Maximising, optimising, empowering : the work of the public health nurse in a college setting : a thesis presented in partial fulfilment of the requirements for the degree of Masters [sic] of Arts in Nursing at Massey University
This qualitative study focuses on the work of one Public Health Nurse delivering primary health care to potentially 950 students during her regular weekly visits to their suburban college. The interesting interface of health and education is captured by a single-case study design. In its ninety years of existence, public health nursing has seen very little research into practice, least of all practice in a secondary school or college. Data was collected from one primary participant in the form of two reflective monologues, six interviews taped at weekly intervals and five participant-observation sessions, and three taped interviews with senior school staff. The use of Yin's (1984) framework for data analysis generated support for the proposition that adolescent health was a great need in the nurse's area. Current literature shows that adolescence is one of the fastest growing areas of need in health today, particularly because of concern with New Zealand's high rate of youth suicide and poor mental health services for this age group. In keeping with the philosophy of primary health care, health promotion and self-responsibility, three key themes and associated subthemes were generated from the data. These were maximising ('working with' and 'working without'), optimising ('building' and 'breaking') and empowering ('using the critical moment' and 'sustaining the self'). These concepts encapsulate the substantial contribution that the Public Health Nurse participant made to adolescent health in a college. In 'working with' the student, the college staff, the nurse's colleagues, as well as the community, the nurse made a difference by 'maximising' or making the most of the moments she spent with the students in making decisions about their health. Issues, including sexuality, drug and alcohol abuse, are further articulated in the optimising and empowering themes which look at the need for young people to hope by empowering themselves to cope with the future. The nurse was seen by the staff at the college as a vital part of the community. It was this connection that was most valued for the balanced perspective that the Public Health Nurse brought to the college in her weekly visits.