Putting ourselves out there
Starting in June 2017, the Lab team have been on the road collecting experiences from family nurses and their clients about how it feels to implement and receive changes to the Family Nurse Partnership.
Keira Lowther reflects on the value of getting out there and talking to practitioners and people using the FNP service
In the space of a few months, we’ve been to Blackpool, Bradford, Derby, Nottingham, Dudley, Crewe, Southend, Lambeth, Lewisham and Portsmouth. We have spoken to over 70 nurses and 13 clients. This has amounted to 28.5 hours of train travel time, 12.5 hours of discussion and many, many hours of transcription and analysis of valuable data.
As you can see from the photo, the other work doesn’t stop whilst this is going on! Interviews with supervisors, ongoing analysis and dissemination and planning for workshops and events needs to continue as we wait for trains, and find time in-between the data collection.
These focus groups are essential to understanding what is driving the changes that we see in the data we are collecting through the online system which the nurses complete as they deliver the revised programme. They help us understand why a certain aspect is difficult to implement or how nurses cope with the additional pressures placed upon them through participating in the research. Often we can make changes almost immediately when we realise that something is problematic.
For example, we shifted the responsibility for the decision to change the frequency of visits (based on client need) into the hands of the family nurses. Nurses told us that taking each decision to the supervisor in supervision was a huge barrier to their ability to responsively tailor the programme to the clients need. It was also potentially unnecessary and slightly undermining given their extensive experience and training. Now the nurses make a decision based on their understanding of client need, and the wishes of the client, with a brief check-in with the supervisor to make sure there is nothing they have missed.
In addition to being essential to this methodology, speaking to clients often feels like a total privilege. We have been touched at how open and articulate nurses and clients are and how honest they have been with us about the very real problems they have faced. They have described to us how the programme has affected their experience of domestic violence, mental health and negotiating with the in-laws! We have met many wonderful people who are working extremely hard for these families. The families themselves constantly surprise us with their grit, determination and commitment to being the best parents they can be.
Keira Lowther, PhD
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