Dancing around the families : a grounded theory of the role of neonatal nurses in child protection : a thesis presented in partial fulfillment of the requirements for the degree of Master of Philosophy in Nursing at Massey University (Albany), New Zealand

Abstract

The Ministry of Health objectives aim to protect the health and safety of children by reducing death rates, injury and disability from abuse. Family Violence is a significant health issue that impacts on children. Health professionals are key in the screening for Family Violence and assessment for child abuse. The philosophies of Family Centered Care and Developmental Care underpinning neonatal nursing practice are especially relevant for child protection. Nurses are in an ideal position to intervene before abuse perpetration. Increased awareness of child maltreatment and requirements for screening and reporting led to my research question, “What is happening for Neonatal Nurses in Child Protection?” Glaserian Grounded theory guided this study and the analysis of data. A total of ten semi-structured interviews was undertaken with nurses working in the participating neonatal units. Data were analysed and constructed into a substantive grounded theory, Dancing Around the Families and a Basic Social Psychological Process of Knowing at Risk Families. Dancing Around the Families explains nurses’ coping and acting upon child protection issues. It is about the creative conversations and work required to help support or enhance the infant’s safety. Difficulty with communication and transparency of information sharing between services, and differing perspectives creates this dance. Knowing at Risk Families captures how neonatal nurses construct child protection by acting on their personal and professional levels of knowledge. Nurses act on gut instincts, intuition or Red Flags to put supports in place for the protection of the infant. Child protection presents a state of conflict for nurses, where a sense of social justice prevails in their care, and their ideals and reality are often not congruent. Implications for practice require nurses to consider the way we look at families, as well as family capacities, capabilities and health literacy, and the importance of facilitating attachment.