. 'South Park' may not be the pinnacle of scholarly credibility, but this quote by Parker and Stone (1998), reflects the value that is placed on the quality of caring relationships within the 'family', and this caring dimension is more important than blood ties alone (Parker & Stone 1998).
We all have a family of sorts - be it a chosen family, one we are born to, or both. Despite all of its frailties, flaws and failings, the family remains a crucial institution and the best chance that we have. More than any other social variable, the family shapes our values and morals and lays down the basis for health and longevity. But families also exist within a matrix of neighbourhoods and communities and for children especially, this 'social geography' has a profound effect on their childhoods and wellbeing (Drukker 2003; Woolf 2002; Morrow 2001; Cummins 2001; Spencer 1999; Davis 1996). Fiona Stanley in one of her 'Australian of the Year' addresses spells this out clearly:
'So it seems that there is evidence that if we neglect the early years of child development then there can be profound effects on a range of problems. Family environments then are crucial to the issues we are discussing. Most parents want to be good parents and want the best for their children but they need to be equipped and capable to do so. We also need to look beyond the family to neighbourhoods, workplaces, the social and economic policies and environments and to ask what is it about modern Australian communities which are what we might call 'family-disabling'? (Fiona Stanley, 2003)
So, in this climate of 'family-disabling' Australian communities, what part can nurses and nursing play?
Nurses enjoy privileged access to the private domains of people's lives - that is, their home and family. Thus nurses are ideally positioned to identify and assist families, to provide on-going support to the most vulnerable and underserved and to advocate for changes at policy and politics levels that will enrich the capacity of families, communities and institutions. In preparing Advances in Contemporary Child and Family Health Care (ISBN 978-0-9750436-3-3) we have included papers on vital aspects of child and family health, focusing particularly on the intersection of family/child health and nursing. This collection of papers has been selected to challenge, extend, engage and above all, to develop nursing practice. It also reflects the variety and scope of the work that nurses are doing to promote and improve child and family health.
We hope that you enjoy this special double issue of Contemporary Nurse and take this opportunity to acknowledge and thank the peer reviewers for their thoughtful critique and collegial feedback on each of the papers published in it.
Philip Darbyshire and Debra Jackson
WCH Chair of Nursing, Women's & Children's Hospital, University of South Australia, and Flinders University, Adelaide, South Australia and Associate Professor, School of Nursing, Family and Community Health, College of Social and Health Sciences, University of Western Sydney, Australia
References
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