Rafael A R
University of Western Ontario, London, Canada.
Public Health Nurs. 1999 Feb;16(1):50-9. doi: 10.1046/j.1525-1446.1999.00050.x.
A feminist, postmodern oral history was undertaken to make visible the work and struggles of public health nurses in Southern Ontario in the midst of drastic cutbacks and dramatic changes in public health. The study focused on the period between 1980 and 1996, during which time two distinct practice modalities were apparent: district nursing and program-focused practice. The narrators' stories describe the nature of their work in both those modalities, the skills and expertise they demonstrated, and the often conflicting influences of medicine and the health promotion movement that dramatically changed their practice. District nursing was characterized by the public health nurse's integral connection with the community; program-focused practice, occurring at a time when political and economic factors also impacted on practice, was characterized by a loss of that integrality. Narrators saw many positive aspects to the changes in public health but identified problems as well. They articulated a preferred vision for the future as one in which "nurses should be nursing." To do that, public health nurses are challenged to return their practice to a nursing center rather than struggling to conform to dominant paradigms in public health.
一项女性主义的后现代口述历史研究得以开展，旨在展现安大略省南部公共卫生护士在公共卫生领域大幅削减开支和发生巨大变革期间的工作与斗争。该研究聚焦于1980年至1996年这一时期，在此期间两种截然不同的实践模式较为明显：地区护理和以项目为重点的实践。讲述者的故事描述了她们在这两种模式下的工作性质、展现出的技能和专业知识，以及医学和健康促进运动常常相互冲突的影响，这些影响极大地改变了她们的实践。地区护理的特点是公共卫生护士与社区紧密相连；以项目为重点的实践发生在政治和经济因素也对实践产生影响的时期，其特点是失去了这种整体性。讲述者看到了公共卫生变革的许多积极方面，但也指出了问题。她们阐述了对未来的理想愿景，即“护士应专注于护理工作”。要做到这一点，公共卫生护士面临的挑战是将其实践回归到护理核心，而非努力去迎合公共卫生领域的主流范式。
