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Listening with care: using narrative methods to cultivate nurses' responsive relationships in a home visiting

Lee Smithbattle1, Rebecca Lorenz, Sheila Leander

  • 1School of Nursing, Saint Louis University, Saint Louis, MO 63104, USA. smithli@slu.edu

Nursing Inquiry
|June 21, 2012
PubMed

Effective public health nursing relies on the development of responsive and collaborative relationships with families. While nurse-family relationships are endorsed by home visitation programs, training nurses to follow visit-to-visit protocols may unintentionally undermine these relationships and may also obscure nurses' clinical understanding and situated knowledge. With these issues in mind, we designed a home-visiting intervention, titled Listening with Care, to cultivate nurses' relationships with teen mothers and nurses' clinical judgment and reasoning. Rather than using protocols, the training for the intervention introduced nurses to narrative methods and therapeutic tools. This mixed-method pilot study included a quasi-experimental design to examine the effect of the intervention on teen mothers' depressive symptoms, self-silencing, repeat pregnancy, and educational progress compared to teens who received usual care. Qualitative data were collected from the nurses to evaluate the feasibility and acceptability of the intervention and therapeutic tools. The nurses endorsed the therapeutic tools and expected to continue using them in their practice. Despite the lack of statistically significant differences in outcomes between groups, findings suggest that further study of the intervention is warranted. Future studies may have implications for strengthening hidden aspects of nursing that make a difference in the lives of teen mothers.

Keywords:
clinical judgementhealth visitingnurse-patient relationshipspublic health nursing

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