Abstract: Plunket nurses are New Zealand child health nurses who work in the community with the families of new babies and preschool children. Their work is called child health surveillance and this is considered to involve routine and unproblematic practices which are generally carried out in homes and clinics in the context of a relationship with the child's mother (Ministry of Health 1996; Royal New Zealand Plunket Society 1997). However, evidence in the literature that surveillance can have implications for power relations throws doubts on official claims that the relationship between the mother and nurse operates as a partnership (Trout and Polaschek 1996). The purpose of this thesis was to explore the way in which surveillance is constituted within the discourses of Plunket nurses and to examine these discourses for any implications of unequal power relations. Foucauldian discourse theory and poststructuralism, which informed this thesis, provided the opportunity to challenge assumptions about power and knowledge in the child health context. Analysis of the discourses generated by interviews with five Plunket nurses revealed that, contrary to the claims in the official literature, the relationship between the Plunket nurse and the mother is not that of an equal partnership but is constituted in various and unexpected ways. It was through the nurses' discourses of surveillance that the power relations underpinning this relationship were surfaced. While these discourses suggested that many mothers who use the nursing service are actively involved on their own terms, there are a number of women for whom the surveillance activities of the nurse have been shown to be particularly intrusive (Mayall 1986; Clinton 1988; Bloor and McIntosh 1990; Knott and Latter 1999). It may be primarily this unwelcome surveillance which accounts for the considerable number of women who, the statistics show, cease using Plunket services particularly in the early months. It is perhaps for this reason that the nurses in this study locate themselves as being caught between divergent discourses of support and surveillance. Findings indicate that the resolution of this dilemma by abandoning surveillance practices might improve maternal satisfaction with the Plunket nursing service. The author concludes that a child health service responsive to mothers' stated needs rather than institutional requirements or the nurse's own agenda could lead to a more open and equal relationship between mother and nurse. This relationship would be likely to benefit mothers and babies and, at the same time, enhance both nursing practice and nurses' satisfaction with their work.

Abstract: The purpose of this paper is to examine the discourses of scientific mothercraft and their implications for the nurse-mother relationship, drawing on the author's recent research into surveillance and the exercise of power in the child health nursing context. The application of Foucauldian discourse analysis to the texts generated by interviews with five New Zealand child health nurses confirms that this paradoxical role has never been fully resolved. Plunket nurses primarily work in the community with the parents of new babies and preschool children. Their work, child health surveillance, is considered to involve routine and unproblematic practices generally carried out in the context of a relationship between the nurse and the mother. However, there are suggestions in the literature that historically the nurse's surveillance role has conflicting objectives, as she is at the same time an inspector and family friend.

Abstract: This paper uses the findings of two studies to explore the nature of nurses' practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. The first study was with the elderly with delirium and used a critical gerontological methodology informed by postmodernism and Foucault's understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology. The findings show that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people's lives outside of the health care environment is ignored. Consequently, the foundations of nursing practice, that of holism, is found to be merely a rhetorical construct.