PDF (PhD Thesis) - UWE Research Repository - University of the ...

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.
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.
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.
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. Those 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,
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