Community nursing and civil liberty*

Abstract

The normative consensus which makes community nursing possible in its present form has come under increasing strain in recent years. Collectivist and individualist criticisms have grown in strength but these are equally antithetical to the Edwardian compromise between family liberties and state supervision which created community nursing and has dominated its organization and practice for 70 years. These critics imply either the extinction of community nursing or its transformation into a social police. If the status quo is indeed worth protecting, community nurses may need more aggressively to defend the moral and political values embodied in their work rather than presenting it as a purely technical matter.

What makes health visiting successful—or not? 2. The service journey

“…Health visitors need to carefully balance the delivery of such public health information with a consideration of parental needs and wishes, which may give rise to tensions in practice. Coping with the ethical and practical tensions that arise from contradictory expectations was the subject of some earlier health visiting literature (Dingwall, 1982;Dingwall & Robinson, 1990;Twinn, 1991), with more recent debates about 'disciplinary power' (Peckover 2002) and using health visitors as agents of state control (Greenway et al, 2008).…”

Structuring health needs assessments: the medicalisation of health visiting

“…Some of these authors have concentrated on the controlling aspects of the role, reporting the resistance tactics of the women being visited (Bloor and McIntosh 1990, Peckover 2002). Others have emphasised the perceived social importance and wide acceptance of surveillance aspects of the role as a necessary means of ensuring that vulnerable children and others are protected (Dingwall 1982, Dingwall and Robinson 1990).…”

“…The focus on social surveillance and child protection was an implicit theme throughout the 20 th century (Abbott and Sapsford 1990, Dingwall and Robinson 1990, Peckover 2002). Health‐enhancing behaviour changes were sought through the informal transfer of knowledge and information, with practitioners maintaining a broad agreement for their purpose by operating within a purposefully ambiguous and shifting conversational context (Dingwall 1982, Cowley 1991).…”

The role of the health visitor in identifying and working with vulnerable families in relation to child protection: a review of the literature

“…From the reseeu'cher s expenence as a health visitor, many health authonbes/tmsts currently have guidelines to assist Health visiting has been closely linked to the development health visitors m identifying 'vulnerable families' of state intervention m public and prevenbve health issues 'Vulnerable families' are ldenbfied m order that mcreased (Dmgwall 1982, Robinson 1982 A health visitor is a regishealth visitor support can be offered to these famibes, m tered nurse who has undergone a further 1-year traimng the hope that health problems can be reduced and child period which focuses specifically on child health surveilprotecbon issues prevented However, although the term lance as well as health promobon and disease prevenbon 'vulnerability' is frequently used withm health visitmg amongst all population groups The majonty of health visipracbce there have been surprismgly few attempts at tors work in the commumty attached to general pracdefining what the term really means There is also a lack bboner surgenes or clinic bases and are well placed to of empmcally based research evidence ahout health visi-idenbfy and work with vulnerahle groups Health visitors tors' clinical judgements m ldenbfying and assessmg fam-have a major role to play m facilitating and empowenng llies as vulnerable vulnerahle groups to make use of availahle services…”