Date of Award


Degree Type


Degree Name

Master of Science in Nursing




Dr. Cathy Ward-Griffin

Second Advisor

Yvette Laforêt-Fliesser


Background: With the release of the Community Health Nurses of Canada standards of practice (2003), the importance for nurses to establish empowering relationships within supportive environments is paramount. Moreover, it is important for nurses to recognize and understand how their position and the power it holds may influence relationships with clients in their practice. Purpose: Guided by feminist inquiry, the major purpose of this research was to critically examine the relationships between Public Health Nurses (PHNs) and adolescent students in the school community. Specific questions included: How do PHNs describe their relationships with adolescent students within a school community? What broader contextual factors shape the formation and development of these relationships? Methods: Using open-ended questions and a dialogic approach, 13 PHNs who work in secondary school nursing at one urban public health unit participated in one of three focus groups. Thematic analysis was conducted as described by Morse and Field (1995). Findings: Study findings suggest that the formation and development of the PHN- Student relationship is likened to that of building a school comprised of five interlocking “building blocks”: visibility, trust, collaboration, continuity and power. Visibility was the PHN “gateway” for individual student contact. PHNs were considered trustworthy due to their outsider status to the school system. Collaboration was foundational to the relationship and involved negotiation, compromise and consultation. Continuity reinforced the need for time and consistency in public health programs and within the relationship. Power was found within hierarchical layers and reinforced by social relations of culture, gender and class. Conclusion: In order to build empowering PHN-student relationships, PHNs must critically reflect on their individual nursing practice and policies, which influence relationship formation. Realizing the potential empowering and disempowering influences of gender, race, class, religion and other social determinants on health, PHNs are in a position to advocate for and promote the health and well-being of adolescent students. Further critical nursing research that incorporates the perspectives of students and others influential in the formation of the PHN-student relationship is needed. Key Words: nurse-client relationship, Public Health Nurse, school nursing, adolescent students, relationship formation, feminist inquiry



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.