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'Faced' with responsibility: Levinasian ethics and the challenges of responsibility in Norwegian public health nursing.
Nordic Council of Ministers, Nordic School of Public Health NHV.
Nordic Council of Ministers, Nordic School of Public Health NHV.
2007 (English)In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 8, no 3, 158-66 p.Article in journal (Refereed) Published
Abstract [en]

This paper is concerned with aspects of responsibility in Norwegian public health nursing. Public health nursing is an expansive profession with diffuse boundaries. The Norwegian public health nurse does not perform 'hands on' nursing, but focuses on the prevention of illness, injury, or disability, and the promotion of health. What is the essence of ethical responsibility in public health nursing? The aim of this article is to explore the phenomenon based on the ethics of responsibility as reflected upon by the philosopher Emanuel Levinas (1906-1995). From an ethical point of view, responsibility is about our duty towards the Other, a duty we have not always chosen, are prepared for, or can fully explain; but it is nevertheless a demand we have to live with. Interviews with five experienced Norwegian nurses provide the empirical base for reflection and interpretation. The nurses share stories from their practice. In interpreting the nurses' stories, the following themes emerge: personal responsibility; boundaries; temporality; worry, fear, and uncertainty; and a sense of satisfaction. As the themes are developed further, it becomes apparent that, despite their diversity, they are all interrelated aspects of ethical responsibility. Responsibility for the Other cannot be avoided, ignored, or transferred. The nurses' responsibility is personal and infinite. Levinasian ethics can help nurses understand the importance of accepting that being a responsive carer can involve not only contentment in the predictable, but also the fear, worry, and uncertainty of the unpredictable.

Place, publisher, year, edition, pages
2007. Vol. 8, no 3, 158-66 p.
Keyword [en]
Levinas; responsibility; public health nursing; ethics
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3701DOI: 10.1111/j.1466-769X.2007.00311.xPubMedID: 17581243OAI: oai:DiVA.org:norden-3701DiVA: diva2:785725
Available from: 2015-02-03 Created: 2015-02-03 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Perceptions of public health nursing practice On borders and boundaries, visibility and voice
Open this publication in new window or tab >>Perceptions of public health nursing practice On borders and boundaries, visibility and voice
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The aim of this comprehensive thesis is to explore different perceptions of public health nursing practice. The intention being to contribute to developing the service, theoretically and practically, in throe with current and future public health needs.

Methods: The thesis comprises five studies. Public health nurses, young people, parents and decision makers are interviewed and share their perceptions of public health nursing practice (studies I, II, III and IV). Consultations at local child health clinics, clinics for young people and at school health services are observed (study III). A cross sectional study amongst a sample of doctors, public health nurses, midwives and child protection workers is carried out (study V). The first four studies have an explorative, descriptive design. Study V, with its focus on interprofessional collaboration, is based on the results of studies I, II, and IV.

Findings: Study I, a case study, provides a backdrop for the remaining four studies. It focuses on changes the nurses have faced during the period 1984-2005. The results point to issues of visibility and that respect is more important for the nurses than authority or status. Study II is a philosophical study based on interviews with public health nurses. It gives an introduction to the philosophy of Emmanuel Levinas and develops a novel theoretical and practical understanding of aspects of responsibility in public health nursing. Study III shows the importance of relationships with service users in public health nursing practice; and that not only pleasantness but also honesty and openness are important. This study has contributed to further developing models of public health nursing interventions. Decision makers in study IV point to the challenges public health nurses face regarding collaboration, visibility and boundaries. Study V is a cross sectional questionnaire study that focuses on interprofessional collaboration. The results show that size of municipality can influence frequency of meeting points and views on issues relating to collaboration; and that mental health services are those most missed in collaborative relationships. The findings warrant further research and should be of interest when organising municipal health- and social services in Norway.

Conclusions: The thesis concludes that service users and decision makers are satisfied with public health nursing services, but that public health nurses face challenges related to collaboration, to boundaries for knowledge and involvement, and in making their health promotive function visible

Abstract [no]

Denne doktorgradsavhandling: Perceptions of public health nursing practice - on borders and boundaries, visibility and voice, fokuserer på ulike oppfatninger av helsesøsters praksis. Helsesøstre, ungdom, foreldre, samt lokale politikere og administratorer er intervjuet om deres syn på helsesøstertjenesten. Konsultasjoner på helsestasjon for barn, ungdom og i skolehelsetjenesten er observert. Et utvalg av samarbeidspartnere har svart på et spørreskjema om samarbeidsforhold. Avhandlingen består av fem studier. De første fire studier har eksplorativ, deskriptiv design. Studie V er en tverrsnittsstudie som bygger på resultatene fra studiene I,II, og IV. Avhandlingen har til hensikt å løfte frem områder som respondentene mener fortjener oppmerksomhet og som kan ha praktiske og teoretiske implikasjoner for utvikling av tjenesten. Studie I, en case studie danner et bakteppe for de andre studiene. Den fokuserer på endringer i helsesøstertjenesten i perioden 1984-2005. Resultatene fra denne studien peker på helsesøstrenes opplevelse av usynlighet og at respekt er mer viktig for helsesøstrene i studien enn autoritet og status. Studie II er en filosofisk studie basert på intervjuer med helsesøstre. Den gir en introduksjon til Levinas’ filosofi og utvikler en dypere forståelse for teoretiske og praktiske aspekter av etisk ansvar i helsesøsters praksis. Studie III peker på betydningen av relasjoner i helsesøsters praksis. Det var viktig at konsultasjonene var hyggelige for helsesøstrene og brukerne, men ærlighet og åpenhet var også vesentlig for gode relasjoner. Beslutningstakere i studie IV peker på utfordringer helsesøstre har når det gjelder samarbeid, usynlighet, samt grenser for deres kunnskap og involvering. Studie V er en spørreskjemaundersøkelse som fokuserer på samarbeid. Resultatene viser at kommunestørrelse har betydning for hyppighet av møtepunkter og syn på samarbeid og at psykiske helsetjenester er savnet mest i samarbeidsrelasjoner. Disse funn burde være av interesse i fremtidig organisering av helse- og sosialtjenester. Avhandlingen konkluderer med at foreldre, ungdom og beslutningstakere er fornøyde med helsesøstertjenesten, men at helsesøstre står overfor viktige utfordringer i samarbeidsrelasjoner, i forhold til grenser for involvering og i å synliggjøre deres helsefremmende funksjon

Place, publisher, year, edition, pages
Nordic School of Public Health NHV Göteborg, Sweden, 2009. 98 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2010:7
Keyword
boundaries; children; Emmanuel Levinas; interprofessional collaboration; interpersonal relationships; Norway; parents; perceptions; public health nursing; visibility; young people, barn; Emmanuel Levinas; familier; folkehelse; grenser: helsesøstertjenesten relasjoner; tverrfaglig samarbeid; synlighet, ungdom
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3704 (URN)978-91-85721-90-0 (ISBN)
Public defence
2010-06-10, Nordic School of Public Health NHV, Göteborg, Sweden, 13:00 (Norwegian)
Opponent
Supervisors
Available from: 2015-02-05 Created: 2015-02-03 Last updated: 2015-02-05Bibliographically approved

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