The meaning of ethically charged encounters and their possible influence on professional identity in Norwegian public health nursing: a phenomenological hermeneutic study

Abstract

Background: In today’s health care, new health reforms focus on market values and demands of efficiency influence health workers’ professional practice. Norwegian public health nurses work mainly with healthy populations, but the children, families and young people they meet can be in vulnerable and even dependent situations. Strategies in coping with ethically challenging encounters can be important for the identity of the profession. Aim: The aim of the study was to illuminate public health nurses’ experiences of being in ethically charged encounters and to reflect upon how these experiences can influence their professional identity. Method: A purposive sample of 23 Norwegian public health nurses with experience ranging from 0.5 to 25 years narrated about their work-related experiences. The interviews were interpreted with a phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur. Findings: Four themes were identified: feeling responsible, being committed, feeling confident and feeling inadequate. These experiences were related to both work and private life and involved an emotional commitment to the well-being of children, young people and families. Conclusion: On the basis of the findings, it can be estimated that PHNs are committed to their work, and defending children’s rights is a strong driving force. Responsibility for service users is a deciding factor that can overshadow institutional demands. It seems as if value conflicts mobilised courage which is essential in maintaining moral strength. This is in turn important for a strong professional identity and can have positive implications for the quality of public health nursing work.