This blog will discuss my doctoral research, which was a critical narrative inquiry that sought to identify patterns in the stories of 10 nurses working in an American Nurse Credentialing Center (ANCC) Magnet re-designated Oncology unit. Critical narrative inquiry is a research method developed by Dr. Suzie Kim (2010).  Critical narrative inquiry reflects upon societal-contextual experience and prescribed power relationships to identify, transform and transcend oppression. It deconstructs normative hegemony (the way things are or expected to be vs. the way things could be) by analyzing language, communication patterns and symbolic meanings in experience (Dunphey & Longo, 2007).

The method has 3 phases: 1) the nurses tell a story that exemplifies their experience of a theory guided practice; 2) the stories are recorded and transcribed, then critically read and reflected upon by the participants and researcher with the purpose of identifying salient patterns that emerge as facilitators or barriers to their theory guided practice; and 3) the nurses identify opportunities for transformative learning and emancipatory praxis.

During the process of the study I used Dr. Peggy Chinn’s Peace and Power model (2008) to share power with the nurses and optimize emancipatory knowledge acquisition by hearing their voices. I asked them what was important to them in their practice and in their experiences. Our research sessions were a dialogue between colleagues and I was careful to value their voice and power throughout the study and publication.

The purpose of the research was to:

• Examine the impact of Human Caring theory guided practice upon nursing qua Nursing.
• Learn about nurses’ educational preparation in theory guided practice and integral nursing.
• Examine the relationship between nurses knowledge, caring and power in the Magnet environment.
• Identify patterns that facilitate and create barriers to nursing qua nursing.

What we learned from the research was:

• Nurses are transformative change agents who advocate for their patients, even against normative views and authoritarian power if it is in the best interest of their patients and families.

• Nurses have a language and culture of rich values enacted through careful and meaningful comportment via her/his self-agency that protects and preserves the integral health of those in their care, community and environments.

• Environments are affected by nurse’s behaviors and actions; external environments are carefully created to enhance patient’s internal environments via; lighting, ambient temperature, music, positioning, cultural, spiritual and religious acts, healing intention, touch, voice and presence.

These findings support Jarrin’s (2012) work where she describes nursing as “Situated caring shaped by internal and external environments. These environments include: the individual nurse’s state of mind, intention and personal nursing philosophy, their scope, role, level of skill, training and experience societal and professional norms, values, and worldview social, political, and economic systems embedded in education and practice environments” (p. 14).

This research further supports Kagan, Smith, Cowling and Chinn’s (2009) work that rally’s nurses together for social justice and to protect and support professional values that empower nurses at all levels. The nurses in my study identified that working with nurses who value and support each other; while valuing and seeing the big picture or true meaning of protecting, advocating for and enhancing the patient and families integral health experience, creates optimal work and patient care environments.

Emancipatory praxis requires a convergence of multiple patterns of knowing, doing and being; where the nurse can sense and see patterns that are emerging; and imagine what can become for self, colleagues and those in their care. The knowledge, caring and power dialect is a rich area of inquiry for nurses to conduct further research.

References

Dunphey, L. & Longo, J. (2007). Reflections on postmodernism, critical social theory and feminist approaches: The mind of the postmodern. In P. L. Munhall (Ed.) Nursing research: A qualitative perspective (4th ed., pp. 127-142). Sudbury, MA: Jones and Bartlett.

Jarrin, O.F. (2012). Redefining the metalanguage of nursing science: Contemporary underpinnings for innovation in research, education and practice. Advances in Nursing Science, 35(1), 14-24.doi10.1097/ANS.obo13e3182433b89.

Kagan, P. N., Smith, M.C., Cowling, W.R., & Chinn, P.L. (2009). A Nursing Manifesto: An emancipatory call for knowledge development, conscience, and praxis. Nursing Philosophy, 11, 67-84.

Kim, H.S. (2010). The nature of theoretical thinking in nursing (3rd ed.). New York: Springer.

Marks, L.W. (2013). The Emancipatory Praxis of Integral Nursing: The Impact of Human Caring Theory Guided Practice Upon Nursing Qua Nursing in an American Nurses Credentialing Center Magnet® Re-desginated Healthcare System. Retrieved October 21, 2014 from http://tinyurl.com/ovqlk3t