In contrast, at the beginning of the twenty-first century there is evidence of increasing interest in storytelling across diverse disciplines, including nursing and other health professions. Commenting on this renewed attention to the narrative nature of human beings, Buford suggested that:.
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Implicit in the extraordinary revival of storytelling is the possibility that we need stories — that they are a fundamental unit of knowledge, the foundation of memory, essential to the way we make sense of our lives We have returned to narratives — in many fields of knowledge — because it is impossible to live without them. Despite the ubiquitous nature and renewed scholarly interest in narratives and stories, there is little agreement about what constitutes either.
Among researchers who engage in narrative inquiry, there are also definitional and methodological differences. Accordingly, researchers from different disciplinary perspectives have constructed multiple approaches to the analysis and interpretation of narratives. At the same time, we struggled to find methodological approaches that fit our philosophical and disciplinary perspectives. Although we were clear about our nursing and feminist bearings, we constantly challenged ourselves to incorporate these multiple perspectives and standpoints into the research processes.
We consider this approach a form of feminist narrative interpretations. The purpose of this paper is to discuss our responses to the various methodological and epistemological challenges, tensions, and opportunities we have encountered as we explored and developed our approach to feminist narrative interpretations. We begin with a brief discussion of the connections and challenges to narrative research posed by both nursing and feminist perspectives, then proceed with a more detailed description of how we addressed these challenges. Nursing "is no stranger to narrative; it has always been a part of how we have explored the shared world of our patients" Vezeau, , p.
Patients and clients often use stories to inform nurses about their experiences with health and illness. Storytelling helps patients to find meaning in their experiences, gives them the opportunity to reconstruct their lives, and can promote health and healing Bartol, ; Sandelowski, Nurses not only listen to patients' stories, they also are storytellers.
In communicating with each other about their experiences with patients, their families, and other health care professionals, nurses commonly use stories. They also incorporate storytelling into health education and in helping patients and families explore ways to identify and cope with illnesses. We were attracted to a narrative approach to research because searching for and sharing stories was a natural extension of our clinical nursing practice. Feminism supports diversity in extending the methods of the qualitative traditions. Experimentation with different forms and texts is one way feminists have found to express more fully the insights arising from transformations in research practice Devault, Feminist methodologies allow for more interpersonal and reciprocal relationships between researchers and the individuals whose lives and experiences constitute the focus of the research Bloom, ; Lawless, ; These are similar to the relationships that nurses strive to develop with their patients and clients.
The context for this paper is our qualitative research exploring women's work during pregnancy. Because we were interested in exploring women's work during pregnancy within multiple contexts, the women we invited to participate were situated in different contexts across multiple continua of weeks of pregnancy, age, race, education, national origin, partnered status, and current employment, economic and living circumstances. Rather than impose our definition of women's work during pregnancy, we simply asked participants to define work and to share their perceptions and experiences concerning work during pregnancy.
We interviewed 29 women at all stages of pregnancy and with diverse ethnic, socioeconomic, cultural, and demographic characteristics. Three of the interviews were conducted with the women and their male partners, interjecting other dimensions into the research dialogues. We anticipated, and found, that these women defined, conceptualized, experienced, and interpreted work differently, and in diverse personal and social contexts and environments.
Staying open to the possibility of "uncovering" or "discovering" diversity in women's experiences with work during pregnancy was a key underlying assumption of the study. The recognition of diversities among women, e. Much of the mainstream research in all disciplines including nursing has been blind to such diversities among women. We agree with Anderson that sound feminist analysis must entail an understanding of race, class, and gender, and other axes of inequality, as researchers seek both the commonalities and the differences across women's experiences.
However, narrative researchers differ in the extent to which they include and consider the larger social context in which narratives are embedded Riessman, At one end of the spectrum, conversation analysts limit their focus to what participants say and do in a particular interaction. We situate ourselves more closely with other feminist narrative analysts such as the Personal Narratives Group , in making a conscious effort to consider how race, class, gender, sexuality, ability, immigration status, and other contexts of diversity and inequality surface in research participants' multilayered daily life experiences, their telling of their stories, and the multiple contexts within which these stories may be represented and interpreted.
Like other feminist researchers who embrace interpersonal and reciprocal relationships with those they study, we were challenged by "concerns about ethics, reflexivity, emotions, positionality, polyvocality, collaboration, identification with participants, intersubjectivity, and our own authority as interpreters" Bloom, , p. Some of the tensions we had encountered in other qualitative approaches led us to experiment with different forms of narrative analysis, which we found posed other challenges as well as opportunities.
Heeding Sandelowski's forewarnings, as nurse scholars engaged in exploring narrative inquiry, we understood the need to address. In addition to grappling with issues of ownership, truth, temporality, and the social and environmental issues surrounding the creation and interpretation of stories within nursing research, underlying our ongoing collaborative efforts to develop this feminist narrative interpretative approach were several questions we felt compelled to attempt to answer: How does this approach to narrative reflect both nursing and feminist perspectives?
What is our "working definition" of story?
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What is the position of the researcher in the co-creation of women's stories? How useful are narrative analysis techniques in feminist narrative interpretations? What are possible forums and formats for adequately and ethically re-presenting these cocreated stories? In the remainder of this paper we discuss how we have responded to these tensions, challenges, and opportunities in developing our approach to feminist narrative interpretations.
In colloquial usage, "story" can mean fantasy, truth, lie, or almost anything in between. Therefore, one of our main challenges has been to develop a working definition for "story" within the context of feminist narrative interpretations. How we defined "story" was a key to the way we approached both the collection and interpretation of qualitative data.
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In developing our working definition, we dealt with the processes of eliciting stories in the context of research, the structure and function of stories, and the gendered nature of narratives. We felt that because each individual can have their own unique definition of "story," requesting a research participant to "tell a story" could miss some of the richness of their experiences around particular topics. Therefore, rather than asking for specific stories, we encouraged participants to talk about their work during pregnancy in whatever way they chose.
The conversations that occurred in the course of research interviews were the direct result of shared moments and experiences that occurred between a storyteller and listener-researcher- interpreter.
Narrative inquiry and nursing research | Emerald Insight
Because we found their experiences were more naturally expressed and more clearly understood during guided conversations, we moved from a more traditional interview format to a style that resembles more a "conversation" Riessman, , p. We found that having a focused conversation allowed for a free flow of thoughts and encouraged participants to participate more fully in the research by offering their own interpretations of their life experiences and contexts.
In both our research and our nursing practice, we have come to view women's stories as representations of their experiences. We approach stories as interpretations of experience, reinterpreted with each telling-hearing-reading.
Therefore, we were not comfortable with the notion of story as an "accurate" or "true" account of what "really" happened. In each co-created research conversation a woman can only share what is "real" and "true" for her at that very moment. That reality can be shaped by, for example, her physical feelings, the weather, what she had for breakfast, how she reacts to the researcher, what she perceives the researcher wants to know, or any number of other environmental or contextual factors.
Likewise, the researcher may be affected by similar factors. These resulting research narratives are conversations bounded by the context i. We view stories as socially constructed tapestries that weave together unique threads of personal, relational, and cultural realities, perceptions, and experiences, in the process of facilitating the creation of fluid meaning Bruner, ; Riessman, ; Richardson, Within the narrative texts transcribed from our research conversations, only rarely have we identified a temporal sequence of plots or found stories that were plainly bounded or had clear indications of a beginning, middle, and end Riessman, Therefore, a definition based on the expectation that stories told within the context of research interviews necessarily have a pre-existing structure was not appropriate for feminist narrative interpretations.
Engaging in this research process from a feminist perspective presented us with the challenge of recognizing and rupturing of our pre-conceived notions of story and narrative. Although feminist scholars have embraced narrative forms and inquiry, they have not done so uncritically. Smith and de Lauretis both expressed misgivings about autobiographical narrative forms based on their association with patriarchal culture.
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Other feminist scholars have proposed that because stories are gendered, the structure, style, form, and content of women's stories need to be considered differently from those of men. A major hurdle is recognition of the distinct characteristics of women's stories. Lawless suggested women's difficulties in identifying and constructing their own stories as women's stories stemmed from the application of male constructs to women's stories, noting the critical need for models and scripts that would fit the wholeness and complexity of women's lives as they experience them.
As one of the participants in Lawless's study of women clergy noted, "We don't know what a woman's story sounds like because we've never heard one Another woman reflected a similar state of unknowing, but welcomed the challenge and opportunity to explore her own gendered stories: "I must say, I don't know what a woman's story sounds like I'm sitting here saying I can't believe I told my story that way. On the other hand, I'm glad I was asked to" p. One of the ways in which we have attempted to create the opportunity for women's stories to surface in our research is not anticipating or imposing a pre-conceived structure or form on the stories women tell us.
For the purpose of our research, we have come to identify stories as the unfolding of a description of a particular woman's experiences around a focused topic of the research e.
Each story is a dynamic representation of a particular woman's experiences around a focused topic as identified and interpreted by both the woman and the researchers. These stories unfold within the original narrative of the research conversation, but not necessarily in any particular order or format. The focus of these stories may be events, relationships, emotions, or environments.
Some stories are more "factual" accounts, others more personal reflections.
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I listened to her story and examined her. Her ear was fine—but her hands were contracted. When I had her walk to the exam table, I noticed an odd gait.
That was when I learned about her fractured care and missed opportunities. I ultimately reached out to a neurologist colleague to discuss the patient and my findings; he and I worked together to track down old medical records and determine that her maladies had nothing to do with her painful ear. She was suffering from an inherited polyneuropathy—a diagnosis she had yet to receive before she came to me. Nurses have spent countless hours caring for patients. We know a thing or two about health care.
But confusion about our roles persists. A wide range of nursing roles fall under the general term—from the Licensed Practical Nurse, an associate degree role that allows this level of nurse to provide basic healthcare needs under the supervision of a Registered Nurse; to the Registered Nurse, often a baccalaureate degree prepared for the delivery of complex critical care; to the Advanced Practice Registered Nurse, a masters or doctoral degree preparing the nurse for the delivery of advanced primary care, preventative care and specialty care.
Everyone should be informed on the essential role nurses play in all forms of healthcare. Head nurse from a surgical unit at a university hospital recruited an experienced nurse, and both written and oral information was provided. The nurse gave her written consent to the interview, and was informed about her right to full confidentiality and to be able to withdraw from the study at any time with no negative consequences [ 24 ].
In order to protect the identity of the nurse in the case presented, some sensitive details were omitted and some were also changed in the published story. The BNIM is a structured and staged method of interviewing and case-based analysis. The interviewer facilitates open responses, but never directs or comments. The interviewee then decides on the shape of her response, which ends the first sub-session. The SQUIN presented to the nurse was: Can you tell me the story of your life and how your work has affected you and maybe changed the way you see yourself?
Include those events and experiences that were personally important to you. Begin wherever you like and take as much time as you need.