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question underlying power, patterns, rhetoric, myths and contradictions at both the individual and organisational level. Consequently exploration and questioning of the complexity embedded in organisations that is, the interrelated patterns and connections, how boundaries are constructed, power differentials, the tensions of difference, the multiple realities, rhetoric, contradictions and unintended consequences, forms the process (Burns 2007, Flood 2001, Midgley 2000, Weil 1998, 1999). How a boundary is constructed or imagined can impact on those working in an organisation (Midgley 2000) and the power reproduced in Bourdieu‘s terms is seen as political, economic, social, cultural or symbolic capital as well as the field and habitus of practice. This chapter expands the inquiry by focusing particularly on the relationship between organisational structures for reflection and nurses‘ sense of their own agency. The main aim of Strand 3 of the inquiry was to inquire into the organisational structures and processes that might encourage and impinge on reflecting during care giving in a hospital ward. At the same time I hoped to feedback into the organisation key learning already generated by this inquiry to understand the context in which nurses may or may not influence organisational learning. Therefore by interviewing risk assessment and senior managers I was keen to explore how they perceived, through their assessment of critical incident forms, an individual‘s developmental or performance issue and when that might become an organisational issue. So my core question for these interviews was “how do you decide what is individual learning or organisational learning”? However, this part of the inquiry posed several difficulties as much of the interviews were sensitive in nature and interviewees asked me not to use the stories because some of these involved litigation battles or would result in a breach of confidentiality. The reflective practice literature claims that reflection promotes empowerment (Chui 2006, Taylor 2006, Gustafsson & Fagerberg 2004, Glaze 2002, Platzer et al 2000b, Ghaye et al 2000, Taylor & White 2000), 179
can transform and widen one‘s perspective (Taylor 2006, Jasper 1999, Platzer et al 2000b, Mezirow 1981) and increase self confidence and assertion skills (Taylor 2001, Platzer et al 2000b) while appreciating and being able to live with uncertainty (Bolton 2005, Bleakley 2000a,b, 1999). Yet, I have suggested that the field and habitus of nursing in the ward often acts as a force to disempower nurses. Discovering aspects of disempowerment in our co-inquiry involved exploring the habitus of being An Approval Slave and the field of nursing that supported a Blame Culture. We noticed the need to ―fit into the nursing team‖ was a predominant characteristic of the field and habitus of practice and seemed contradictory to another finding that nurses in this inquiry were feeling isolated in practice. Could both realities co-exist? This chapter presents these findings and questions: to what extent is it possible to influence an organisation through reflecting-in-action especially a large organisation such as the NHS? One of the shifts in my thinking since beginning this inquiry has been to appreciate more fully the impact of the system in inhibiting or promoting the actions for change and the learning from my own and other‘s reflections (Weil 1998). It is ―the working with the mess‖ (Weil 1999 p.175) and ―the deep cultural barriers to innovation, development and partnership working‖ (ibid p.176) that systemic inquiry hopes to address and overcome to provide sustained or second order change. As I have attempted to show already, many reflections serve as an offloading process and so do not move to identifying changes in practice. I have shown in the previous chapters the powerful culture of the ward that creates the habitus and field through vicarious spoken and unspoken messages becoming internalised and embodied by the nurse and then played out without awareness with others as games. Thus the dominant discourses are kept in place and are not challenged. Given this context how easy is it therefore, to achieve changes in working practices as a consequence of reflecting? Driscoll and Teh (2001) suggest standing out from the crowd and being labelled a troublemaker can be just two of the many burdens associated with being a 180
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Hopkinson, C. (2010) More than a go
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Abstract Reflection-in-action is a
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Special Thanks Special thanks are d
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Conclusion.........................
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List of Appendices Appendix 1 Infor
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stories and metaphor as ways of ref
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mostly learning happened through pl
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other patients on the unit who need
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The next story I present also had a
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help us process the experience. I d
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emotional and difficult events in t
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In the Classroom I won‘t do this
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through an avoidance of the body/mi
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Action and Stories in Developing Pr
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mattered to them and were relevant
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Clarke et al (1996) suggested refle
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and qualitative approaches have bee
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alienated from the thinking and dec
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In collaborative inquiry ‗critica
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enabling organisational patterns ov
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ideas with Bourdieu‘s concepts wh
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process 13 which has been central t
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encompasses Bourdieu‘s complex co
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Gaining Ethical Approval: A Story o
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process. Nevertheless, the committe
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time. Two practitioners joined the
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generation was through sharing prac
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from returning to practice and the
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conversation in order to deepen our
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possibilities and tensions of refle
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and gaps in my knowledge so that my
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esearcher (and reader) cannot under
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Strand 2: Emerging Processes As par
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searching and reading published lit
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Chapter 3: A Poetic Inquiry Every p
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What Does the Healthcare Literature
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There are several themes emerging f
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Having searched the poetry literatu
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objectivity and functionality throu
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Qualitative Inquiry journal in thei
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―defamiliarize‖; science freque
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that I puzzled over what the powerf
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I wish I could take this in my stri
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A few days later there was a discus
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Moving towards Co-Inquiry through S
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‗The Wounded Nurse‘ created a d
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off for mandatory training sessions
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experiential exercise, a lecturer w
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Just a Pair of Hands I get my hands
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potentially stifles the spontaneity
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layered and provide new insights ov
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Surprisingly I did not anticipate a
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illusionary as the Douglas Adams qu
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Reflecting through Diary Writing To
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comfortable, positive and relaxed.
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For Jordon, unless she had a perfor
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used time in a contradictory way; s
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Alex found being so busy was isolat
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go and find the area is actually ok
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Does a Busy Environment Affect Refl
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Jane: Well staff won‟t…once upo
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About a year later, in March 2006,
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I started to wonder if the busy syn
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My argument is, that if ‗being bu
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Page 131 and 132: was also prevalent and was a way th
Page 133 and 134: Photograph from Davies (1980 p. 7-8
Page 135 and 136: Nightingale was a woman of action a
Page 137 and 138: and romantic/feminine appeared most
Page 139 and 140: woman‘. I see this as a gender an
Page 141 and 142: The kettle‘s boiled Milk and suga
Page 143 and 144: Whinging Women? Gossip, whinge, nag
Page 145 and 146: whinge? That‟s interesting, it‟
Page 147 and 148: Breaking News: You need to stop wri
Page 149 and 150: The story above highlights the loss
Page 151 and 152: experience with the ethics committe
Page 153 and 154: This made me wonder about the compl
Page 155 and 156: She thought it helped nurses reliev
Page 157 and 158: I realised through the creative wri
Page 159 and 160: emotions can become exaggerated in
Page 161 and 162: she ‗likes‘ all her patients th
Page 163 and 164: my patient, you answer it‖; somet
Page 165 and 166: sibling derives. Therefore in medie
Page 167 and 168: Susan had also received a phone-cal
Page 169 and 170: So what does Susan learn? To keep h
Page 171 and 172: Silence and/or Reflection Inaction?
Page 173 and 174: the usual place for this form of ca
Page 175 and 176: Conclusion This chapter has questio
Page 177 and 178: game. This embodied habitus keeps n
Page 179: Minnie 45 captured the difficulties
Page 183 and 184: drawn to this question. In the last
Page 185 and 186: Perhaps this was due to nurses not
Page 187 and 188: combination, or purely a matter of
Page 189 and 190: mistrust of hierarchy and are not p
Page 191 and 192: Recently I discovered in Native Ame
Page 193 and 194: I think I can veer between feeling
Page 195 and 196: At times you feel you don‟t have
Page 197 and 198: to gain more resources and to flag
Page 199 and 200: The rabbit twitches it‘s whiskers
Page 201 and 202: She talked about the freeze on post
Page 203 and 204: context in which the person may be
Page 205 and 206: imagine staff will feel personally
Page 207 and 208: We discussed how this process would
Page 209 and 210: exposing the imaginary boundaries a
Page 211 and 212: unlikely to encourage political or
Page 213 and 214: Chapter 7: Embodying Reflexivity: D
Page 215 and 216: cultural and systemic tensions alre
Page 217 and 218: Rising above the Wall: Getting Angr
Page 219 and 220: does not permit this kind of action
Page 221 and 222: At the bottom of the power station
Page 223 and 224: when the staff nurse who I imagine
Page 225 and 226: So when I lost it, on the ward, I m
Page 227 and 228: change it? Thus getting angry could
Page 229 and 230: y creating a dialogue. Similarly, S
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I‟ve always focused more on pract
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Careful Talk: Naming Emotions and D
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I‟m getting a lot of confidence i
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pavement”. This image came to rep
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Shocking He was chatting Then dead
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to come into work on her day off to
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for incompetence? In describing vul
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They don‟t see that they have got
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esponses‘ and ‗what is yours‘
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Chapter 8: Invisible Learning: More
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206). I have tried to demonstrate s
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I think this misses the point of Bo
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came to embody and experience them
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change can be orchestrated, sustain
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field of feeling unsupported by man
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silent subversion, their felt power
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I suggest a lack of two-way explici
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etween nurses while talking away an
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evident may feel physically tired t
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Embodying reflexivity mostly uses s
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a blanket answer because being over
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power) concentrate on time saving,
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Many of the training needs and chan
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creating an illusion of control and
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possible to learn from stories irre
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interplay between the two positions
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Final Thoughts or Beginnings? Refle
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I was further challenged to conside
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has value. My hope is that this the
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Bleakley, A. (2000b) Writing with I
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Clandinin, D.J. Connelly, F.M. (199
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de Vault, M.L. (1997) Personal Writ
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Ghaye, T., Lillyman, S. (2006) Lear
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Hodkinson, P., Biesta, G., James, D
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Johns, C. Freshwater, D. (1998) Tra
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Midgley, M. (1996) Utopias, Dolphin
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Powell, J. (1989) The reflective pr
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Searle, R., Sheehan, D. (2008) Inno
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Tripp, D. (1998) Critical Incidents
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Appendix 1 Information Sheet for Pa
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sense of the research material. You
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produced. However, at the end of th
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Date.................. I can be con
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Appendix 4 Interview Schedule for S
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many as I would like due to other w
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poems. Claire has used pros (sectio
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Appendix 8 Why Reflect X NHS Trust
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Guidance Notes 1. Description of ex
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