How an appreciation of politics, power and control informs an ethical attitude towards research into chief nurse leadershi

Bassett, Sally

English

Oxford Brookes University: RADAR

ContextOperational ProcessResearch RelationshipCultural        HegemonyPowerControlWhat are the ethical issues So what are the implications for the study What next to ethically enhance chief nurse leadership research How an appreciation of politics, power and control informs an ethical attitude towards research into chief nurse leadershipAcademy of Social Sciences (2016) Economic & Social Research Council Framework for Research Ethics Antrobus, S. Kitson, A. Nursing leadership: influencing and shaping health policy and nursing practice Adv Nurs. 29(3):746-53)Baylis, A. (2017) Learning from human guinea pigs: Creating open, and supportive organisational cultures Boden, R. Epstien, D. Latimer, J. (2009) Accounting for ethos or programmes for conduct? The brave new world of research ethics committees. The Sociological Review, 57:4.Butler, N. et al (2012) Professions at the margins. Hooaard, J. (2016) Clinical Research & Bioethics.7.2. ephemera, theory& politics in organization. Editorial:259-272.Gabriel, Y. (2015) The caring leaders- What followers expect of their leaders and why?. Leadership vol. 11(3) 316-334.Josselson, R. (2006) The Ethical Attitude in Narrative Research Principles and Practicalities. p535-566 In Clandinin, D.J. (2007) Handbook of Narrative Inquiry. Thousand Oaks, Ca: Sage Publications.PoliticsAll healthcare, leadership & nursing is politicised & gendered; research into chief nurse leadership is political and nuanced throughout by power and control Design of job roles, functions processes and procedures are predicated on the power and control condoned by society. Knowledge and ethics are also gendered and influenced by a western cultural hegemony; we consent to the power exercised over us, for example by the state, social norms expressed within positivism, post positivism, modernism, post modernism, post truth. There is a need to  recognise methodological diversity.The research question is sensitive.  Attention needs to be paid to consciously addressing both “big P and little p” politics, the explicit and hidden power and control associated with the systems and the players.Neither ethics or epistemology are static, continuously evolving often triggered by crisis & evidenced by progression from Nuremberg (1947); Helsinki (1964); Human Guinea Pigs (1969); New Brunswick Declaration Ethics Rupture Summit (2012) and Economic & Social Research Council Framework (2015). The growth of qualitative and narrative research which creates valued epistemology.  Ethical issues associated with narrative research and the care of participants are not as well served by deontological approach and overly bureaucratic research governance.The study design, including recruitment warrant careful consideration.Participants may not have a sense of the broader issues of power and control or be aware of their vulnerabilities.Ethical consideration is absent or limited in some leadership research.Therefore, there is a need to adopt an ethic of care as leader, nurse and researcher.Nomothetic researchers seek independence, guided by an ethical duty to do no harm, there is a focus on informed consent free from coercion as at the beginning of the research, on safe data storage, ensuring  privacy, confidentiality and the option to withdraw from the study. The person is seen separately from the data they donate and expect to be non-identifiable in the results write up. A social science and qualitative researcher is not independent from the study. They are the instrument through which the data is collected; their power comes in many forms; participant protection cannot be afforded by procedural ethics. A person cannot be considered distinct from their story.There is a risk of influencing the story telling through ethical procedures, research aims, interview technique and questions. Issues of power and control will be overt and hidden in the research relationships and embed within the experience. The relationship is collaborative, the experiences are intrusive and unfolding. Consent cannot be one off, it must be continuous.Recruitment has the potential to be politically influenced. It will be by self-selection, with power and control laying with the participants who volunteer through their story sharing.Anonymity in write up may not be possible; the write up interpretation may cause distress.Need to take a pragmatic approach to procedures and processes, exercising an ethical attitude and imagination.Adjust planned recruitment approach and accept the limitations and influences of snowballing recruitment through networks. Guide participants on the risk of vulnerability & identification.Information sheet to be transparent on the ethical issues and challenges of narrative research.A progression is needed from the use of codes and checklists to relationships, both between ethics committees and researchers, and researchers and participants.Recognise that the purpose of building of trust, rapport and empathy is to support participants to feel safe to tell their story, knowing that intimacy yields greater disclosure reflecting the power of self-interest of the researcher.As a possible peer, role boundaries could be blurred. The researcher has multiple roles in the relationship. Conflicts and tensions could compromise the relationships, reputation and scholarly endeavour.The procedural steps remain, it’s the manner of execution that reflects the moral imagination.Researcher to manage own emotions and views whilst taking “care” of participants.Narrative ownership; who owns the story needs to be understood  and agreed through the negotiation of the contract between researcher and participant. Explain withdrawal implications, unable to not know and be influenced as a researcher. Ensure a cooling off period between giving consent and interview. Discuss available support mechanisms prior to interviews Transcript approval by participants, power and control over interpretation & reinterpretation of transcripts to sit with researcher. Use of coding for analysis and separation of codes from data. Be alive to the power and controlling influences for participants, venting/distorting events and the researchers desire to do justice to the stories. Explain that participants may not recognise themselves; use of vignettes may be appropriate. Consider advising participants to not disclose their participation to wider community.In the approach to write up, be alive to and mindful of the sensitivities and “big P” politics.Stay vigilant to who may be in the room and reading when presenting and publishing findings. Seek consent for specific quotes where heightened sensitivity is identified. Study findings to be shared and discussed with participants before publication. Use of reflexivity and supervisory team provide for checks and balances.Aim of study: To identify how leadership success is understood and what it means to Chief Nurses’ and their board, policy and regulatory colleaguesTo understand any relationships, differences or important contextual factors that may exist between the understanding and the meaning of Chief Nurses’ leadership role; To describe what success is from the perspective of Chief Nurses’ and other board, policy and regulatory colleagues to inform policy and practice to improve the impact of the Chief Nurse leadership role NHS Improvement (2019). Executive nurse handbook. London.Pappworth, M, H. (1967) Human Guinea Pigs Experimentation on Man. Penguin Books, EnglandSmythe, E, W. &Murray J, M. (2000) Owning the Story: Ethical Considerations in Narrative Research Ethics & Behaviour 10 (4), 311-336.Titus, O. & Gill, R. (2003) Gender differences and similarities in the leadership styles and behaviours of UK managers Women in Management Review Vol 8(6) 288-298The New Brunswick Declaration (2013): A Declaration on Research Ethics, Integrity and Governance resulting from the 1st Ethics Rupture Summit,Fredericton, New Brunswick, Canada

How an appreciation of politics, power and control informs an ethical attitude towards research into chief nurse leadership

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How an appreciation of politics, power and control informs an ethical attitude towards research into chief nurse leadership

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