The process of implementing a new baby-friendly hospital initiative for nurses: a grounded theory study

Maternity nursing practice is changing across Canada with the movement toward becoming “baby friendly.” The World Health Organization (WHO) recommends the Baby-Friendly Hospital Initiative (BFHI) as a standard of care in hospitals worldwide. Very little research has been conducted with nurses to explore the impact of the initiative on nursing practice. The purpose of this study, therefore, was to examine the process of implementing the BFHI for nurses. The study was carried out using Corbin and Strauss’s method of grounded theory. Theoretical sampling was employed, which resulted in recruiting and interviewing 13 registered nurses whose area of employment included neonatal intensive care, postpartum, and labour and delivery. The data analysis revealed a central category of resisting the BFHI. All of the nurses disagreed with some of the 10 steps to becoming a baby-friendly hospital as outlined by the WHO. Participants questioned the science and safety of aspects of the BFHI. Also, participants indicated that the implementation of this program did not substantially change their nursing practice. They empathized with new mothers and anticipated being collectively reprimanded by management should they not follow the initiative. Five conditions influenced their responses to the initiative, which were (a) an awareness of a pro-breastfeeding culture, (b) imposition of the BFHI, (c) knowledge of the health benefits of breastfeeding, (d) experiential knowledge of infant feeding, and (e) the belief in the autonomy of mothers to decide about infant feeding. The identified outcomes were moral distress and division between nurses. The study findings could guide decision making concerning the implementation of the BFHI.

When petro-capitalism comes knocking: community interpretations and responses to the Gros Morne fracking controversy

With the depletion of conventional oil and gas sources, the world is turning to what Urry terms “tough oil,” such as oil from the Alberta oil sands and Arctic. Fracking is a prominent example of this. Situated within an environmental justice framework, I analyze community interpretations and responses to proposed fracking development near Gros Morne National Park, Newfoundland, Canada. Based on data generated from interviews, field observations and content analysis of texts, my findings suggest that how residents view rural place is highly significant in influencing supportive or oppositional positions on fracking. Proponents picture place as a resource extraction landscape, whereas opponents understand place as a restorative landscape for leisure/tourism activities. Through debates about fracking, place is contested and re-imagined. In many ways, fracking is a struggle over who has the power to define the meanings and characteristics of rural community in an era of tough oil and significant rural change.