Nowhere to Stand: A critical discourse analysis of nurses’ responses to child neglect and abuse

Abstract

Nurses working with families are well positioned to respond to child neglect and abuse (CN&A), yet in Canada, their role is poorly defined and they remain peripheral to child protection work. The purpose of this research is to better understand nurses’ contributions to addressing CN&A and to support nursing practice in this regard. The research questions ask: how do nurses respond to CN&A; what influences these responses; and what might support nurses to respond more effectively than they currently do? Fairclough’s dialectical-relational critical discursive analysis was chosen as a method because of its strength in addressing resistant social problems. Texts that represent and guide nurses’ responses to CN&A in British Columbia were collected and discursively analysed. These texts include legislation, policy and practice guidelines, nurse interviews, and popular news media texts. Philosophical ideas from Žižek and Spinoza support the theorisation of violence and suspicion, while Haraway supports the identification of three tropic figurations, which form obstacles to meaningful responses to CN&A. Tracing the operations of these figurations throughout the texts, The Vulnerable Child is shown to justify oppressive proprietary relations and surveillance over children, The Responsible Family is shown to legitimise social inequity for children and isolate them in the home where they are most likely to experience abuse, and The Monstrous Perpetrator is shown to focus attention on spectacular cases, diverting it away from most CN&A. Findings demonstrate how nurses are frustrated by social structures that govern their practice and leave them in challenging ethical positions, often with nowhere to stand. In this thesis, I argue that the dominant individualised responses to CN&A are misaimed and call for a social response to interrupt everyday violations that children experience.