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Contextual Factors Influencing the Evolution of Nurses' Roles in a Primary Health Care Clinic


Barbara L. Paterson, University of New Brunswick Faculty of Nursing, PO Box 4400, Fredericton, NB, Canada E3B 2A5. E-mail:


ABSTRACT Objectives: The purpose of the research was to explore the everyday experiences and responses of stakeholders of a university-sponsored nurse-managed clinic (CHC) in regard to how nurses' roles in the clinic changed over time and the factors that influenced this change.

Design and Sample: The research used a qualitative interpretive description design to interpret participants' accounts of their experience and perspectives as constructed narratives. The participants (N=23) included clients, community members who were volunteers at the CHC, staff of other community agencies or organizations, and nursing or social work students who had a clinical learning experience at the CHC.

Measures: Data collection involved two interviews, one semistructured, face-to-face interview at the location selected by the participant, and a group interview held in a boardroom at the CHC. Each interview lasted approximately 60–90 min.

Results: The research findings revealed the profound effects of the social, political, and economic context in determining nurses' roles within a nurse-managed primary health care clinic. The evolution of nursing roles occurred in reaction to these effects, causing the nurses within the CHC to juggle their priorities and commitments.

Conclusions: The study provides a contemporary example of the political activism work of nurses that is often invisible and illustrates how the commitment of primary health care nurses to social justice contributes in a significant way to the resolution of health inequities experienced by marginalized populations.