1. Student Nurses Defining Stories of Spirituality Wendy Wigley Year 4: Clinical Doctoral Student ww1@soton.ac.uk

2. 2 Working Title: What influence might practice experiences have on pre-registration nursing students awareness and understanding of their own spirituality?

3. 3 Working Definition: Wider than religion, the inner self that arouses feelings of love, faith, hope and trust that provide meaning, inner peace and purpose in life (Adapted from Meyer 2003 and Narayanasamy et al 2004).

4. 4 Methodology: A two year, longitudinal two phased study of pre registration nursing students Constructivist grounded theory

5. 5 The aims of the study : 1.Establish pre-registration nursing students perceptions and definitions of their own spirituality; 2.Explore pre-registration nursing students attitudes and feelings about their own spirituality from their experiences in nursing practice; 3.To identify how and why pre-registration nursing students may or may not recognise certain experiences as spiritual.

6. 6 Data collection thus far …. 2 x discussion group of 2nd year pre registration nursing students - get a feel as to their perception of spirituality 6 participants have been involved in 9 individual face to face interviews with me to date To continue at 4-6/12 intervals (after placements) until September 2010

7. 7 Students have been encouraged to consider, explore their own spirituality and what it means to them and how this enables them to make sense of practice; the affect on self and/or visa versa.

8. 8 Vehicles: explorative means for guiding the questioning/analysis process Keep a diary Keep narratives Keep reflective accounts/stories Identify meaningful imagery Create their own imagery

9. 9

10. 10 Struggling/ grappling to explain Defining story Seeking Affirmation The Wave of defining stories

11. 11 Struggle, story, affirmation B: Because… I wouldnt behave like that. And Ive realised you dont have to behave like that. Because I realise how important it is to a patient. Because the one with the flowers she was like on her last legs and… shed wanted a window. She knew she was dying. She never did get to the window, be in the window. And she had her flowers. And I wasnt go to take them away. Dyou know what Im saying[W1] ? [W1] [W1] Bs Defining story[W1]

12. 12 Struggle But I do find its quite lacking, um, on the wards, like its not really the sort of thing people discuss and um, theres a Liverpool Care Pathway and theres this whole spiritual section which normally is left blank and I struggle[W1] with that because I dont feel like I have been trained to kind of go through that section with patients but, um, to me that was the most important thing on the pathway but its not usually addressed. Um, yes. So I just kind of want to learn a bit more about that.[W1] [W1]Trying to make sense struggle[W1]

13. 13 Story But there was one patient on my first placement who had liver cancer and who refused treatment because God had told her she was going to be healed and I mean – I saw her for about a month and her jaundice initially was – she was fluorescent yellow; before she was discharged and she was almost like the right colour and… she hadnt had treatment[W1]. Um, but I found that a lot of – I dont know if I should say this[W2] … but a lot of the nurses didnt respect her because of that decision that shed made[W1][W2] [W1]Defining story[W1] [W2]Apprehension about questioning what she has seen[W2]

14. 14 Affirmation R: Well, um, I mean Christianity has got a lot of stick, mainly because the church tends to fight kind of evolution and science which I think is a big mistake because theres a lot to prove evolution and science - life science obviously. Um, and I think because they are so separate, because the church fights science and science always tries to prove evolution which disproves the world being made in seven days or whatever, um, then they have just become separate and science has a lot more respect I think. Yea... Um… Maybe I should research it more because I mean doctors have seen miracles happen – it is kind of a recognised phenomenon isnt it… miracles[W1] ? [W1] [W1]Seeking affirmation[W1]

15. 15 Tentative categories: C ontradictions in Life –cant always make people better Trained staff – loose it Lectures – cant teach it, experience, learnt not taught Frustration – people not wanting to help themselves Art and Science in Nursingthis thing being outside the box Part of human being individual and unique Good nurse is spiritual…but tied up in this was a notion of spiritual protection…protecting self and other… Recognition of self in other. Being allowed

16. 16 References: Charmaz, K. (2006) Constructing Grounded Theory. A Practical Guide Through Qualitative Analysis. London, SAGE Publications. Meyer, C.L (2003) How Effectively Are Nurse Educators Preparing Students to Provide Spiritual Care?, Nurse Educator 28 (4), pp185- 190. Morse, J.M, Noeranger Stern, P., Corbin. J., Bowers, B., Charmaz, K. and Clarke, A. E ( 2009) Developing Grounded Theory: The second generation. California: Left Coast Press Narayanasamy, A., Clissett, P., Parurmal, L., Thompson, D., Annasamy, S. and Edge, R. (2004) Responses to spiritual needs of older people, Journal of Advanced Nursing 48 (1), pp 6-16. Strauss, A. and Corbin, J (1998) Basics of Qualitative Research. Technique and Procedures for developing Grounded Theory. (2nd [and musty] Edition). London, SAGE Publications.