This interpretive study examined the expertise that is often unrecognized in the everyday practice of community health nurses. Twenty-five nurses participated in the study and were asked to describe meaningful clinical situations during group and individual interviews. Field notes of observations of clinical situations and transcribed interviews were analyzed as a text. A major finding of the study involved the nurse's responsive use of self. Responsiveness to the other enabled the nurse to gain a situated understanding of clients' lives and to cultivate clients' strengths and connections to a responsive community.

An interpretive study conducted in a Midwestern metropolitan area was designed to examine expertise in everyday community health nursing (CHN) practice. Twenty‐five nurses from three practice areas (traditional, nontraditional, and program development) participated in group and individual interviews and field observations, sharing stories of their practice. Transcribed interviews and field observation notes were analyzed as a text. One of the major findings of the study focused on experiences of the nurses as they developed the population aspects of their everyday practice. Part I describes the natural development of a population focus of CHN generalists whose care most often targeted individuals and families. The stories of how their practices evolved and were supported by their institutions provided insights into how nurses develop a broad population‐focused practice perspective. Part II examines the practice of those CHN specialists who nurse their target populations from an intentional perspective. Their population‐focused practice, in which they repeatedly displayed what the research team terms multilingual and multiperspectival skills, was solidly based in their prior individual and family‐focused experience and expertise in program planning and evaluation.

An interpretive study conducted in a Midwestern metropolitan area was designed to examine expertise in everyday community health nursing (CHN) practice. Twenty-five nurses from three practice areas (traditional, nontraditional, and program development) participated in group and individual interviews and field observations, sharing stories of their practice. Transcribed interviews and field observation notes were analyzed as a text. One of the major findings of the study focused on experiences of the nurses as they developed the population aspects of their everyday practice. Part I describes the natural development of a population focus of CHN generalists whose care most often targeted individuals and families. The stories of how their practices evolved and were supported by their institutions provided insights into how nurses develop a broad population-focused practice perspective. Part II examines the practice of those CHN specialists who nurse their target populations from an intentional perspective. Their population-focused practice, in which they repeatedly displayed what the research team terms multilingual and multiperspectival skills, was solidly based in their prior individual and family-focused experience and expertise in program planning and evaluation.

The proliferation of classification schemes, practice guidelines, and critical pathways expresses our modern faith in theoretical reasoning and scientific evidence. This mode of knowing is almost universally championed for providing the evidence that will guide and advance nursing practice. The nature and complexity of clinical expertise, however, are misconstrued with the quest to standardize nursing practice. After distinguishing between theoretical and clinical reasoning, several narratives from two interpretive studies of public health nursing practice will illustrate how clinical practice resists theoretical understanding and must be more fully articulated if clinical and ethical reasoning is to be preserved and strengthened.

While community health nursing (CHN) leaders speculate about the future, nurses on the front lines care for vulnerable families and populations in the midst of diminishing resources, radical changes in health care delivery systems, and unwieldy bureaucracies. Narrative data from a recent interpretive study provided an unexpected opportunity to explore how CHN practice in diverse settings is evolving in response to such changes. Data consisted of interviews and observations of 25 nurses in their practice setting. Several clinical stories or exemplars are selected to highlight how the "culture" of agency settings shapes public health nursing (PHN) practice in ways that need to be recognized and strengthened or affirmed. Clinical storytelling can play a crucial role in preserving the PHN tradition and restoring and transforming local cultures when PHNs, administrators, educators, and researchers commit to PHN excellence.