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More than a good gossip? An inquiry into nurses' reflecting in the ward

By C. Hopkinson

Abstract

Reflection-in-action is a complex concept, proposed by Schon (1983) to describe practitioners’ tacit knowing and ability to work with uncertainty and value conflicts in the midst of action. Its existence is widely accepted in the nursing literature and is a requirement of many healthcare professions. Yet it remains underexplored, especially in the context of the hospital ward. \ud \ud This inquiry used poetry to support a collaborative action research approach, to explore the tensions and possibilities of reflecting during care giving in a hospital ward. Three levels of inquiry: personal, relational and organisational informed the multi-stranded design that involved a co-inquiry group of practising nurses, participant observation in a ward and action learning sets with senior nursing staff.\ud \ud Bourdieu’s concepts of habitus and fields of practice, wider fields of power and various capitals were used with feminist and systemic inquiry perspectives to explore nurses’ ability to use reflection to influence their workplace. The text uses stories, images, metaphors and poetry to generate powerful new insights into the conscious and unconscious ward learning culture and nurses’ embodied dispositions that enable and inhibit reflecting. \ud \ud This thesis presents the reality of reflecting by highlighting some unconscious games, paradoxes and contradictions present in the ward resulting in reflecting inaction. These included: we do it all the time, the paradox of the busy syndrome, the waiting game, whinging creating an emotional orgy, feeling unsupported by managers and talking behind your back. Nurses, who embodied reflexivity, reflected spontaneously which sometimes appeared as gossip. They developed systemic and political agency, noticed their body and used relational processes in the midst of action. They influenced change systemically gaining resources, demonstrating effective leadership and challenging policies. Relationally, they created improved collegial working relationships with managers and staff overcoming collective negativity in the ward. Personally, they managed the complexity of emotions in the ward, encouraging patient centred care, reducing job stresses and improving job satisfaction

OAI identifier: oai:eprints.uwe.ac.uk:10626

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