Student Nurses Defining Stories of Spirituality

1. Student Nurses Defining Stories of Spirituality Wendy Wigley Year 4: Clinical Doctoral Student ww1@soton.ac.uk

2. “What influence might practice experiences have on pre-registration nursing students’ awareness and understanding of their own spirituality?” Working Title:

3. Working Definition: “Wider than religion, the inner ‘self’ that arouses feelings of love, faith, hope and trust that provide meaning, inner peace and purpose in life” (Adapted from Meyer 2003 and Narayanasamy et al 2004).

4. Methodology: • A two year, longitudinal • two phased study of pre registration nursing students • Constructivist grounded theory

5. The aims of the study : • Establish pre-registration nursing students’ perceptions and definitions of their own spirituality; • Explore pre-registration nursing students’ attitudes and feelings about their own spirituality from their experiences in nursing practice; • To identify how and why pre-registration nursing students may or may not recognise certain experiences as ‘spiritual’.

6. Data collection thus far…. • 2 x discussion group of 2nd year pre registration nursing students - ‘get a feel’ as to their perception of spirituality • 6 participants have been involved in 9 individual face to face interviews with me to date • To continue at 4-6/12 intervals (after placements) until September 2010

7. Students have been encouraged to consider, explore their own spirituality and what it means to them and how this enables them to ‘make sense’ of practice; the affect on ‘self’ and/or visa versa.

8. Vehicles: explorative means for guiding the questioning/analysis process • Keep a diary • Keep narratives • Keep reflective accounts/stories • Identify meaningful imagery • Create their own imagery

10. The ‘Wave’ of defining stories Defining story Struggling/grappling to explain Seeking Affirmation

11. Struggle, story, affirmation • B: Because… I wouldn’t behave like that. And I’ve realised you don’t have to behave like that. Because I realise how important it is to a patient. Because the one with the flowers she was like on her last legs and… she’d wanted a window. She knew she was dying. She never did get to the window, be in the window. And she had her flowers. And I wasn’t go to take them away. D’you know what I’m saying[W1] ?   • [W1] B’s Defining story

12. Struggle • But I do find it’s quite lacking, um, on the wards, like it’s not really the sort of thing people discuss and um, there’s a Liverpool Care Pathway and there’s this whole spiritual section which normally is left blank and I struggle[W1]  with that because I don’t feel like I have been trained to kind of go through that section with patients but, um, to me that was the most important thing on the pathway but it’s not usually addressed. Um, yes. So I just kind of want to learn a bit more about that. • [W1]Trying to make sense “struggle”

13. Story • But there was one patient on my first placement who had liver cancer and who refused treatment because God had told her she was going to be healed and I mean – I saw her for about a month and her jaundice initially was – she was fluorescent yellow; before she was discharged and she was almost like the right colour and… she hadn’t had treatment[W1] . Um, but I found that a lot of – I don’t know if I should say this[W2] … but a lot of the nurses didn’t respect her because of that decision that she’d made • [W1]Defining story • [W2]Apprehension about questioning what she has seen

14. Affirmation • R: Well, um, I mean Christianity has got a lot of stick, mainly because the church tends to fight kind of evolution and science which I think is a big mistake because there’s a lot to prove evolution and science - life science obviously. Um, and I think because they are so separate, because the church fights science and science always tries to prove evolution which disproves the world being made in seven days or whatever, um, then they have just become separate and science has a lot more respect I think. Yea... Um… Maybe I should research it more because I mean doctors have seen miracles happen – it is kind of a recognised phenomenon isn’t it… miracles[W1] ? • [W1]Seeking affirmation

15. Contradictions in Life – “can’t always make people better” Trained staff – “loose ‘it’” Lectures – “can’t teach ‘it’”, “experience”, “learnt not taught” Frustration – “people not wanting to help themselves” Art and Science in Nursing “this thing” being outside “the box” Part of human ‘being’ individual and unique” Good nurse is ‘spiritual’…but tied up in this was a notion of spiritual protection…protecting ‘self’ and ‘other’… Recognition of ‘self’ in ‘other. Being ‘allowed’ Tentative categories:

16. References: • Charmaz, K. (2006) Constructing Grounded Theory. A Practical Guide Through Qualitative Analysis. London, SAGE Publications. • Meyer, C.L (2003) ‘How Effectively Are Nurse Educators Preparing Students to Provide Spiritual Care?’, Nurse Educator 28 (4), pp185-190. • Morse, J.M, Noeranger Stern, P., Corbin. J., Bowers, B., Charmaz, K. and Clarke, A. E ( 2009) Developing Grounded Theory: The second generation. California: Left Coast Press • Narayanasamy, A., Clissett, P., Parurmal, L., Thompson, D., Annasamy, S. and Edge, R. (2004) ‘Responses to spiritual needs of older people’, Journal of Advanced Nursing 48 (1), pp 6-16. • Strauss, A. and Corbin, J (1998) Basics of Qualitative Research. Technique and Procedures for developing Grounded Theory. (2nd [and musty] Edition). London, SAGE Publications.