A mantle of protection? : a critical analysis of the personal safety of district nurses : a thesis presented in partial fulfilment for the degree of Master of Arts in Nursing at Massey University

Abstract

This qualitative inquiry, informed by Critical Social Theory, explored the personal safety experiences of district nurses in a New Zealand city. While interest in workplace safety in New Zealand has been gaining momentum, there has been no formal research to date regarding the personal safety of district nurses. Studies by Beale, Fletcher, Leather and Cox (1998), Koch and Hudson (2000), and White (1999) have begun to address district nurses' experience and management of violence in the community but do not address the power issues implicit in the existence of the problem. The Critical Social Theory perspective that underpins this study aimed not only to initiate discussion about occupational safety for nurses working in the community, but paid critical attention to the power systems that are perpetuated by ensuring district nurses remain vulnerable and relatively powerless. It also explored the tolerance that nurses demonstrate for an unsafe working environment. District nurse participants recalled incidents in which they felt their personal safety was compromised. Data was collected from six district nurses using interviews based on the incident(s), in order to explore the ways in which personal safety of district nurses was compromised. Data was also collected from a focus group discussion with the participants. Analysis of the data suggests that nurses have modest expectations for their own safety and even these were circumscribed by institutional practices. The complex power relationships that shape the experience of nursing in a community impinged on the ability of the nurses in this study to confidently and safely fulfil their role. Recommendations emerging from the research are that issues of building security, access to client information, provision of cellphones and regular safety in-service require urgent attention. Attention must also be given to the development of institutional policy that prioritises nurse safety, and has in place post-incident plans and support structures.