Managing medical advice seeking in calls to Child Health Line

• Published in: Sociology of health & illness 2009-09, Vol.31 (6), p.817-834
• Main Authors: Butler, Carly W., Danby, Susan, Emmison, Michael, Thorpe, Karen
• Format: Article
• Language: English
• Subjects: Australia; Authority; Child; Child Development; Child health; Communication; conversation analysis; Counseling - methods; Decision making; Delivery Systems; Health care; Health Care Services; Hotlines - standards; Humans; Medical treatment; nurse; Nurses; Nursing Process - organization & administration; Occupational roles; Parents; Parents & parenting; Pediatric Nursing - methods; policy; Professional responsibilities; Remote Consultation - organization & administration; Telecommunications; telehealth; Telemedicine; Telemedicine - methods; Telephone; Telephone hotlines
• ISSN: 0141-9889; 1467-9566
• DOI: 10.1111/j.1467-9566.2009.01179.x

Child Health Line is a 24‐hour Australian helpline that offers information and support for parents and families on child development and parenting. The helpline guidelines suggest that nurses should not offer medical advice; they do, however, regularly receive calls seeking such advice. This paper examines how the service guidelines are talked into being through the nurses’ management of callers’ requests for medical advice and information, and shows how nurses orient to the boundaries of their professional role and institutionally regulated authority. Three ways in which the child health nurses manage medical advice and information seeking are discussed: using membership as a nurse to establish boundaries of expertise, privileging parental authority regarding decision making about seeking treatment for their child, and respecifying a ‘medical’ problem as a child development issue. The paper contributes to research on medical authority, and nurse authority in particular, by demonstrating the impact of institutional roles and guidelines on displays of knowledge and expertise. More generally, it contributes to an understanding of the interactional enactment and consequences of service guidelines for telehealth practice, with implications for training, policy and service delivery.