Can you feel the force? The
importance of power in practice
In this chapter some short case studies are presented, which provide examples of practice development in four of the community nursing specialisms. After each case study, the key themes that emerge are explored in detail, and strategies that can help practitioner's work through issues raised are identified. Readers are strongly advised not to be tempted to read only the case study that relates to their specific specialism, but to explore each one. The themes–namely conflict, primary to secondary care shift, medical dominance, negotiation and user perspectives–that emerge from the case studies are of relevance to nursing practice development generally.
'Bloody tribalism!' screamed Fiona as she replaced the telephone handset. She had just received another irate call from a local school nurse, Cynthia Hardwick, to enquire why she was seeing Claire Graham, a 7-year-old with cerebral palsy. Cynthia had accused her of undermining Claire's mother's confidence in the school health service by taking over her care and starting treatment for her daytime incontinence problems. Cynthia was one of a long line of school nurses and health visitors who were going to complain to their manager, Miss Arlington, about the role of the community children's nurse, and in particular, about Fiona.
Fiona wondered why she had bothered to take the job in the first place. As she boiled the kettle, she quietly seethed about the Constant criticism levelled at her by her colleagues from the community trust. If