The ethics of relation: public health nurses and child protection clients

The aim of this paper is to show how a framework of relational ethics may be used in establishing trusting relationships with at-risk families.

Public health nurses have historically carried out assessment and monitoring of parenting within the family home, particularly with at-risk families. In this role, they are placed in the position of simultaneously supporting and policing the family. A trusting relationship may be difficult to develop if parents feel threatened by the surveillance aspect of home visiting and the threat of action (such as removal of children) being taken against the family.

Development of optimal trust relationships may be a challenge when families are experiencing powerlessness and oppression. The four themes of relational ethics--mutual respect, engaged interaction, embodiment and creating environment--provide a framework for developing trusting relationships with families.

It is possible to have a moral and trusting relationship with at-risk families, but this needs to based on critical self-reflection by nurses and mutually respectful nurse-family relations.