Stage 7: Theme construction

While the unifying categories demonstrated connections and consistencies between participants’ responses, they were not interpreted within the context of what is already known about the experiences and views of NuH nurses. The next stage of analysis therefore considered the links between the findings and the wider social world. This next stage focused on a Gadermerian hermeneutic process that fused the horizon of the participants’ responses (represented in the unifying categories), and the researcher’s horizon, which consisted of:

 my pre-understandings of the topic arising from my personal experiences of NuH nursing.

 my knowledge of the literature (presented in the literature review).

 the outcomes of earlier data analysis stages, which had extended my awareness of alternative meanings and prompted me to widen my studies of literature beyond those examined in the initial literature review.

During this stage, I (as both reader and researcher) became the ‘writer’ of the text, by the acts of reading and reflecting on the participants’ responses presented within the unifying categories. As discussed in chapter 3, readers ‘concretise’ the text via the act of reading, i.e they ‘write’ for themselves works founded on the integration of their own understandings and the ‘schemata’ offered by the data. This process of ‘writerly’ reading is a creative activity in which thematic aspects are refined from unifying categories. These are then deliberated upon by the reader (researcher) to be made relevant by referencing them to the reader’s (researcher’s) own contexts. Van Manen (1997a) explains this vital process thus:

A genuine artistic expression is not just representational or

imitational of some event in the world. Rather, it transcends the experiential world in an act of reflective existence…the artist recreates experiences by transcending them (p.97).

Thus, themes are different to categories in that categories reflect participants’ actual experiences and views, whereas themes reflect concepts which exist within the experiences and views, but which transcend the experiences and views of the individual and relate to, and are recognised within, wider social contexts. For example, in the participants’ responses about:

 their discomfort regarding business and sales activities (discussed in unifying category ‘business aspects of the NuH nurse role’),

 their responses concerning social and personal care for residents (discussed in the unifying category ‘nursing residents rather than nursing patients’), and

 their responses about feeling stigmatised (discussed in the unifying category ‘NuH nursing as a stigmatised role’)

they discussed their experiences, perceptions and feelings. They did not refer to concepts of social identity constructs, ‘knowledge-based status’, or ‘dirty work’. These concepts exist in the culture of academic sociology, and were introduced by the researcher after reflecting on participants’ responses and exploring literature with the aim of identifying concepts that were congruent with the participants’ views and experiences.

During the theme construction process, three themes emerged:  Uncertainty about role identity

 Unpreparedness for the demands of the role  Low occupational status

For Iser (1978a; 1978b), the act of ‘writerly’ reading results in a modification of readers themselves, because the process not only prompts readers to bring their own experiences to the text, but enables them to learn more about their experiences from the text. This occurred in this study during the process of theme development. During this process, some aspects of the data resonated with my own knowledge gained from my experiences as a NuH nurse, and my studies of the topic (presented in the literature review). In these cases, the fusion of the data’s horizon with my own horizon supported understanding of the data within a broader context or frame of reference. Other aspects of the data, however, opened up enquiries into areas that I was unfamiliar with in terms of experience or study. Such occurrences prompted me to explore new lines of enquiry by reflecting upon these occurrences and investigating topics in the literature that were not relevant during the project’s initial literature search. This process modified my knowledge and understanding of the topic, and allowed the identification of gaps in the literature specific to

the topic of the NuH nurse’s role and status. For example, it became apparent that no studies explore the ‘moral taint’ that business and sales bring to the NuH nurse’s role and status, the impact on role identity that emanates from integrating business and sales within the nursing role, or the unpreparedness of NuH nurses for their business role.

As stated in chapter 3, ‘writerly’ reading is not only the remit of the researcher interpreting the data. It is as much a concern for readers of the thesis, as for the researcher. Thus, the aim of offering researcher interpretations via ‘writerly’ outcomes is not to provide a definitive understanding of the text under review. ‘Writerly’ reading is more a process of debate – a Gadamerian dialogue - whereby the researcher offers his/her own interpretation which emanates from his/her own contexts (and which was checked against participants’ interpretations via discussions facilitated by the multiple interview technique), in order to invite readers to join the discussion. During the process, the researcher is saying to readers, ‘This is what I understand from within my context, and in the light of what the participants say. What do you understand from within your context, and in the light of my interpretation?’ In this manner, participants’ responses are embedded in, and simultaneously illuminate increasingly wider social contexts.