Working with complexity : experiences of caring for mothers seeking residential parenting services in New South Wales, Australia

Aim and objectives: To investigate staff perception of the changing complexity of mothers and infants admitted to two residential parenting services in New South Wales in the decade from 2005-2015. Background: For many mothers with a young child, parenting is difficult and stressful. If parenting occurs within the context of anxiety, mental illness or abuse it often becomes a high-risk situation for the primary caregiver. Residential parenting services provide early nursing intervention before parenting problems escalate and require physical or mental health focused care. Design: A qualitative descriptive design using semi-structured interview questions was used as phase three of a larger study. Data were gathered from 35 child and family health nurses and ten physicians during eight focus groups. Results: Three main themes emerged: (1) dealing with complexity; (2) changing practice; and (3) appropriate knowledge and skills to handle greater complexity. Conclusions: There was a mix of participant opinions about the increasing complexity of the mothers presenting at residential parenting services during the past decade. Some of the nurses and physicians confirmed an increase in complexity of the mothers while several participants proposed that it was linked to their increased psychosocial assessment knowledge and skill. All participants recognised their work had grown in complexity regardless of their perception about the increased complexity of the mothers. Relevance to clinical practice: Australian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional and physical problems. Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and nurses need to be adequately supported and educated to manage the complex presentations of many families.