Policy imposed practice change: a critical ethnography of child and family health nursing in NSW
Annie Dullow
University of Newcastle
Contact Email:   Annie.dullowhealth.gov.au

The implementation of the Families First initiative and changes in the Children and Young Persons (Care and Protection) Act 1998, between 2000 and 2002, presented Child and Family Health (C&FH) nurses in New South Wales with an unprecedented degree of change in their daily practice. This paper reports on a qualitative study exploring the nurses’ experiences of these changes (in progress). Grounded in critical social theory the nurse participants’ expressed meanings and assumptions, and apparent discords between these meanings and assumptions were critically analysed. The paper discusses the dissonance between the nurses’ historically bound understanding of their role in primary health care and their emerging roles and functions arising from policy and legislative changes. Some C&FH nurses described how they were working with families experiencing hardship, uncovering sometimes long standing emotional issues during home visits, and developing their community brokerage role. Along a continuum of responses some nurses reported working beside families through the notion of friendship, others described their role in terms of building families’ self-esteem and facilitating positive health behaviours and protective factors in the family home, while others felt challenged by a new level of intensity in their relationships with families and were in need of additional professional support.

Paper Download Information (if available):

Copyright © 2007 Social Policy Research Centre.