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Taking a closer look at Nursing
As the next stage of our research commences, we turn our attention to exploring nurses’ experiences of stress, distress and suicidality. Whilst all elements of our study are interested in women nurses’ psychological wellbeing and health, we are taking a closer, in some senses ‘deeper’, look at the everyday experiences of individual nurses.
Exploring the everyday psychological and emotional experiences of women nurses
By: Louise Isham & Hilary Causer
Why explore the ‘everyday’ experiences of nurses?
As the next stage of our research commences, we turn our attention to exploring nurses’ experiences of stress, distress and suicidality. Whilst all elements of our study are interested in women nurses’ psychological wellbeing and health, we are taking a closer, in some senses ‘deeper’, look at the everyday experiences of individual nurses. We also want to understand how nurses make sense of the emotional and psychological demands of nursing and their own sense of their identity as a nurse, over time.
As such, we are now recruiting women nurses to help us address questions like:
How do nurses make sense of their nursing experiences and nursing identity during or after periods of stress and distress?
In what ways do nurses’ experiences of suffering vary in relation to demographic factors, ethnicity and migration history/status and/or their social-cultural identities?
How can institutional practices contribute to nurses’ experiences of suffering?
Recognising the formal and informal ‘work’ of nurses
The study draws on principles of institutional ethnography (Smith, 2005) by recognising that the distinction between formal and informal work is often blurred. The (emotional) skills required of nurses to work in environments that present physical and sometimes psychological risks, is rarely defined as a distinct part of their role. When some aspects of work are not recognised by organisations that work and contribution can feel hidden or silenced, further deepening feelings of isolation and alienation. For our study, expanding the scope of what counts as ‘work’ means understanding the way nursing is shaped by, and spills over into, women’s personal lives. For instance, women’s intimate and family relationships, their domestic and social spaces and their previous histories of caring. In this sense, we recognise that nurses’ personal and professional lives (and identities) are often deeply inter-linked.
What are we going to do?
We have worked in partnership with nurse advisors to design the study. We are using qualitative methods to explore how people think, talk about and make sense of their personal and professional experiences of stress and distress. We are also drawing on ‘creative’ methods in the sense that we are inviting nurses to use diaries and photos to express some of their thoughts and feelings, alongside talking with researchers (and peers). There are two main strands to the study:
Phase 1: We will ask nurses to complete a short diary for a six-week period, creating at least one diary entry each week. The entries can be written or captured by a quick photo or audio-note – whichever is most convenient and appealing to the individual nurse. Nurses will then be invited to reflect on their diary entries with a researcher in a one-to-one online interview.
Phase 2: We will ask highly experienced nurses to take part in an online group discussion, reflecting on their experiences of nursing and supporting nurses, with a focus on the emotional and psychological dimensions of their work. Nurses will be asked to bring some images or photos to the group discussion to share as part of the discussion.
What is feminist institutional trauma?
We will analyse the data using ideas from feminist institutional trauma (Thompson, 2021). This approach looks at how workplace structures, policies, and organisational culture may contribute to nurses’ higher risk of suicide, rather than focusing only on individual experiences of distress and recovery. For example, we will examine how workplace practices can place too much responsibility and risk on individual nurses, which may affect their psychological wellbeing. We will also consider how factors such as insecure migration status and poor workplace induction can increase stress for internationally recruited nurses.
From this perspective, experiences such as moral distress are recognised as real and important, but they are understood as effects of broader organisational problems rather than simply personal difficulties. Institutional trauma also explores how gender roles and workplace cultures influence organisations, and how these factors interact with issues such as social class, ethnicity, and migration status. This reflects the study’s feminist and intersectional approach, which considers how different forms of inequality and disadvantage can overlap and shape people’s experiences.
Recruiting now
We warmly welcome nurses at any stage of their career, from a diverse range of personal and professional backgrounds, to take part in the diary + interview phase of the study (Phase 1). We also warmly welcome highly experienced nurses to join us for the photo-based discussion groups (Phase 2).
If you are interested in finding out more about this study or what taking part would involve, please contact one of the researchers, Dr Louise Isham (l.j.isham@bham.ac.uk) or Dr Hilary Causer (h.causer@surrey.ac.uk) or see the poster below. We look forward to hearing from you.
References
Smith, D. (2005). Institutional ethnography: A sociology for people. Bloomsbury Publishing PLC.
Thompson, L. (2021). Toward a feminist psychological theory of “institutional trauma”. Feminism & Psychology, 31(1), 99-118. https://doi.org/10.1177/0959353520968374
We are grateful for the support of the Wellcome Trust who have funded this project.