“They just do my dressings”: children’s perspectives on Community Children’s Nursing

Abstract

The increase in the number of children living with complex, long term nursing needs has led to an expansion of services. The growth in community children’s nursing has been influenced by local politics and the needs of individual children, rather than by research investigating children’s perspectives (Whiting 2005). At the same time, policy and professional agendas have included a willingness to listen to children as service users (Department of Health 2001a, Coad and Shaw 2008). The aim of this study was to address the lack of an evidence base for community children’s nursing by exploring children’s experiences of receiving nursing care in community settings. A mosaic of qualitative methodologies, within the philosophical framework of Clark’s (2004) Mosaic approach, was used to investigate the experience of children, aged 5-12. The study engaged a core group of seven children in participatory activities spread over one year. A larger, non-core group of fourteen children was also observed receiving nursing care. The children’s perspectives were placed in context using data from observation of six nurses’ working days, and individual and group interviews with community children’s nurses. Four themes emerged. Firstly, the dominant theme for children was how they portrayed themselves as children, like other children. Secondly, findings show, for the first time, that children have negative as well as positive regard for nurses. Children’s regard for nurses seemed to be influenced by children’s understanding of their illness and their involvement in receiving care. Thirdly, children and nurses focused on highly visible clinical interventions, not on the work of nurses which helped children to access social or educational opportunities. Finally, some of the children wanted to receive care from a nurse of the same sex as themselves. These findings have significant implications for quality measurement, the management of relationships between children and nurses, and the organisation of children’s nursing