Public health nursing practice with 'high priority' families: the significance of contextualizing 'risk'

Public health nurses (PHNs) play a vital role in supporting families at risk; few studies, however, have focused on how PHNs actually work with families to provide support, build trust, and use their clinical judgment to make decisions in complex, at-risk situations. In this study, we report on findings from research that illustrate how PHNs use relational approaches in their work with 'high priority' families. Drawing on data collected from interviews and focus groups with 32 PHNs, we discuss three central features inherent to working relationally with families at risk: (i) contextualizing the complexities of families' lives; (ii) responding to shifting contexts of risk and capacity; and (iii) working relationally with families under surveillance. These findings show that the ability to recognize risk and capacity as intersecting aspects of families' lives, and to practice from a stance that recognizes risk as contextualized is foundational to effective working relationships with high-priority families.