Same, but different
: contemporary child and family health nursing practice in New South Wales

  • Susan Kruske

    Student thesis: Doctor of Philosophy (PhD) - CDU


    Child and family health (C&FH) nursing services in New South Wales (NSW) have undergone rapid change in recent years. This is largely in response to policy change bought about by the implementation of ‘the Families First’ initiative of the State Government. 

    This thesis utilised a health services research framework to explore, describe and analyse contemporary C&FH nursing practice and identify the major factors which impact on their ability to effectively support families. An ethnographic approach guided data collection and analysis across three different practice settings, reported as case studies. Case Study One explored C&FH nursing practice as provided to families through individual consultations in the home or the health centre. The second case study investigated the C&FH nurse as a facilitator of groups for parents with new babies. Finally, the third case study explored C&FH nursing practice as a member of a multidisciplinary team. 

    The research identified the complexity of current C&FH nursing practice and a change in the philosophy that underpinned their practice that was difficult to adopt. While the findings across the three case studies were varied, one outcome apparent throughout the thesis was that nurses predominantly continue to frame their practice within an expert model. The nurses also struggled to deliver new service models whilst maintaining access to all families. 

    Some explanations for the tensions experienced by the nurses relate to the age, educational preparation and leadership within the workforce. Other factors relate to the structures and management systems that were evident within the health service that employs them. Without suitable recognition and attention to the some of the key findings of this research, the C&FH nursing workforce will not achieve its maximum potential in the support of families with young children.
    Date of AwardSept 2005
    Original languageEnglish
    SupervisorLesley Barclay (Supervisor)

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