WITHIN VULNERABILTY: UNDERSTANDING THE PRACTICES AND EXPERIENCES OF ENHANCED HOME VISITING PUBLIC HEALTH NURSES AND COMMUNITY HOME VISITORS

Abstract

In Nova Scotia, a targeted Enhanced Home Visiting program began in 2002 as an enhancement to the universal healthy beginnings program for families requiring additional support at home with healthy child development. Public health nurses (PHNs) and community home visitors (CHVs) began working together in this program. There have been informative evaluations done of the EHV program however a deep understanding of the personal experiences of both CHVs and PHNs who work together to support mothers and families was not evident in the reports. The purpose of this qualitative research study was to explore how the Nova Scotia Enhanced Home Visiting program for marginalized mothers and their families was organized, delivered and experienced through the practices and experiences of PHNs and CHVs. Feminist post structuralism informed by discourse analysis was used to explore and examine PHNs and CHVs’ personal experiences working in the EHV program. The ways in which their practices had been constructed and continued to be influenced by social and institutional discourses emerged within the data analysis. The social discourse on mothering layered within the social discourse of being part of a vulnerable population added an interesting understanding about gender and class. Six PHNs and eight CHVs participated in one on one in depth interviews. Four PHNs and six CHVs also attended a focus group where they responded to a presentation of the preliminary study findings. The findings of the study are focused on 1). Building relationships with mothers living within vulnerability 2). Communication in EHV practices within vulnerability 3). The unique practices of support for mothers living within vulnerability. This research contributes to an understanding of the ways in which PHNs and CHVs’ practices have been constructed and influenced by social and institutional discourses. The social discourse on mothering layered within the social discourse of being part of a vulnerable population added an interesting understanding about gender and class in this study.