title: Contextual factors influencing the evolution of nurses' roles in a primary health care clinic.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Tier 1 Canada Research Chair, University of New Brunswick, Fredericton, PO Box 4400, Fredericton, New Brunswick E3B 2A5, Canada. bpaterso@unb.ca
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Paterson
authors.forename: Linda
authors.initials: L
authors.lastname: Duffett-Leger
authors.forename: Kathleen
authors.initials: K
authors.lastname: Cruttenden
mesh_terms: D000554:Ambulatory Care Facilities; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D024802:Nurse's Role; D011320:Primary Health Care