Archives
Nursing Practice in Community Child Health
Developing the nurse-client relationship
Carolyn Briggs
Senior Lecturer, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Lindfield NSW
Abstract
Community nursing services to parents with young children have been an established part of child health services in Australia for more than a century. Although the titles vary within states, community child health nurses provide support services for parents with infants and young children and typically their scope of practice includes public health functions such as health surveillance of the developing infant and child up to the age of 5 years and early intervention. More recently state health policies have instituted universal home visiting and emphasized the primacy of psychosocial support for parents.
These policies are accompanied by education programs that propose a change in nursing practice to a more egalitarian partnership model of practice. As a consequence greater attention now has to be paid to the processes used in developing a working relationship with the client in the community setting. Whilst there has been little published in the Australian nursing literature on the methods used by community child health nurses to engage their clients, the international literature offers some insights into the nurses' practice.
This paper describes the practices of community child health nurses in engaging the parent and developing a complementary and therapeutic relationship that enables the nurse to promote the health of the child and family. Published accounts of community child health nursing practice in the United Kingdom, Scandinavia and northern America are described and compared to the Australian context.
Keywords
nursing practice, child health nursing, community child health, health visiting, public health nursing, paediatrics, home visiting
References
Abbott P and Sapsford R (1990) Health visiting: policing the family? In Abbott P and Wallace C (eds) The Sociology of the Caring Professions, pp.120-152, Falmer Press, Basingstoke.
Arborelius EU and Bremberg SG (2003) Supportive and nonsupportive qualities of child health nurses' contacts with strained infant mothers, Scandinavian Journal of Caring Sciences 17: 169-175.
Barnes-Boyd C, Fordham Norr F and Nacion KW (2001) Promoting health through home visiting by a nurse-managed community worker team, Public Health Nursing 18(4): 225-239.
Barnes M, Courtney M, Pratt J and Walsh A (2003) Contemporary child health nursing practice: Services provided and challenges faced in metropolitan and outer Brisbane areas, Collegian 10(4): 14-19.
Bloomfield L, Kendall S, Applin L, Attarzadeh V, Dearnley K, Edwards L, Hinshelwood L, Lloyd P and Newcombe T (2005) A qualitative study exploring the experiences and views of mothers, health visitors and family support centre workers on the challenges and difficulties of parenting, Health and Social Care in the Community 13(1): 46-55.
Blundo R (2001) Learning strengths-based practice: Challenging our personal and professional frames. Families in Society 82(3): 296-304.
CAFHNA (2001) Scope of practice of child and family health nurses, Child and Family Health Nurses Association, Sydney.
Cody A (1999) Health visiting as therapy: A phenomenological perspective, Journal of Advanced Nursing 29(1): 119-127.
Cowley S (1988) In search of a model for health visiting, Health Visitor 61(5): 149-151.
Cowley SA (1991) A symbolic awareness context identified through a grounded theory study of health visiting, Journal of Advanced Nursing 16: 648-656.
Cowley S (1995a) In health visiting, a routine visit is one that has passed, Journal of Advanced Nursing 22: 276-284.
Cowley S (1995b) Health as process: A health visiting perspective, Journal of Advanced Nursing 22: 433-441.
Cowley S and Houston A (2003) A structured health needs assessment tool: acceptability and effectiveness for health visiting, Journal of Advanced Nursing 43(1): 82-92.
Chalmers KI (1992) Giving and receiving: An empirically derived theory of health visiting practice, Journal of Advanced Nursing 17: 1317-1325.
Davies C (1988) The health visitor as Mother's Friend: A woman's place in public health, 1900-14, Social History of Medicine 1: 39-60.
Davis H, Day C and Bidmead C (2002) Working in partnership with parents: The parent advisor model, The Psychological Corporation Limited, London.
de la Cuesta C (1994a) Marketing: A process in health visiting, Journal of Advanced Nursing 19: 347-353.
de la Cuesta C (1994b) Relationships on health visiting: Enabling and mediating, International Journal of Nursing Studies 31(5): 451-459.
Department of Human Services (2002) Best start, State Govt of Victoria, Melbourne.
Ellefson B (2001) Changes in health visitors' work, Journal of Advanced Nursing 34(3): 346-356.
Fagerskiold A and Ek A-C (2003) Expectations of the child health nurse in Sweden: Two perspectives, International Nursing Review 50: 119-128.
Fagerskiold A, Timpka T and Ek A-C (2003) The view of the child health nurse among mothers, Scandinavian Journal of Caring Sciences 17: 160-168.
Fowler C (2005) Child and family health nursing practice learning package, Tresillian Family Care Services, Sydney.
Government of Victoria (2006) Every child every chance, accessed at www.dhs.vic.gov.au on 20 September 2006.
Jack SM, DiCenso A and Lohfeld L (2005) A theory of maternal engagement with public health nurses and family visitors, Journal of Advanced Nursing 49(2): 182-190.
Kruske S, Barclay L and Schmeid V (2006) Primary health care, partnership and polemics: child and family health nursing support in early parenting, Australian Journal of Primary Health Care 12(2): 57-65.
Luker KA and Chalmers KI (1990) Gaining access to clients: The case of health visiting, Journal of Advanced Nursing 15: 74-82.
Mayall B (1990) The division of labour in early child care - mothers and others, Journal of Social Policy 19: 299-330.
Mitcheson J and Cowley S (2003) Empowerment or control? An analysis of the extent to which client participation is enabled during health visitor/client interactions using a structured health needs assessment tool, International Journal of Nursing Studies 40:413-426.
Normandale S (2001) A study of mothers' perceptions of the health visiting role, Community Practitioner 74(4): 146-150.
National Public Health Partnership (2005) Healthy children - strengthening promotion and prevention across Australia NPHP Strategic Framework for Children Melbourne: NPHP.
NSW Health (1999) The start of good health: Improving the health of children in NSW, NSW Dept of Health, Sydney.
NSW Health (2006) NSW interagency guidelines for child protection and intervention,: NSW Government, Sydney.
NSW Health (2005) Supporting families early (draft), NSW Dept of Health, Sydney.
Ochiltree G (1991) An ear to listen and a shoulder to cry on: The use of child health services in Melbourne, Adelaide and Perth, Australian Institute of Family Studies, Melbourne.
Olds D, Henderson CR, Kitzman HJ, Eckenrode JJ, Cole RE and Tatelbaum RC (1999) Prenatal and infancy home visitation by nurses: Recent findings, Future of Children 9(1): 44-65.
Peckover S (2002) Supporting and policing mothers: an analysis of the disciplinary practices of health visitors, Journal of Advanced Nursing 38(4): 369-377.
Queensland Health (2002) A strategic policy framework for children's and young people's health 2002-2007, Go Print, Brisbane.
Queensland Govt (2006) Discussion paper; towards an early years agenda February 2006, accessed at www.communities.qld.gov.au/family on 20 September 2006.
Robinson J (2004) Health visitors or health police? AIMS Journal 16(3): 14-25.
Robinson S and Hill Y (1998) The health promoting nurse, Journal of Clinical Nursing 7(3): 232-238.
Seedhouse D (1997) Health promotion: philosophy, prejudice and practice, John Wiley and Sons, Chichester.
Senate Community Affairs Committee (2005) Protecting vulnerable children: a national challenge, Commonwealth Government, Canberra.
Sparrow G, Hay J, McGillivray I and Waugh M (2005) Service provision in child health clinics, Journal of Community Nursing 19(5):26-29.
Twinn SF (1991) Conflicting paradigms of health visiting: A continuing debate for professional practice, Journal of Advanced Nursing 16: 966-873.
WHO (1996) Health promotion: An anthology, World Health Organisation, Geneva.
eContent Home