How Nurses Can Facilitate Meaning-making and Dialogue: Reflections on Narrative and Photo Stories
In healthcare, nurses often have a great deal of contact with patients on a 24-hour basis. They are in a position to hear the patient’s stories not only while giving care, but also during more informal communication throughout the day. This puts them in a position to use their response to patients in a more conscious manner and realize therapeutic aims by exploiting narrative means in a methodological way. This book extensively describes how this can be accomplished, not only through a theoretical exposé, but also using case studies. In addition to this pragmatic focus, it explains how narrative relates to larger concepts such as self-management, shared decision making, recovery and person-centred care, and shows that narrative can be a vehicle to these desired outcomes. The book also considers organizational aspects of narrative-oriented healthcare by introducing a model in which narrative plays an important role. As such, it will allow nurses in the field to make a paradigmatic switch from a perspective dominated by delivery of care to one that is person-centred, recovery-oriented and dialogic in nature.
Jan Sitvast was educated as a historian, before becoming a nurse in mental health care, bringing with his fascination with the narratives of ordinary people. He trained as a nurse practitioner (2003) and worked as such for a couple of years before becoming a researcher working in a mental health institute. His PhD thesis explored the therapeutic application of photography and visual narratives for patients in mental health care. He has published a number of articles and books on empowerment photography, self-management, nursing and narrative.
“How Nurses Can Facilitate Meaning-making and Dialogue is an exceptionally rich collection of essays, 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.”
Associate Professor, University of Auckland
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