Reviewed by Michael Hanne

The narrative medicine movement had its origins in the US in the 1990s and was developed in this century by Rita Charon of Columbia University and many others to become a major force in medical education in North America, Europe, and beyond. It is a form of patient-centered healthcare which asserts not only that serious illness disrupts our narrative sense of self, but that it is incumbent on medical professionals to attend closely to the stories their patients tell them and, as far as they can, to co-author with them narratives of recovery and management of their illness.

Narrative medicine has achieved prominence primarily in the education of doctors. This outstanding book draws attention to the fact that nursing educators have, rather less ostentatiously perhaps, adopted and adapted central features of narrative medicine for their specific professional role. In fact, the author, Jan Sitvast, an experienced Dutch mental health nurse and educator rightly insists that nurses, precisely because they are in the privileged position of caring for their patients on a more continuous, day-to-day basis than doctors, have greater opportunities to listen to patients and help them to work on their self-narratives.

How Nurses Can Facilitate Meaning-making and Dialogue is an exceptionally rich collection of essays, most of which the author has published previously as journal articles, setting out a theoretical foundation in phenomenology and hermeneutics for a narrative nursing practice. Their common focus is on how nurses may employ narrative to assist their patients to make meaning out of their experience and specifically (re)create their identity in positive ways. Narrative is seen as an empowering device by which patients gain agency in their step-by-step journey towards recovery. Part of the value of narration by patients is that it can engage them in a therapeutic dialogue with others.

A major strength of the book is that the theoretical chapters are peppered with case studies, which bring the theory to life. Several chapters concern the use of visual narratives, especially photos taken by patients, which may serve as starting points for dialogue around strengths and values as part of an identity-creation process.

While Sitvast’s background is in mental health nursing and the case studies are mainly taken from the same field, the essays will undoubtedly be of value to nurses in other fields. Essentially, he is arguing that all serious illness has implications for our mental health and that narrative fosters in the patient a concern for positive change in the future.

Michael Hanne founded the Comparative Literature programme at the University of Auckland and directed it for 15 years. His research for more than 20 years has focussed on human reliance on narrative and on metaphor across a wide range of disciplines. In 2010, he convened a conference at UC Berkeley entitled Binocular Vision: Narrative and Metaphor in Medicine and subsequently edited a selection of the outstanding papers presented. He teaches a medical humanities course for third-year medical students at the University of Auckland, entitled Unexamined Metaphors, Uncharted Stories. A selection of his writings can be found at: narrativemetaphornexus.weebly.com

How Nurses Can Facilitate Meaning-making and Dialogue: Reflections on Narrative and Photo Stories is available now in Hardback and eBook formats.