Primary Health Care, Partnership and Polemic: Child and Family Health Nursing Support in Early Parenting

Abstract

This qualitative research utilised a health services research framework and ethnographic methods to explore, describe and analyse contemporary child and family health (C&FH) nursing practice in an area of New South Wales, and identify the major factors that impact on their ability to effectively support families. The research identified the complexity of current C&FH nursing practice and changes in the philosophy that underpinned this at the policy level that were difficult to adopt. Despite a change in policy direction that advocated a partnership approach, nurses predominantly continue to frame their practice within an "expert" model. The nurses also struggled to deliver new service models while maintaining access for all families. Some explanations for the tensions experienced by the nurses relate to their age and educational preparation within the workforce. Other factors relate to the structures and management systems evident within the health service that employs them. To effectively support new families within the community, health systems must adequately resource services and support C&FH nurses in changing from a paradigm of expert to partner, consistent with primary health care practice.