Being and becoming a specialist public health nurse: net weaving in homeless health care
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AbstractIn this study, systematic reflection in professional practice is seen as a dynamic process towards socio-political action, negating a navel-gazing critique. Positioned within nursing, the pioneering narrative inquiry approach will be highly valuable in medicine, education and other health fields. When I embarked on this study, research to guide me in homeless health care was limited and there is, even yet, insufficient evidence to demonstrate the effectiveness of advanced nursing practice in England particularly with homeless people. Through its reflexive narrative nature that research gap is addressed in a profound journey that illuminates my transformation over a three year period of being and becoming a Specialist Public Health Nurse (homelessness). The methodology draws dynamically on an eclectic, philosophical framework which includes reflective practice/guidance, narrative inquiry, hermeneutics, aesthetics, critical social science theory, storytelling, performance-ethnography and ancient wisdom. The Six Dialogical Movements (Johns, 2009) provides coherence to the twenty-one practice experiences that adequately marked my transformation towards my practice vision. I used the Being Available Template (Johns, 2009) as a reflexive framework which became the metaphoric net of my practice, showing where and how homeless people fall through the net of care, and my role in weaving a stronger net. I also drew on the work of Belenky et al's (1986) voice perspectives to show empowerment in my specialist role. Within the narrative, each story illuminates complexity and brings new knowledge about homeless health care. The study tangibly links childhood trauma to adult homelessness; it illuminates suffering in homelessness, showing where and how mainstream health professionals contribute to suffering when they do not grasp their role within the net, perpetuating homelessness. Appreciating precarious engagement in four quadrants: health services, homeless services, the homeless person and my SPHN role, is a concept that illuminates the precariousness of the net. The study concludes with a SPHN Homeless Health Care Model. Towards an ensuing social action through dialogue, I use the term 'audiencing' rather than transferability of findings. Hearing stories from 'street to boardroom' - making the invisible visible - has been profound in health services as evidenced in the narrative.
CitationFordham, M. (2012) 'Being and becoming a specialist public health nurse: net weaving in homeless health care' PhD thesis. University of Bedfordshire.
PublisherUniversity of Bedfordshire
TypeThesis or dissertation
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