Qualitative interview

Unstructured qualitative interviews were planned as the secondary method of data collection which would support the observational data. Good questions in qualitative interviews should be open ended, neutral, sensitive, and clear to the interviewee (Patton, 1987). Consideration was given to the six types of questions that can be asked during an interview: those based on behaviour or experience, on opinion or value, on feeling, on knowledge, and sensory experience. According to Britten (1995) it is possible to collect data through interview even in stressful circumstances, making the interview a suitable tool for the AMU environment. Interviews with participants were intended to be conducted immediately following a period of participant observation, and were expected to last approximately fifteen minutes. Recognised as providing rich data and insights into people’s experiences

(May, 2008), interviews were used to clarify observations, verify understanding and to encourage the nurses to discuss their thoughts and perceptions of events.

Potential difficulties for interviewers include interruptions and distractions during the interview. In the AMU environment these ‘pitfalls’ became apparent immediately. The nurses were under considerable time pressure and their workload was unpredictable. Participants were unable to afford the planned time for interview. This challenge had to be accepted and dealt with by adapting the interview technique. These adjustments are discussed in greater detail in section 3.9.3.

122 There are various ways of recording qualitative interviews: notes written in context, notes written in retrospect, and audio taped (Britten,1995). Each has advantages and disadvantages. For example, hand written notes may cause loss of detail while audio taping requires transcription, which is time consuming and can be expensive. I opted to document the interviews by hand immediately, using key words and phrases and to also make a record of any hesitation or uncertainty, body language, confidence or other subtle gestures which could be used during the analysis later. Recording of interview data could have been achieved using digital recording equipment, which releases the researcher’s time to focus on the conversation and allow recording of body language. However, this was not felt to be appropriate in the context of an AMU environment where the presence of recording equipment might impede the spontaneity of conversation. Furthermore, the noisy surroundings might produce poor quality recordings and the loss of essential data. It was therefore decided that written records of the interviews would be made. Wheatley (2006) also decided to opt for hand written notes of interviews during his mini-ethnograpy since staff were reluctant to have their interviews digitally recorded.

Other authors have explored a similar research question to that proposed within the thesis and have employed similar methodology, although the majority identified in the literature review (section 2.10) utilised retrospective interviews with the participants. Whilst enabling the conduct of the interview in a quiet place without interruption, this was rejected as an option as the capture of participant perceptions ‘in the moment’ was considered to be a critical element of the study. Interviews were planned to take place immediately following a short period of

123 observation, away from the bedside, but not removing the nurse from the clinical area. Interviews were planned to last for approximately fifteen minutes each and would focus on asking questions relating to the observed activities. Other authors have identified challenges with this approach, since interview time with participants is greatly reduced if conducted within working hours (Wheatley, 2006). However, in order to meet the objectives of the study, long periods of time between observation and interview were not considered ideal. A decision was made to continue with plans to interview participants in the context of the live practice environment.

After obtaining the necessary ethics committee approvals, the study commenced in November 2010. A purposive sample of seven qualified nurses was identified as the participants. Their written consent to participate was obtained, in accordance with National Research Ethics Committee requirements. All data were collected by the author as the sole investigator and research instrument and took six months to complete.

Twenty-six participant observations were conducted totalling 37.3 hours. The observation sessions were performed on various days of the week and at different times of the day, although participant observations were not performed overnight. In part, the decision for this was to not interrupt sleep for the patient by discussing observations with the nurse participants. As a consultant nurse, there had never been a commitment to working the night shift. To work a night shift would have been unusual, and may have influenced the behaviour and responses of the nurses. Most importantly, the ratio of nurses to patients was greatly reduced

124 overnight. It was considered inappropriate to conduct field work which may have impacted upon the time available for nurses to provide care. This may be considered a limitation of the study and is discussed in section 5.5. Time allocated for participant observations was dependent upon personal work commitments and on the day to day pressures in the department for the nurse participants. Interviews with the nurse participants were conducted in context.