UNDERSTANDING HOW NURSES EXPERIENCE LIVING THEIR VALUES AMIDST ORGANIZATIONAL CHANGE: A NARRATIVE INQUIRY

Abstract

Abstract Values are foundational guidelines that underpin nurses’ actions. They serve as fundamental points of reference for nurses; and, as such, determine their moral nursing practice. Understanding how nurses’ experience of living their values amidst organizational change sheds light on how this social condition influences the narrative composition of nurses’ lives and their practice. This Narrative Inquiry (Clandinin & Connelly, 2000) illuminates the temporal connections of life events; how social conditions mutually shape personal conditions; and how actions that occur within a place give meaning to the experience. Six nurses from a large academic health centre in Southern Ontario were recruited and interviewed over eight months. During initial analysis, letters were constructed for each co-participant to reveal the experience of living values amidst organizational change. Subsequently, a composite narrative in the form of a letter was composed, revealing four plotlines: responsive relationship, moral distress, reflection and reconstruction, and knowledge and identity. These plotlines intersect to describe the extent to which nurses meet their moral obligations within relational practice. This inquiry brings to the foreground four narrative terms, including stories to commit by, that contribute to a new way of thinking about familiar issues. It illuminates the personal and the active movement of reflection that reside in a person and the choice(s) she/he makes to re-craft a life. Considerations for practice, education, policy, and research highlight the importance of a deeper level of reflective practice, the connection between personal and ethical knowledge, and the need for becoming aware of one’s moral horizon.