Maintaining the balance: New Zealand secondary school nurses' perceptions of skin infections in young people--a grounded theory.

Abstract

The objective of this study was to explore the perceptions of New Zealand secondary school nurses regarding skin infections in young people aged 14-18 years. A constructivist grounded theory method was adopted. Ten non-structured interviews were conducted with secondary school nurses working in Auckland, New Zealand, between January and July 2013. Interviews were audiotaped, transcribed and analysed using all tenets of grounded theory that included writing memos, theoretical sampling and the constant comparative method. Analysis revealed the core category Maintaining the balance, which is presented as a grounded theory model. It represents the constant state of balancing the school nurse undergoes in trying to counter the risk to the student. The nurse attempts to tip the balance in favour of action, by reducing barriers to healthcare, providing youth-friendly, affordable and accessible healthcare, and following up until resolution is achieved. The nurse is aware that failing to monitor until resolution can again tip the fulcrum back to inaction, placing the young person at risk again. It is concluded that nurses are knowledgeable about the risks present in the communities they serve and are innovative in the methods they employ to ensure satisfactory outcomes for young people experiencing skin infections. School nursing is an evolving model for delivering primary healthcare to young people in New Zealand. The grounded theory model 'Maintaining the balance' describes a model of care where nursing services are delivered where young people spend time, and the nurse is immersed in the community. This model of care may be transferable to other healthcare situations.