Elizabeth Smythe

Re-Viewing Literature in Hermeneutic Research

In academia there seems to be a taken for granted assumption that there is one way to do a literature review. This paper argues that the manner of reviewing literature needs to be congruent with the particular research methodology. As an example, the authors explicate reviewing literature in hermeneutic research. The paper begins by discussing philosophical assumptions. The authors then offer personal accounts of their experiences of working with literature in ways that are congruent with hermeneutic methodology. It is argued that the key purpose of exploring literature in hermeneutic research is to provide context and provoke thinking. Literature, which can include anything that provokes thinking on the phenomenon of interest, becomes an essential dialogical partner from which scholarly thinking and new insights emerge. In conclusion distinguishing hallmarks of ways of working hermeneutically with literature are articulated

Thinking as Leadership/Leadership as Thinking

Heidegger challenges that as the world becomes more thought provoking, we are still not thinking. Yet, the very nature of being human is to think. This article presents the findings of a research project exploring the nature of thinking as described by 14 leaders using hermeneutic phenomenological research methodology. The findings are presented in a visual representation which describes how leaders think through the coming of a call to lead. There is a point when a leader makes a turn, committing them to centring their thinking on the quest. To lead is always to follow, going amidst the noise of activity and the silence of thought-full-ness. In the silence the leader awaits the guidance that will direct the way of serving. Leaders live thinking, experience a resonance of knowing, and are always on the way of change. Thinking is drawn to the ‘for the sake of’under the guidance of the embodied values.

Uncovering the meaning of 'being safe' in practice.

Abstract This paper moves away from the prevalent discourse of competence to consider the meaning of the experience of ‘being safe’ within the context of childbirth. It offers findings from a doctoral study, informed by the philosophies of Heidegger and Gadamer. Following ethical approval, the data was collected in New Zealand by tape-recorded interviews of 5 midwives, 4 obstetricians, 1 general practitioner and 10 women. The method was informed by van Manen. The findings reveal that in seeking the meaning of being safe one needs to be aware that the unsafety may already be present in the situation. Practitioners may be able to do little to rectify the unsafeness. There is, however, a spirit of safe practice, explicated in this paper, that is likely to make practice as safe as it can possibly be. Wise practitioners are ever mindful that a situation may be or become unsafe, and are always aware of their own limitations.

International Humanitarian Nursing Work Facing Difference and Embracing Sameness

This article explores the experience of humanitarian disaster and emergency nursing, asking the question, “How is difference (and sameness) in being a nurse revealed when working in a disaster/relief context?” The articles discusses interviews with seven nurses, plus the primary researcher, who tell their stories of humanitarian nursing. Stark differences are revealed: extent of injuries, limits of treatment, and overwhelmingness of need. Alongside this is the huge difference of personal danger. Sameness shows itself in the human-to-human call and response to need that holds nurses in such work. Difference and sameness are not fixed; one readily becomes the other.

Professional supervision: trusting the wisdom that ‘comes’

ABSTRACT The lived experience of professional supervision is complex and dynamic. Techne, the knowledge that informs the ‘know-how’ of practice, offers guidance. Phronesis, the dynamic wisdom that trusts the ‘play’ of relationship in the supervision encounter, recognises the spirit of the encounter. While it is hard to capture that which is uniquely in the moment, this paper argues for an opening of the space that allows the phronesis of practice to be revealed. The notion of ‘play’ is explored, recognising supervision arises from the interaction between both parties. To yield effective supervision, play must be rooted in integrity, played out in a safe supportive environment, and underpinned by humility and courage. How the supervisor listens determines what the speaker will say. Unless a listening space is opened there is only empty talk. To embrace the phronesis of practice is to gift the supervision encounter with a rich wisdom that is beyond the scope of mere techne. One must also acknowledge however that this safest-of-all mode of practice paradoxically exposes the supervisor to vulnerability from a public scrutiny that seeks pre-defined ways. Techne has the certainty of the nod of approval while phronesis trusts in its own instinctual wisdom that can seldom be adequately explained. Yet, it is phronesis that makes the difference.

Kairos time at the moment of birth.

BACKGROUND there is something extraordinary in the lived experience of being there at the time of birth. Yet the meaning and significance of this special time, named Kairos time in this paper, have received little attention. AIM to describe the lived-experience of Kairos time at birth and surface its meaning. METHODOLOGY this is an interpretive hermeneutic phenomenology study informed by the writings of Heidegger and Gadamer. 14 in-depth interviews with mothers, birth partners, midwives and obstetricians were transcribed and stories from the data were hermeneutically analysed. FINDINGS there is a time, like no other, at the moment of birth that is widely known and valued. This paper reveals and names this phenomenon Kairos time. This is a felt-time that is lineal, process and cyclic time and more. Kairos time describes an existential temporal experience that is rich in significant sacred meaning; a time of emergent insight rarely spoken about in practice yet touches everyone present. The notion of Kairos time in relation to the moment of birth is introduced as a reminder of something significant that matters. KEY CONCLUSIONS Kairos time is revealed as a moment in and beyond time. It has a temporal enigmatic mystery involving spiritual connectedness. Kairos time is a time of knowing and remembrance of our shared natality. In this time life is disclosed as extraordinary and beyond everyday personal and professional concerns. It is all this and more. IMPLICATIONS Kairos time at birth is precious and powerful yet vulnerable. It needs to be safeguarded to ensure its presence continues to emerge. This means maternity care providers and others at birth need to shelter and protect Kairos time from the sometimes harsh realities of birth and the potentially insensitive ways of being there at the moments of birth. Those who find themselves at birth need to pause and allow the profundity of its meaning to surface and inspire their actions.

Feeling like a nurse: re-calling the spirit of nursing.

Purpose: To explore the essential meaning of being a nurse. Design: Nine registered nurses were each asked to write a story of a time when they felt like a nurse. Analysis was informed by Heideggerian hermeneutic philosophy, seeking to reveal the phenomenon of “feeling like a nurse.” Methods: As part of a workshop on phenomenological methodology, participants were invited to reflect on a personal experience of feeling like a nurse. These documents were analyzed according to the method of van Manen. Participants were kept informed throughout each phase. Findings: Feelings announce primordial meaning of feeling like a nurse. Nurses experience the call as mood attuned by an anxiety that creates possibilities for authentic caring. It is a way of being that encompasses watching and acting, doing to and caring for, and taking over and giving back. Moreover, it is after the encounter that the essential meaning is more clearly revealed. We argue that there is value in continuing to question the meaning of “being a nurse.” Amid a complex and increasingly technological world, this calls the profession to remember the human encounter at the heart of all nursing.

The Teacher as Midwife: A New Zealand Narrative

This article explores the metaphor of the teacher as a midwife in the context of the teacher-student relationship. The conceptual framework reviews Freire, Habermas and the Feminist Perspective drawing these threads together in the triad of emancipation, dialogue and caring. The writer then discusses her own reality of teaching midwifery students. Evaluation is seen as a possible constraining factor in the relationship. Caring and emancipation are seen as dialectic. A brief postmodern critique is offered wondering how we will respond to students who redescribe the professional values we have held in consensus.

Open, trusting relationships underpin safety in rural maternity a hermeneutic phenomenology study.

BackgroundThere are interwoven personal, professional and organisational relationships to be navigated in maternity in all regions. In rural regions relationships are integral to safe maternity care. Yet there is a paucity of research on how relationships influence safety and nurture satisfying experiences for rural maternity care providers and mothers and families in these regions. This paper draws attention to how these relationships matter.MethodsThis research is informed by hermeneutic phenomenology drawing on Heidegger and Gadamer. Thirteen participants were recruited via purposeful sampling and asked to share their experiences of rural maternity care in recorded unstructured in-depth interviews. Participants were women and health care providers living and working in rural regions. Recordings were transcribed and data interpretively analysed until a plausible and trustworthy thematic pattern emerged.ResultsThroughout the data the relational nature of rural living surfaced as an interweaving tapestry of connectivity. Relationships in rural maternity are revealed in myriad ways: for some optimal relationships, for others feeling isolated, living with discord and professional disharmony. Professional misunderstandings undermine relationships. Rural maternity can become unsustainable and unsettling when relationships break down leading to unsafeness.ConclusionsThis study reveals how relationships are an important and vital aspect to the lived-experience of rural maternity care. Relationships are founded on mutual understanding and attuned to trust matter. These relationships are forged over time and keep childbirth safe and enable maternity care providers to work sustainably. Yet hidden unspoken pre-understandings of individuals and groups build tension in relationships leading to discord. Trust builds healthy rural communities of practice within which everyone can flourish, feel accepted, supported and safe. This is facilitated by collaborative learning activities and open respectful communication founded on what matters most (safe positive childbirth) whilst appreciating and acknowledging professional and personal differences.

Revealing Tact Within Postnatal Care

In this article, we explore the nature of good postnatal care through a hermeneutic unpacking of the notion of tact, drawing on the philosophical writings of Heidegger, Gadamer, and van Manen. The tactful encounters considered were from a hermeneutic research study within a small, rural birthing center in New Zealand. Insights drawn from the analysis were as follows: the openness of listening, watching and being attuned that builds a positive mode of engagement, recognizing that the distance the woman needs from her nurse/midwife is a call of tact, that tact is underpinned by a spirit of care, within tact there are moods and tact might require firmness, and that all of these factors come together to build trust. We conclude that the attunement of tact requires that the staff member has time to spend with a woman, enough energy to engage, and a spirit of care. Women know that tactful practice builds their confidence and affects their mothering experience. Tact cannot be assumed; it needs to be nurtured and sheltered.