Nursing Students: A search for Passion
My Philosophy of Inquiry
Why a blog?
The
purpose of this blog is to present a phenomenon of interest to me that is the
centre of my philosophy of inquiry. I
believe my question is a big one and that is why I have decided to create a
blog in order to reach a large audience for feedback. This research may impact students, instructors
and institutions that employ Registered Nurses.
Setting up a Blog and inviting members from all groups to participate
allows me to present my philosophy of inquiry, research question and the
rationale for my research in a more accessible place. Outlining my methodology along with my
philosophical underpinnings will help in understanding my rationale for
each. It would also allow everyone to
provide feedback and ask questions which will help me to reflect on my own
understanding of my research. As this
personal growth and reflection occurs, I will add any relevant information
reflecting this growth. This blog will start
out with an Introduction which will contain my research question. I will lay out my research objective(s) and
clearly define and discuss my research Design.
The Central Question
Since
I began teaching and mentoring nursing students, one of the biggest rewards I
have experienced as a clinical instructor is the moments when I have been able
to see and further inspire nursing students to become passionate about nursing. However, I have often wondered exactly what
it is that contributes to the creation of passion for nursing students? Also, what is it as nurse educator that will
help me tap into that spark of passion that nursing students may feel for nursing? Therefore, my research question will be: What are the experiences of nursing
students that contribute to feeling passionate about nursing?
My
interest in this research topic has developed from
my own experiences and feelings of passion for nursing. When I was a nursing student I felt very
passionate and excited about nursing. I
felt that being a nurse meant that you were someone that made a difference and
this was what I was meant to do. After
graduation, I felt nervous to begin my practice without the security of my
instructors, but the passion and love for my job soon helped me to overcome
those fears. However, as time went on and I began to experience some of the
realities of being a nurse and I began to feel my passion waning. There were times when I even began to wonder
if nursing really was the calling that I thought it was for me. I began to realize that I was no longer as
passionate about nursing as I used to be. I then became concerned and wondered
if nursing really was the calling that I thought it had once been for me? Had I lost my passion for nursing completely?
This is the point in my career where I realized I had become “Burned Out”. The symptoms of burnout have been described
in the literature as “apathy, hopelessness, fatigue, disillusionment, sadness,
forgetfulness, irritability, minor physical complaints, time pressuredness, and
social isolation” (C. G. Macinick & Macinick, 1990, p. 247). Upon reflection, I realized that these were
all symptoms that I experiencing at this time in my career.
Problem Formulation
In a study commissioned by The Canadian
Nurses Association, it was predicted that by the year 2016, Canada will have a
shortage of nurses estimated at 113,000 (as
cited in Fletcher, 2000). The shortage
of nurses has reached critical proportion and we seeing more and more Canadian
nurses leaving the profession including new nursing graduates. It is noted that between 1995 and 1997, 10 %
of nursing graduates migrated to the United States. Of those graduates interviewed, 1 out of 3
stated they would not choose nursing as a career again (Spurgeon, 2000). This is disturbing news as it is known that
retaining nurses in the nursing profession is safer, much quicker and more
lucrative than trying to train new nurses (Rajepaska & Rothstein, 2009).
Also the loss of senior nurses has many consequences and results in
rising recruitment and orientation costs as well as a rise in adverse patient
outcomes all contributing to nurse job dissatisfaction. Nurses who feel more job satisfaction are
more likely to have increased morale and commitment to their jobs which could result
in remaining within their profession (Hayes, Bonner, & Pryor, 2010).
This
is where I feel my problem lies. My
philosophy of inquiry will provide some insight into understanding what experiences
that student nurses may have that contribute to becoming passionate about nursing. By understanding this, we can shed some light
on what is it that occurs in that transition to their practice that may
eventually lead to the loss of passion for nursing or feeling burned out after
they graduate and why. Based on this,
what can then be done to keep that initial passion thriving.
Assumptions that Contribute to my Method of Choice
In 1979, Burrell
and Morgan discussed four paradigms of social theory there were based on
different assumptions about the world, in particular, social sciences. These authors created a diagram which places
each assumption on a continuum of approaches to social science ranging from the
subjective to objective. Each assumption
has an opposing paradigm which reflects the opposite poles subjectivity and objectivity. These four paradigms consist of Ontology,
Epistemology, Human Nature and Methodology.
In this section, I will discuss these four paradigms in relation to my
own careful examination of my philosophical beliefs about the world, society
and how I relate to it.
Ontology
The first
paradigm that will be discussed is Ontology.
Ontology is the branch of philosophy that addresses "the nature of
a phenomenon being examined" (Van de Ven,2007, p. 14).
Ontology helps us define what is real in the world, what exists,
regardless of whether it is a physical or an abstract structure (Schuh &
Barab, ?). The two opposing poles of
Ontology are Nominalism and Realism.
Nominalism belongs to the subjectivist approach of social science and is
based on the premise that there is no real structure to the world and that we
construct reality by names, concepts and labels. The only purpose of 'names' are to construct
and make sense of the world around us as they help us to describe and negotiate
the world (Burrell & Morgan, 1979). Gubrium and Holstein (2008) state that realism
belongs to the objectivist paradigm and postulates that there is a real world out
there, an external world that is made up of objects and structures. This world exists independent of our
thoughts, our perceptions, the language we use or material images we use to
represent reality. Our understanding of
this reality is based on cause-effect relationship with one another (as cited
in Chen, Shek, & Bu, 2010, p. 133).
According to the
continuum proposed by Burrell & Morgan (1979), my own beliefs regarding
Ontology would place me on the left towards Nominalism. However,
there is a form of constructionism that postulates that there is some
reality that exists beyond our contextual meaning. These are considered critical and objective
constructionists. This is a form of
constructionism that is a relativist position and it considers multiple
realities. The research process is
meant to bring out reality within the context that it is being studied rather
than represent it. Constructionists
claim that "there exists no truth but a multitude number of reality
constructions shaped by cultural, social and historical factors." (Chen,
Shek, & Bu, 2011, p.129). I believe
this more accurately reflects my understanding that there is a real and
objective world out there. However, we
perceive and understand that world by the names and the meanings that we give
to the things we see, feel, taste, and hear.
Without our perception and interpretation of these things, there is no
reality.
Epistemology
Epistemology
refers to knowledge, the nature of knowledge, how we understand the world and
communicate this understanding. The continuum proposed by Burrell and Morgan
(1979) discusses Anti-positivism on the extreme subjective end and Positivism
on the objective end. Anti-positivism
states that social reality can only be understood or constructed by discovering
the point of view or the interpretations of the persons directly involved in
the activity to be studied (Burrell & Morgan, 1979). Anti-positivism does not believe in laws or
underlying patterns in the world.
However, on the opposite end of the continuum is Positivism which
attempts to be completely objective in nature.
Positivism is based on the premise that reality can be known and
confirmed only through the senses and that this is what constitutes
knowledge. All ideas must be tested in
an empirical manner to be accepted as
knowledge (Bryman, Teevan, &Bell, 2009).
Berger
and Luckman (1966) state that its main focus of epistemology is on the
"relationship between "knower"
(the research participant) and the "would-be knower"
(researcher)" (as cited in Chen,
Shek, & Bu, 201 p. 133). Madill,
Jordan, and Shirley (2000) state that in qualitative research the epistemology
position can range from "naive realist to radical relativist" (as
cited in Chen, Shek, & Bu, 2011, p. 133).
This is also true within the paradigm of Constructivism as argued by
Chen, Sheek and Bu (2011). These authors
state that Constructivism can range from several degrees of objectivity and
subjectivity such as "objective social constructionism" versus
"interpretive social constructionism" (p. 134). I feel that I am within the relativist
paradigm which is more subjective and within the interpretivist paradigm. This paradigm believes that there is no "pure
experience" and that "the aim of research should be an exploration of
how cultural and discursive resources are used to construct diverse versions of
experience within varied contexts" (Willig, 2008, as cited in Chen, Shek,
& Bu, 2011, p. 133). However, I can
also acknowledge that I also believe some tennents of objective
constructionists that postulate that "there is some reality existing
outside of discourse and texts" (Chen, Shek, & Bu, 2011, p. 133).
Human Nature
The
assumptions regarding human nature examine how human beings interact with their
environment. Human life is the basis of
all inquiry in social sciences and therefore the main component to be studied
(Burrell & Morgan, 1979).
Voluntarism and Determinism are the two opposite poles of human nature
as proposed by Burrell and Morgan (1979).
Voluntarism is very objective and implicitly states that "man is
completely autonomous and free-willed" (Burrell & Morgan, 1979, p.
6). Determinism however, is on the
opposite end of the spectrum and refers to man being completely determined by
his environment or the situations in which he is placed (Burrell & Morgan,
1979).
I
feel that my own assumptions are based within the paradigm of Symbolic
Interactionism. Symbolic Interactionism lies
within the subjectivist paradigm. It studies
human group life and the conduct of humans within those groups. This conduct is dependent on three different
premises. First, human beings act toward
the world and each other based on meanings that they assign to object or
situations they encounter. Second, then
the meanings that they derive are created from their social interactions. And then lastly, the human modifies those
meanings by an interpretive processes that is based on the person's experiences
(Blumer, 1969, as cited in Deppoliti, 2008, p. 256). I agree with this paradigm as I feel that
there is an objective reality out there.
However, this objective reality is very much based on each individual
and their interpretation of that reality.
Methodology
Burrell
and Morgan's (1979) continuum consists of Ideographic on the subjective pole
and Nomothetic on the objective pole.
The basic premise of Ideographic methodology is that the researcher must
obtain firsthand knowledge of a subject to be studied in order to really
understand it. Therefore, it is of
upmost importance that the researcher get to know their subjects by getting
inside their experiences and involving themselves in the participants lives. The subject is able to unfold by the detailed
analysis of accounts that occur within these encounters. This method stresses "letting one's
subject unfold its nature and characteristics during the process of investigation" (Burrell & Morgan, 1979, p. 6). Nomothetic pertains to basic research which
is grounded in the natural sciences. The
methods employed focus on rigour, the testing of hypothesis, and quantitative
measurements.
An
examination of my assumptions as previously discussed had lead to me to have a
greater understanding of my philosophical stance and how this stance will
influence the type of research methodology that I am interested in. This understanding has also lead to an
understanding of which methodology would best fit with my research question of:
What are the experiences of nursing
students that contribute to feeling passionate about nursing?
An
examination of my own assumptions within the continuum place me half way
between the center and the subjectivist approach. This fits in with my choice of Narrative
Inquiry which is subjective in nature but not completely subjectivist such as
Phenomenology.
Narrative
inquiry is a research methodology that has been increasingly used in the
educational setting. Narrative Inquiry
fits very well with my research question and the assumptions that I have
already discussed. This is because
Narrative Inquiry poses that "humans are storytelling organisms who,
individually and socially, lead storied lives" (Connelly & Clandinin,
2012, p. 2). The study of narrative is
the study of how we see the world or of how nursing students see the world. Thus it is both subjective and interpretive
in nature. Education or nursing
education is then the creation and the recreation of personal and also social
stories in which "teachers and learners
are the storytellers and the characters in their own and other's
stories" (Connelly & Clandinin, 2012, p.2). This fits in with my research will be
interviewing nursing students who are enrolled in clinical practice in order to
discover their experience of what inspires them to feel passion in their nursing
practice. Narrative inquiry will allow
me to discover student's stories of what
experiences contributed to feeling passionate about nursing. This is something that as the researcher I cannot
and do not know about nursing students experiences and would be interpreted by
each student differently. Student’s
knowledge is only know by them and can only be understood by exploring their
view point or their story.
Evidence
The
qualitative research I conduct will help me to have a further understanding
into what inspires nursing students to become passionate about nursing as they
have experienced and describe it. This
will contribute to knowledge for Instructors that may promote students to
become passionate about nursing and how to support those students in discovering
and maintaining that passion. This will
also be helpful to institutions that hire graduates to have a better
understanding of nursing graduates needs and how they can be better supported transitioning from graduate to nurse. Also this may
provide valuable answers to ways in which senior nurses can be helped to
rediscover the things that once inspired them to be passionate about nursing
thus maybe preventing job dissatisfaction and burnout. This may contribute to keeping knowledgeable
and skilled nurses from leaving the profession prematurely thereby retaining a
valuable resource to the nursing profession.
References
Bryman, A., Teevan, J. J., & Bell, E. (2009). Social Research Methods. Ontario: Oxford University Press.
Burrell, G. & Morgan, G. (1979). Sociological Paradigms and Organizational
Analysis. Burlington, VT: Ashgate Publishing.
Connelly, F. M. & Clandinin, D. J. (2012). Stories of experience and narrative
inquiry. Educational Research, 19(2).
Deppoliti, D. (2008).
Exploring how new registered nurses construct professional identity in hospital settings. The Journal of Continuing Education in
Nursing, 39(6).
Fletcher, M. (2000). Handmaidens no more:
Nurses are adding their voices to the chorus
demanding significant health care
reform. The Canadian Nurse, 96(5), 18.Hayes, B., Bonner, A., & Pryor, J. (2010). We must not forget what we once knew: An exemplar for helping nurses reconnect with their history and rediscover their passion for nursing. Journal of Nursing Management, 18(7), 804-814. Doi: 10.1177/0898010110376322
Macinick, C. G. & Macinick, J. W. (1990). Strategies for
burnout prevention in the mental
health setting. International Nursing Review, 37(2), 247.
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influence the decisions of men and women nurses
to leave nursing. Nursing Forum, 44(3),
195-206. Doi:
10.1111/j.1744- 6198.2009.00143.x
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Stiles, J. (2003). A
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Journal, 320(7241), 1030.Van de Ven, A. (2007). Engaged Scholarship: A Guide for Organizational and Social Research. Oxford: Oxford University Press.
