Narrative inquiry in a nursing practicum

Narrative Inquiry

Narrative Inquiry is a research methodology that we adapted over the past two decades from Canadian higher education and curriculum studies to nursing research, education, and health-care practice. The Narrative Inquiry we use originated from Connelly and Clandinin in the 1990s, and rests on John Dewey’s philosophy that experience is relational, temporal, and situational, and as such, if intentionally explored, has the potential to be educational. More specifically, it is only when experience is reflected upon and reconstructed that it has the potential to reveal the construction of identity, knowledge, and the humanness of care. Congruent with the expectation that nurses are reflective practitioners and knowledge-makers, Narrative Inquiry provides a means to enhance, not only quality of care, but quality of experience of those in our care: in education, our students, and in practice, our patients. In this article, we explicate how Narrative Inquiry may be lived in health-care education and practice, with a primary focus on nursing. We illuminate how we support our graduate students, the next generation of narrative inquirers, through a Narrative Inquiry Works-in-Progress group.

Developing Clinical Knowledge through a Narrative-Based Method of Interpretation

The results of research using a narrative analysis provide new clinical knowledge, but the methods used are unknown to many readers. In this paper we present an example of how an analysis may be performed in practice. The purpose of the interpretation of this specific story was to develop clinical knowledge of how it is to live with chronic heart failure from a daily life perspective. The steps in the interpretation process, within the framework of Paul Ricoeur's Interpretation theory, were: (1) general or naïve reading, (2) distancing, (3) examination of discourse, (4) conjectures and questions, and (5) reflection over the whole. The demonstrated interpretation of the interview resulted in a theme called: “Struggling to comprehend medical information”. This systematic way of working with narratives makes implicit assumptions about the relationship between meaning and language explicit. These themes can be used in everyday practice as clinical tools. Because of the interpretative nature of human understanding the experienced health professional will be capable of integrating evidence-based research findings and individual illness experience.

Narrative hermeneutics: in search of narrative data

As human beings, we live in a storied world. This worldview requires us to think about how to re-present it in research. My purpose with this article is to reflect upon narratives from an ontological and epistemological point of view, taking Ricoeur's writings on narrative identity as a starting point. From this perspective, narration is an aspect of self-interpretation and self-understanding. Furthermore, self-understanding is not only achieved within our own narratives, but depends upon the regard, words and actions of others. This must be accounted for in our search for narrative data. Researchers would benefit from being alert to this and also aware of how narratives are co-authored in a dialogue with participants. Reflections on narration from this perspective could guide ethical considerations - and also methodological - as they could support questions that would create space for the narrative. Furthermore, the researcher must be aware that the quality and trustworthiness of narratives to a high degree depend on the researcher and not only on the participant.

Thinking narratively: artificial persons in nursing and healthcare

Positioned within my research program that explores nurses' experience and construction of their daily praxis, I think narratively about how to stay in my work as a nurse-teacher, how students enter the profession and how registered nurses stay in nursing practice. I present co-participants' stories (all names are pseudonyms except for the author's "I") that reveal how a nurse is often in between autobiographically informed actions and the certainty of institutional roles that shape us into artificial persons. I explore the nature of the relationship between nurses, their professional roles and a primary accountability to people who happen to be patients - or students. This paper has implications for retention of nurses in practice and in education within the context of a global shortage of nurses. Further inquiry is invited in relation to our ability to shape social situations towards health. When narrative inquiry is working, people are drawn into their own experience and can discern new plotlines for relationships and possibilities for action within their social environments.