Abstract
The purpose of this study was to describe the experiences of public health nurses (PHNs) in outsourced infant health examination services, and to identify the implications of the role of PHNs in outsourced services and the factors necessary to promote effective outsourcing. Semi-structured interviews were conducted with 11 municipal PHNs who had participated in the activities of the infant health examination service before and after outsourcing. The data were then qualitatively analyzed. For the PHNs, their experience with outsourcing the infant health exam was "a process in which they realized changes in the wake of outsourcing and identified the meaning of outsourcing." PHN responses reflected three perspectives on their relationships with community members ; as member-to-be-protected, member-as-client, or member-as-partner. Three meanings of outsourcing were identified : 1) "it creates distance from community members ;" 2) "outsourcing is a way for survival ;" and 3) "it brings more resources to the community." The analysis suggested that three factors were most important to the PHNs : 1) the realization they needed to focus on relationships with community members and work more to understand their perspectives ; 2) the value of attempting to see the services with a broader perspective ; 3) that their responsibility was to check with community members to see whether the services were provided in a suitable manner. Outsourcing required their vision of practice to change.
