Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Mary Jo Clark, PhD, RN, Chair; Diane C. Hatton, DNSc, RN; Patricia A. Chin, DNSc, RN


home visit, nursing, Occupational safety, perception, public health, southern California


By the year 2005, there will be an estimated 1.25 million workers involved in providing nursing care to individuals in their homes (Bureau of Labor Statistics, 1997). There is limited empirical data available on the issue of safety of nurses within the context of home visiting or in the public health venue. Recent research on safety in home visiting has focused on home health rather than public health nursing. The purpose of this study was to explore and explain the perception of safety among field public health nurses. A purposive sample of 19 public health nurses employed in an official public health department in Southern California participated in semi-structured interviews. Participants in this study had an average age of 45.2 years and an average length of public health nursing practice of 10.5 years. This study used grounded theory research methodology. Findings of this study have provided a substantive explanation on the process of keeping safe for field public health nurses. This process had three stages, (a) risk awareness, (b) risk estimation, and (c) risk limitation. Public health nurses maintained risk awareness through vigilance. Universally, the nurses in this study were vigilant regarding idle young men, dogs, suspicious and threatening behavior, substance abuse, angry family members, and communicable diseases. Risk estimation involved the nurses' estimation of their own vulnerability and safety decision-making. The final stage of the emerging theory constituted the actions taken by the nurse while keeping safe. Risk limitation were actions that either prevented or avoided actual or perceived risks. The process of keeping safe continued to evolve for public health nurses with the influence of peer and supervisory support, family, feelings, and vicarious knowledge. The findings of this study have implications for nursing education, practice, and research. The need to educate students and novice public health nurses on the process of keeping safe is of particular importance.

Document Type

Dissertation: Open Access



Included in

Nursing Commons