Nurse-client Relationship Research Articles

Work-related barriers and resources of migrant and autochthonous homecare nurses in Germany: A qualitative comparative study

BackgroundThere is substantial research about the occupational health of nurses worldwide. However, empirical evidence about the psychosocial health of migrant and minority nurses in outpatient settings in Germany in comparison to that of autochthonous nurses is lacking. ObjectivesThis study aims to identify work-related stressors, resources and the corresponding coping strategies of migrant and minority nurses in comparison to autochthonous nurses. Design24 migrant and 24 autochthonous nurses employed in the German homecare sector were interviewed in qualitative explorative manner while a distinction was made between non-commercial and private-commercial services. SettingsThe interviews took place in the nursing services' premises or in the nurses' private homes. ParticipantsServices were randomly chosen among all homecare providers in the second largest German federal city-state Hamburg. Nurses were invited for an interview, once their management agreed to participate in the study. Registered nurses and nursing assistants as well as those with a foreign certificate but validated or in process were eligible to participate. MethodsRelevant literature findings formed the base for the semi-structured interview guide. Key areas in the interview guide were barriers, resources and coping strategies in the collaboration with colleagues, superiors and clients as well as in the collaboration within a linguistically and culturally diverse team and clients. The conventional approach to qualitative content analysis by Hsieh and Shannon guided the analysis. ResultsRegardless of their origin or culture, nurses perceive time pressure, lifting patients, lack of appreciation or the client's personal fate as burdening. In the intercultural context, the divergent understanding of behavioral patterns as well as of nursing care and a non-functioning communication impede the collaboration within a diverse nursing workforce. Migrant and minority nurses suffer prejudices, verbal and sexual harassment proceeding from their clients. However they keep it to themselves and don't broach it to their supervisors or colleagues. The interaction with humans, the verbal exchange with colleagues and supervisors at eye level as well as the sensemaking of being a nurse helps nurses to cope with occupational stressors. ConclusionsDifferences in language is a main stressor which impedes a functioning team collaboration as well as a positive nurse-client relationship. Migrant and autochthonous nurses share similar coping strategies to master occupational burdens. A good collaboration within the team and having an appreciative supervisor are resources that support migrant and minority nurses as well as autochthonous nurses to face the stressors and to cope with those. Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing commonalities. Contribution of the paperWhat is already known about the topic?•The growing demand for care due to the demographic change leads to an increasing trend to hire healthcare personnel such as nurses from abroad.•The nurses' workplace is characterized by physically and psychologically demanding tasks leading to musculoskeletal pain and job dissatisfaction.•Migrant healthcare workers experience additional stressors like discrimination practices as well acculturative stress.What this paper adds:•Migrant and Autochthonous nurses share similar coping strategies to master occupational burdens•Differences in language is a main stressor, which impedes a functioning team collaboration as well as a working nurse-client relationship. More autochthonous than migrant and minority nurses report these differences as stressful.•Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing the same destiny – this appears as an important resource for migrant and minority nurses.

Presence in the Nurse–Client Relationship: An Integrative Review

Aim:To integrate empirical literature related to the use and outcomes of presence. Design: An integrative review of empirical research was conducted.Method:A comprehensive search from 1966 to August 2017 was conducted using Whittemore and Knafl’s five-step method. Twenty-six studies were eligible for the review.Results:Presence is a deliberate, interpersonal intervention that is implemented through physical, psychological, and spiritual actions to promote client well-being. Nursing actions associated with presence include use of self, availability, and therapeutic communication.Conclusion:This diverse range of primary sources indicates the significance of presence to nursing practice.

Exploring predictors of medication adherence among inpatients with schizophrenia in Singapore's mental health settings: A non-experimental study

Schizophrenia is a mental disorder, which is marked by frequent relapses. The main reason for relapse is nonadherence to antipsychotics. A cross-sectional, correlational research study was conducted with a convenience sample of 92 participants. The primary aim of this study was to explore the predictors of medication adherence among inpatients with schizophrenia hospitalised at tertiary hospitals in Singapore. Post-hoc analysis revealed that insight, religion, side effects, types of antipsychotics, social support from significant others, nurse-client relationship, were significant predictive factors. Results from this study added knowledge to the nursing literature about medication adherence of schizophrenia patients and in Singapore setting.

Nurses' professional stigma and attitudes towards postpartum women with severe mental illness.

To examine professional stigma and attitudes of parenthood towards postpartum women with severe mental illness and the association between postpartum nurses' attitudes and nursing interventions that promote motherhood. Stigma and attitudes towards parenthood of women with severe mental illness may influence nurses' clinical practices. Cross-sectional, mixed methods. The Stigma among Health Professionals towards People with Severe Mental Illness, Attitudes towards Parenthood among People with Severe Mental Illness and Nursing Interventions that Promote Becoming a Mother Questionnaires were used in the study, as well as qualitative analysis. Sixty-one postpartum nurses participated in the study. Increased stigma was associated with an increase in negative attitudes towards parenthood among people with severe mental illness, in general, and towards their parenthood skills, in particular. Postpartum nurses reported a decrease in nursing interventions and a therapeutic nurse-client relationship that fosters mother's empowerment.Themes that emerged from the qualitative analysis were postpartum nurse's perceptions of inadequacy, difficulty of postpartum nurses taking responsibility for managing women with severe mental illness and a paternalistic approach to these women, rather than empowerment, regarding infant care. Nurses providing care to postpartum women with severe mental illness and their infants may provide fewer routine postpartum interventions due to professional stigma and negative attitudes concerning parenting skills. Nurses should provide individualised, tailored care that allows women with severe mental illness to become a mother to the best of her ability. Not all women with severe mental illness are capable of caring for themselves and/or their baby. Nurses should provide individualised, tailored care that allows the women with severe mental illness to become a mother to the best of her ability.

Academic Electronic Health Record Implementation Proposal

In today’s complex and evolving healthcare system it is crucial for nurses to proficiently comprehend electronic health records (EHR) in the provision of quality, safe patient care. Electronic health records have become a federal mandate for patient funding securement in many settings. Studies suggest that implementation of an academic electronic health record (AHER) augments student learning for assuming the nurse role in key areas such as: data analysis, assessing patient care needs, administering medications safely, documenting effectively and professionally, and learning how to maintain a therapeutic nurse-client relationship with effective communication in the presence of technology (Jansen, 2014; Herbert & Connors, 2016). Additionally, evidence shows that the implementation of AEHR in a simulation enhances the realism and depth of learning for students as it better mirrors the clinical setting while facilitating faculty assessment of student skills (Meyer, Sternberger& Toscos, 2011). Even though research demonstrates ample benefits to the implementation of an AEHR in nursing education, the Nursing Department at Fort Hays State University (FHSU) utilizes paper patient charts in practice scenarios and in simulation experiences. This researcher recommends the implementation of an AEHR at FHSU to promote aptitude of the EHR, giving more time to direct patient care at time of clinicals.

Students' Perceptions of the Psychological Well-Being of a Transgender Client Through Simulation.

The need to address mental health concerns for transgender clients is imperative. Nursing curricula must prepare students to provide holistic care for individuals within this community. The purpose of this study was to explore undergraduate nursing students' experiences providing mental health care for a transgender client through simulation. Focus group interviews were conducted with data analyzed using content analysis. The three categories that emerged were limited experience addressing mental health needs, intervening with client anxiety with the subcategories of prioritizing care and collaboration, and therapeutic nurse-client relationship with the subcategory of therapeutic communication. Nursing students must be prepared to provide holistic care for transgender individuals. Simulation allowed students to assess the client and evaluate their therapeutic communication in a safe learning environment. Further understanding of mental health care needs of transgender clients is essential for the promotion of their well-being. [J Nurs Educ. 2017;56(12):741-744.].

An exploration of paediatric nurses' views of caring for infants who have suffered nonaccidental injury.

To explore paediatric nurses' views of caring for infants who have suffered nonaccidental injury. Children less than twoyears of age are at greater risk of serious abuse than those in any other age group. An infant's physical and mental immaturity makes them especially vulnerable. Abuse in this age group is often caused by a parent who does not report the abuse. The experience of caring for abused children is recognised as being both personally and professionally challenging. However, despite the increased risk of serious or fatal injury, caring for these infants who have suffered abuse is relatively unexplored. A qualitative research design using purposive sampling was adopted. The setting for this research was a paediatric unit in Ireland. Semi-structured interviews were conducted with 10 paediatric nurses and data were analysed using the framework approach. Paediatric nurses' views of caring for infants who have suffered a nonaccidental injury were established under four main themes: (1) 'Personal impact', (2) 'Professional roles', (3) 'Nurse-client relationship' and (4) 'Resources'. Findings highlighted that the experience for the nurse is complex. Personal emotions are evoked and the experience influenced reflection on their own lives. Communication with the parents of the infant is often difficult. Professional relationships were sometimes hindered by poor sharing of information. However, nurses strived to maintain their professionalism and to provide nursing care for the infant and their parents that was holistic. Paediatric nurses relied heavily on each other for support and their nursing experience was a valuable resource for managing nonaccidental injuries. The general consensus was that a nurse could never fully be prepared to care for an infant who had suffered a nonaccidental injury. However, recommendations for future practice and education are identified and include frequent and practical education sessions.

A Study on the Changes in Ethical Values of New Nursing Students

Objectives: After understanding the level of ethical values of freshmen nursing students, comparing to the previous studies,and checking the trend of changes, this study intends to suggest the direction of the future ethical education. Methods/Statistical Analysis: To understand the level of ethical values among the university students, the freshmen were selected who had no clinical experiences. The survey sheets were distributed by the investigator and collected after self-report. 192 copies were analyzed. Findings: There has been a tendency of principle of duty from the ethical values of students in the record of 86.10±8.94 (25.00˜125.00) followed by 24.02±4.59 (8.00˜40.00) in human life area, 25.39±3.98 (7.00˜35.00) in nurse-client relationship area, 20.86±2.73 (6.00˜30.00) in nurse-nursing task relationship area, and 15.82±2.35 (4.00˜20.00) in nurse-colleague relationship area. Therefore, the tendency of principle of duty been confirmed in all the areas. According to the changes in the period from ethical values, the area of human life has represented relatively upward tendency, while the nurse-client relationship area and nurse-nursing task relationship area maintained a bit upward tendency.The area of nurse-colleague relationship represented downward tendency. In the correlation of sub-categories of ethical values, the human life area and nurse-nursing task relationship area were positively related (.151 p<.05) followed by a strong positive correlation between the nurse-client relationship area and the nurse-nursing task relationship area (.397 p<.01), between the nurse-client relationship area and nurse-colleague relationship area (.508 p<.01), and between nurse-nursing task relationship area and nurse-colleague relationship area (.499 p<.01). Upon the results of ethical values differentiation by general characteristics, the significant differences were shown in religion (.043 p<.05) and satisfaction level on Nursing(.015 p<.05). Improvement/Application: According to the result of research, this study suggests the development of ethics education program through ethical cases related to an issue of life sanctity, single mothers related to artificial abortion, death with dignity, and error of medical service providers.

Assessment of Cancer Patient’s Satisfaction Regarding Nurses Communication Skills in Azadi Teaching Hospital/ Oncology unit

Background and aim: Communication is the process of transmitting thoughts, feelings, facts, and other information, includes verbal and nonverbal behavior. Communication is an essential element of the nurse-client relationship, teaching of client, and entire activities performed by nurses. To be an effective communicator, the nurse must be aware of the different levels on which communication is conducted between nurses and clients and among members of the health care team. Applying the aspects of communication level helps the nurse establish a therapeutic relationship with the client and thereby achieve successful outcomes of care. The study aims to assess Cancer Patient’s Satisfaction Regarding Nurses Communication Skills in Azadi Teaching Hospital as well as to find out the relationship between Patient’s Satisfaction and some Socio- demographic characteristic such as age, gender and level of education. Materials and method: A descriptive study of a quantitative design was carried out at oncology unit in Azadi teaching hospital in Kirkuk city for cancer patients from 1st of December, 2015, up to the 16th of February, 2016. A non-probability (convenience) sample of (120) definitely diagnosed with cancer disease. Selected from patients who were attended to Azadi teaching hospital generally for receiving chemotherapy dosage. Developed questionnaire was constructed for the purpose of the study which consisted of three parts: the demographic data of the respondent, the nature nurse-client relationship, and satisfaction regarding therapeutic communication. The data were collected through the use of interview with the patients. They were analyzed through the application of descriptive statistical analysis and inferential statistical data analysis. Results: The findings of the study indicated that (24.2%) of the samples were in age group (50-59) years and (≥60) years, (51.7%) of them were male, (32.5%) of the sample were illiterate, (40.0%) of them were housewife, (87.5%) of the sample were married, (79.2%) of the sample were urban residency, (23.3%) of the sample had have breast cancer, and (70.8%) of the sample were staying ≤ 1 day in the hospital. Conclusions: the study concluded that most of the patients were dissatisfied regarding the nature of Nurse-Patient communication. Most of patients were satisfied regarding Therapeutic communication. RECOMMENDATIONS The present study recommends that trained educational program should be designed to increase nurses’ awareness and knowledge about modes of communication.

A Study to Assess the Professional Socialization Perceived by the Basic B. Sc. Nursing Graduates Employed in the Selected Nursing Teaching Institutes of Gujarat State

The current shortage of registered nurses will most likely continue, exacerbated by the increased health care needs of the baby boomers as they approach retirement, the aging of the nursing workforce, and increased employment opportunities for women1. The American Association of Colleges of Nursing (AACN) reported that the Bureau of Labour Statistics announced a need for a potential million new nurses by 2010. To address this shortage, colleges and universities nationwide investigated creative ways to attract students to nursing; and B. Sc. nursing programs. These baccalaureate nursing programs which is in existence. Basic B. Sc. Nursing students carry heavy course loads in addition to completing required clinical practice hours to meet the same prelicensure requirements2. Basic B. Sc. Nursing programs are attractive to individuals for variety of reasons like employment opportunities, short time frame for program completion, and financial security etc. Many B. Sc. Nursing students enter in to nursing because they are unable to find employment in their other field of their study, have worked for companies that have downsized, or have identified within themselves the need to work with other human beings instead of engaging in technical occupations.3 Students are exposed to nursing values during the nursing program as they observe the behavior of the nursing faculty. Found in the Code of Ethics for Nurses, these values focus on the nurse-client relationship and represent the fundamental values and commitments of the nurse as well address the duty and loyalty of the nurse. Socialization begins upon entry into the nursing program and continues with entry into the workforce. Professional socialization, however, is ongoing, a facet of lifelong learning. Through the development of the affective domain, professional socialization occurs; however, nursing literature focuses on socialization primarily from the perspective of cognitive and psychomotor aspects instead of the affective aspect of being a nurse.4 But can B. Sc. Nursing students become socialized into nursing in 4–5 Years? Dr. G. Meyer voiced this concern at St. Louis University, where the first B. Sc. Nursing program originated in the early 1970s. Dr. Meyer stated, There are so many pieces in nursing; it's learning to know, it's learning to do, it's learning to be socialized into a profession. Studying socialization from the affective perspective allowed for determination whether the development of professional identity, specifically the feeling of being a nurse, was possible in Basic B. Sc. Nursing program.

Long-term home visiting with vulnerable young mothers: an interpretive description of the impact on public health nurses.

BackgroundThe Nurse-Family Partnership (NFP) is a targeted, nurse home visitation program for young, low-income, first-time mothers. While the effectiveness of the NFP has been established in the United States, and is currently being evaluated in the Canadian public health care system, we have minimal understanding of how work of this nature impacts public health nurses (PHNs), an essential component of this program delivery model, on both professional and personal levels.MethodsThis two-phase study consisted of a qualitative secondary analysis of data from five focus groups conducted with PHNs (N = 6) who delivered the NFP intervention as part of a pilot study assessing feasibility and acceptability conducted in Hamilton, Ontario. The second phase, an interpretive description of individual interviews with the PHNs (N = 10) who have delivered the NFP in this context, further explored themes identified in the first phase. A practice, problem and needs analysis was conducted to describe and understand the phenomenon and promote sustainability of PHNs in this practice environment. Conventional content analysis was used to code and categorize data in the two datasets.ResultsThe nurse-client relationship, the core elements and structure of the NFP program and support of NFP colleagues were described as rewarding factors, while workload and workplace factors were identified as significant contributors to stress. PHNs described transforming their nursing practice through redefining success and shifting to a philosophy where the client is the expert of her own life. PHNs described the personal impact of worry about clients and doubt about their effectiveness in addressing client concerns. High levels of satisfaction were described in relation to the depth and intensity of relationships with clients and seeing them succeed over time.ConclusionsPHNs are impacted in multiple ways by their work with vulnerable, young mothers. The study findings have implications for identification of strategies to support PHNs in reducing staff turnover, PHN burnout, secondary traumatic stress and compassion fatigue, and improving program delivery.

Nursing practice in community child health: developing the nurse-client relationship.

Community nursing services to parents with young children have been an established part of child health services in Australia for more than a century. Although the titles vary within states, community child health nurses provide support services for parents with infants and young children and typically their scope of practice includes public health functions such as health surveillance of the developing infant and child up to the age of 5 years and early intervention. More recently state health policies have instituted universal home visiting and emphasized the primacy of psychosocial support for parents. These policies are accompanied by education programs that propose a change in nursing practice to a more egalitarian partnership model of practice. As a consequence greater attention now has to be paid to the processes used in developing a working relationship with the client in the community setting. Whilst there has been little published in the Australian nursing literature on the methods used by community child health nurses to engage their clients, the international literature offers some insights into the nurses' practice. This paper describes the practices of community child health nurses in engaging the parent and developing a complementary and therapeutic relationship that enables the nurse to promote the health of the child and family. Published accounts of community child health nursing practice in the United Kingdom, Scandinavia and northern America are described and compared to the Australian context.

Teaching Communication to Nursing Students: Contemporary Perspectives on Practice

Client-centred communication is an integral part of nursing and is the foundation stone for the provision of high quality nursing care. The success and effectiveness of the nurse-client relationship lies in the words and body language that nurses choose to use when providing client care. Increasingly attention is being given to the therapeutic relationship between the nurse and the client, rather than a discrete set of communication skills for given situations, it is proposed that client-centred communication is an integral part of nursing and is the foundation stone for the provision of high quality nursing care. The impetus for this paper arose due to similarities arising between four independent research studies conducted by the authors, and the resultant need to share these key themes as a basis for improving communication teaching to nursing students. The aim of this paper is to present a novel examination of a core aspect of the nursing curriculum across four strands of the profession with a view to eliciting key communication skills that underpin the profession of nursing. This combined approach to understanding communication assisted lecturers to both understand and teach communication skills to three disciplines of nursing. These four conjoint studies demonstrate how the deployment of finely honed communication skills is important in the development of the nurse client relationship and ultimately the achievement of high quality nursing care. The paper further aims are to use the combined results of these four studies to demonstrate important characteristics of nurse/client communication that is relevant and applicable to diverse areas of nursing and ought to be encouraged in teaching practice.

Second-Degree Bachelor of Science in Nursing Students' Preconceived Attitudes Toward the Homeless and Poor: A Pilot Study

The current economic climate of the United States has contributed to the crisis in health care delivery services. As a result, an increasing number of individuals present as poor and vulnerable. Currently, poverty rates in the United States are climbing, with literature clearly reflecting an association between poverty and ill health. With a number of economic barriers to health care, it has been suggested that health care providers' attitudes and subtle prejudices have also contributed to access. These preconceived negative attitudes can shame and embarrass vulnerable, homeless, immigrant, and poor individuals from attempting to access care. This research attempted to identify preconceived attitudes that second-degree baccalaureate nursing students possess prior to clinical exposure to poor and homeless populations through qualitative and quantitative investigative methods. Senior-level community health students preparing to deliver health care at a suburban homeless day shelter were asked to describe their experiences and opinions relative to homeless and poor persons before and after their actual contact with this population. Collected data suggest that there are subtle stereotyping and negative attitudes regarding the plight of overtly impoverished individuals before rendering care. After an 8-hour clinical experience with the aforementioned population, attitudes toward the vulnerable slightly improved, suggesting that clinical and didactic exposure to the plight of poor populations may assist to sensitize student nurses to exude compassion through a holistic therapeutic nurse-client relationship.

Narrative Writing: Its Role in Nursing Literature

Narrative Writing: Its Role in Nursing Literature

Benefits of psychosocial intervention and continuity of care by child and family health nurses in the pre‐ and postnatal period: process evaluation

To report a programme theory for pre-natal home visiting by nurses in the context of a sustained nurse home visiting programme by exploring pre- and postnatal outcomes and characteristics of the intervention that may have contributed to the outcomes. Studies have shown sustained nurse home visiting commencing pre-natally to be effective. Few studies have explored the processes by which pre-natal activities by nurses contribute to achieving effective outcomes. Process evaluation. Process and outcome data from a randomized controlled trial of sustained nurse home visiting in an area of socioeconomic disadvantage in Western Sydney between 2005-2008 were collated. The pre-natal intervention focused on improving transition to parenting by supporting mothers through pregnancy. Health and service use outcome data were analysed for 208 women (111 intervention; 97 comparison receiving usual care). Five nurses delivering the intervention completed checklists detailing activities undertaken. Nurses provided information, psychosocial support, and health promoting activities for families. Intervention mothers had a higher rate of unassisted vaginal births than the general population. Compared with comparison mothers, intervention mothers at 4-6 weeks postnatally reported better general health and felt significantly more enabled to cope with and understand their baby and to care for themselves and their baby. Comprehensive support, in a context of enabling client-nurse relationships and continuity of carer are the ways by which antenatal nurse home visiting achieves benefits for women and infants, having an impact on both clinical outcomes such as rates of normal vaginal delivery and maternal service engagement.

Examining the language-place-healthcare intersection in the context of Canadian homecare nursing

Currently, much of the western world is experiencing a shift in the places where care is provided, namely from institutional settings like hospitals to diverse community settings such as the home. However, little is known about how language and the physical and social aspects of place interact to influence how health-care is delivered and experienced in the home environment. Drawing on ethnographic participant observations of homecare nursing visits and semi-structured interviews with Canadian family caregivers, care recipients and nurses, the intersection of language, place and health-care was explored in this secondary analysis. Our findings reveal four themes: homecare nurses view themselves as 'guests'; home environments facilitate the development of nurse-client relationships; nurses adapt healthcare language to each home environment; and storytelling and illness narratives largely prevail during medical interactions in the home. These findings demonstrate the spatiality of language and how the home environment informs decisions regarding language use. Furthermore, these findings exemplify how language and place mutually influence the experiences and delivery of home health-care. We conclude by discussing the importance of considering the language-place-healthcare intersection in order to gain a better understanding of medical exchanges in places and the associated implications for optimizing best nursing practice.

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

This study explored the meaning of a positive client-nurse relationship for seniors with chronic disease receiving in-home care. In this phenomenological study, eight participants aged 65 to 86 were purposefully selected from the Southwest Community Care Access Centre (SW-CCAC) in London, Ontario. Narrative data were collected through audiotaped, in-depth interviews using a semi-structured interview guide. The analysis and interpretation of the interviews revealed that the meaning of a positive client-nurse relationship for these seniors encompassed two patterns of the meaning: having comfort and being connected within this relationship. These two patterns were contextualized by being a senior with chronic disease and were socially constructed through the relational experience of co-creating a positive relationship. Although further research is needed, the insights gained add to what is known about the theory and practice of relational health promotion for seniors living with chronic disease receiving in-home care.

Coping focus counselling in mental health nursing

The aim of this paper was to describe a newly-developed system of mental health nurse counselling (coping focus counselling (CFC)) for people with serious and complex mental health needs. The system is based on the recovery alliance theory (RAT) of mental health nursing. The paper identifies shortcomings in current practices in psychotherapy and counselling in the exclusive use of techniques from a single approach, for example, cognitive behaviour therapy, client-centred therapy, attachment theory, or Gestalt theory. It also discusses the opposite dangers of the use of many techniques from different approaches, without a clear rationale for their selection. CFC was developed to avoid these practices. It accommodates the selective use of techniques from different approaches. Techniques selected are viewed as deriving their meanings from the theoretical framework into which they are assimilated, namely RAT, and no longer take the same meaning from the theory from which they originated. Central to this integrative process is the use of the concept of coping. Other distinguishing features of CFC are the use of everyday language in using the system and the reaffirmation of the nurse-client relationship within a working alliance as the basis in which the CFC operates.

Nurse Home Visitors' Perspectives of Mandatory Reporting of Children's Exposure to Intimate Partner Violence to Child Protection Agencies

To examine nurse home visitors' perspectives of and intentions to report children's exposure to intimate partner violence (IPV) in the context of the home visitation setting. Cross-sectional study of 532 nurse home visitors in the Nurse-Family Partnership home visitation program. A web-based questionnaire assessing nurse home visitors' support for and attitudes toward mandatory reporting of children's exposure to IPV. Nurses' considerations of what levels of exposure constitute maltreatment and their intended reporting behaviors were also examined. Variability and uncertainty were observed in participants' attitudes as well as in their determinations as to which situations constitute child maltreatment. Most of the sample believed reporting exposure to IPV can help the battered woman (67%) and can protect children (92%), while 56% indicated that reporting can negatively affect the nurse-client relationship. Nurses were more likely to endorse reporting children's exposure to IPV when the child was at greatest risk for being physically injured as a result of IPV. Training about maltreatment reporting procedures in home visitation programs should focus on the interpretation of child maltreatment laws as well as collaborations with local child protection service agencies to determine if children's exposure to IPV is reportable.