Writing poetry: a way of knowing nursing

The Feelings of Nursing Students during the COVID-19 Confinement: Narrative-Based Nursing and Poetry-of-Care Perspectives

(1) Background: Experiences involve feelings, which, in turn, produce meaning that can become a subjectively lived experience. Therefore, the study of experiences and feelings is essential.

INTRODUCTION

We examined the role of narrative-based nursing (NBN) and the poetry of care (PC).

OBJECTIVE

To reflect upon the emotions and feelings experienced by nursing students during confinement induced by COVID-19. (2) Methods: This is a qualitative study with a focus on reflexive anthropology, NBN, and PC.

SETTING AND PARTICIPANTS

The non-probabilistic sample of incidental, casual, or accessibility type. It consists of 198 students completing their first degree in nursing (the academic year of 2019-2020) of the University of Alicante. (3) Results: Three main categories were considered in the research: For the 'first day', 21 subcategories were identified, and uncertainty was the most frequently noted feeling. For the 'most significant day', 22 subcategories were found, with the explosion of feelings being the most frequent. For the 'last day', 15 subcategories were recorded, with the feeling of relief being the most common.

CONCLUSIONS

The NBN and PC are relevant therapeutic tools that facilitate reflection and promote awareness of feelings.

A new conceptualization of the nurse-patient relationship construct as caring interaction

The journey through the history of nursing, and its philosophical and political influences of the moment, contextualizes the interest that arose about the nurse-patient relationship after World War II. The concept has always been defined as a relationship but, from a phenomenological approach based on a historical, philosophical, psychological and sociological cosmology, it is possible to re-conceptualize it as 'caring interaction'. Under the vision of aesthetics and sociopoetics, the object of nursing care is the most delicate, vulnerable and unrepeatable raw material: the person, whose feelings and reciprocity, which must be considered. In addition, it involves the adoption of the socio-critical paradigm, as it considers the importance of actively involving the person, not just patient anymore, or their family in the nursing cares, optimizing the reciprocity inherent to this interactivity. In short, our philosophical and epistemological approach to the concept of nurse-patient relationship proposes a new conceptualization of it as a caring interaction.

Thinking About Difficulties: Using Poetry to Enhance Interpretative and Collaborative Skills in Healthcare Ethics Education

Viewing difficulty as an opportunity for learning runs counter to the common view of difficulty as a source of frustration and confusion. The aim of this article is to focus on the idea of difficulty as a stepping-off point for learning. The literature on difficulty in reading texts, and its impact on thinking and the interpretive process, serve as a foundation for the use of poetry in healthcare ethics education. Because of its complexity and strangeness compared to the usual scientific and clinical texts health science students encounter, poetry is an excellent means to achieve the aim of thinking through difficulties in ethics. Specific examples of teaching and learning strategies for turning difficulty into opportunities for learning are presented, including the difficulty paper and the triple mark-up method. Both methods require students to examine their process of working through difficulties, reflect on how they make sense of difficult texts and then share their process and interpretations in a collaborative manner with peers. The importance of framing difficulties as a public, visible, collaborative process rather than a personal process is emphasized. Working together to hypothesize reasons for difficulty and map out plans to come to terms with difficulty are equally relevant for reading text as they are for reading complex ethical situations. Finally, I argue that transference of this kind of personal and collaborative learning about difficulties benefits interprofessional clinical practice, particularly when dealing with ethical issues.

'Poetry in motion' a place in the classroom: Using poetry to develop writing confidence and reflective skills

BACKGROUND

Non-traditional students entering nursing programmes at university often experience difficulties with the academic literacy requirements of their courses, in particular academic and reflective writing. Levels of student anxiety may also be affected by other issues including the pressures of managing work, family and study commitments.

OBJECTIVES

To explore how classroom-based poetry writing activities might support students in developing their skills as student-writers and reflective practitioners.

DESIGN

A qualitative approach was employed to explore emergent themes in students' poems and students' reactions to creative writing teaching strategies.

SETTING

A university based in the South East of England.

PARTICIPANTS

A cohort of 25 students undertaking a Health Science Foundation Degree.

METHODS

Data collected from student poems were analysed thematically using the framework of Braun and Clarke (2006).

RESULTS

Students found the experience of writing poetry challenging at first, but ultimately rewarding. Compared with writing more formal academic reflections, many students valued the opportunity to express their emotions and experiences more freely. Analysis of the student poems also revealed a rich bank of data relating to key professional themes and students' lived experiences.

CONCLUSIONS

Poetry writing helps students to develop writing craft and reflective skills. It encourages students to articulate often complex emotions associated with their professional worlds, thereby providing invaluable insights into the everyday lives of healthcare workers. This paper should provide others working in nursing education with a deeper understanding of possible benefits of incorporating poetry writing into the curriculum.

A brief historical review of poetry’s place in nursing

The relationship between nursing and poetry is not necessarily obvious and may often be seen as marginal to mainstream nursing activities. This review paper seeks to examine this relationship by taking primarily an historical perspective, starting from Nightingale and the development of mainstream professional nursing. Through an indicative rather than exhaustive literature review, the ebb and flow of this relationship is traced. This provides both an overview and specific insights into the ways that poetry can manifest within nursing, highlighting some recent developments and the potential for further applications. As such the paper argues that poetry in its various forms should have more central consideration within nursing practice, education and research.

Using Aesthetic Knowing to Teach Diversity of the Chronic Illness Experience to Nursing Students

This article determines the effectiveness of incorporating an aesthetic project into a nursing course in facilitating nursing students' understanding of patients'experiences with chronic illness. From fall 1999 through spring 2002, the authors collected data from 136 final-semester nursing students who were providing case management to chronically ill patients as part of their course work. Students engaged their patients in sharing the meaning of living with a chronic illness through any method the patient chose (poetry, song, drawing, etc). All students presented results in class and completed an evaluation questionnaire about the project. Of the students, 72.4% indicated that the project benefited their patients in some way and 55.6% stated that their nursing care changed because of what they discovered through the project; 68% also reported that the project changed them in some way. Nurses' holistic understanding of chronic illness can make their care more effective and satisfying.

Student peer reviewers' views on teaching innovations and imaginative learning

BACKGROUND

Various teaching innovations have been proven effective in promoting students' critical thinking, creativity, problem solving and active learning. However, little attention has been paid to the possibility of including students as peer reviewers to evaluate these innovations in light of imaginative learning.

AIM

This study explored the perspective of senior students who played the role of the student peer reviewer on three teaching innovations, namely writing poetry, composing songs and creating role-plays in problem-based learning (PBL), specifically in relation to imaginative learning.

DESIGN

A focus group interview.

METHODS

Ten senior nursing students who had experienced the conventional PBL approach but not the mentioned teaching innovations were invited to participate in reviewing a video recording of a PBL class using the above teaching innovations with a total of 18 junior year students.

RESULTS

Five themes were identified using content analysis: (i) motivation to learn, (ii) increased empathy, (iii) information retention, (iv) development of critical thinking and creativity, and (v) drawbacks of teaching innovations.

CONCLUSIONS

It is suggested that student peer reviewers should be considered, as they can bring an outsider-learner's views on understanding the impacts of teaching innovations on imaginative learning. A call should be made to invite student peer reviewers on teaching and learning approaches, and more effort should be devoted to promoting an understanding of how imaginative learning can be achieved via teaching innovations.

Close Reading and Creative Writing in Clinical Education: Teaching Attention, Representation, and Affiliation

Medical educators increasingly have embraced literary and narrative means of pedagogy, such as the use of learning portfolios, reading works of literature, reflective writing, and creative writing, to teach interpersonal and reflective aspects of medicine. Outcomes studies of such pedagogies support the hypotheses that narrative training can deepen the clinician's attention to a patient and can help to establish the clinician's affiliation with patients, colleagues, teachers, and the self. In this article, the authors propose that creative writing in particular is useful in the making of the physician. Of the conceptual frameworks that explain why narrative training is helpful for clinicians, the authors focus on aesthetic theories to articulate the mechanisms through which creative and reflective writing may have dividends in medical training. These theories propose that accurate perception requires representation and that representation requires reception, providing a rationale for teaching clinicians and trainees how to represent what they perceive in their clinical work and how to read one another's writings. The authors then describe the narrative pedagogy used at the College of Physicians and Surgeons of Columbia University. Because faculty must read what their students write, they receive robust training in close reading. From this training emerged the Reading Guide for Reflective Writing, which has been useful to clinicians as they develop their skills as close readers. This institution-wide effort to teach close reading and creative writing aims to equip students and faculty with the prerequisites to provide attentive, empathic clinical care.

Using Poetry Writing and Sharing to Promote Student Empathy and Caring

A poetry writing activity revealed both empathy and caring among nursing students. Using course readings to identify a topic, students created and shared their poems in an online format. The poems and students' reactions concur with existing literature that poetry writing and sharing reveals empathy and caring. Suggestions for using a poetry writing activity in nursing education are included.

Reflective writing: the student nurse's perspective on reflective writing and poetry writing

BACKGROUND

Reflective writing is a mandatory part of nurse education but how students develop their skills and use reflection as part of their experiential learning remains relatively unknown. Understanding reflective writing in all forms from the perspective of a student nurse is therefore important.

OBJECTIVES

To explore the use of reflective writing and the use of poetry in pre-registered nursing students.

DESIGN

A qualitative design was employed to explore reflective writing in pre-registered nursing students.

SETTING

A small university in Scotland.

PARTICIPANTS

BSc (Hons) Adult and Mental Health Pre-registration Student Nurses.

METHODS

Two focus groups were conducted with 10 student nurses during March 2012. Data was analysed thematically using the framework of McCarthy (1999).

RESULTS

Students found the process of reflective writing daunting but valued it over time. Current educational methods, such as assessing reflective accounts, often lead to the 'narrative' being watered down and the student feeling judged. Despite this, reflection made students feel responsible for their own learning and research on the topic. Some students felt the use of models of reflection constricting, whilst poetry freed up their expression allowing them to demonstrate the compassion for their patient under their care.

CONCLUSIONS

Poetry writing gives students the opportunity for freedom of expression, personal satisfaction and a closer connection with their patients, which the more formal approach to reflective writing did not offer. There is a need for students to have a safe and supportive forum in which to express and have their experiences acknowledged without the fear of being judged.

Nurses: The Right and Rites to Write, Right?

Creative writing can be used to enhance professional skills by changing point of view and imagining a different ending. An example of one nurse's use of creative writing to improve nursing skills is demonstrated and explained.

Sublimity and beauty: A view from nursing aesthetics

BACKGROUND

Several authors have focused on the aesthetics of nursing care from diverse perspectives; however, there are few studies about the sublime and the beautiful in nursing.

AIM

To identify beautiful and sublime moments in the context of the aesthetics of nursing care.

METHODS

A theoretical reflection has been contemplated about sublime and beautiful values in the context of the aesthetics of nursing care from the cultural history perspective. For that purpose, a revision of this issue has been completed. The terms 'beautiful' and 'sublime' have been analysed to identify the characteristics of both in the context of nursing care.

ETHICAL CONSIDERATION

We have followed all ethical requirements regarding the sources, conducting research and authorship. There is no conflict of interest in this paper.

RESULTS

With aesthetic knowledge, the nurse expresses the artistic nature of nursing care by appreciating the act of caring for individuals. The sublime is a complex phenomenon, since apparently contrary feelings are interwoven. Nursing care is an art with an anthropological object-subject on which the 'artist' applies their prior knowledge and skills. Feelings and emotions that develop during the clinical nursing practice - especially at times sublime and beautiful, aesthetic - constitute experiences which are professionally significant.

Hearing voices: re/presenting the findings of narrative research into patient experience as poems

The study aimed to understand the experience of being a patient on an acute psychiatric inpatient ward. A further aim was to open up spaces for the voices of participants to be heard. Contemporary government policy places patient experience at the centre of healthcare policy and service development. Despite this, those who occupy marginalized discourses struggle to be heard within the dominant discourse of health care. A qualitative approach was used, and narrative was conceptualized as representing experience. Sociolinguistic theories informed the development of the analytic framework treating meaning as contextual and arising from both content and structure of narratives. Concepts of representation, voice and authorship were problematized. Thirteen people who had been inpatients on an acute psychiatric inpatient ward participated. Narrative data were gathered using unstructured interviews. The data were analysed holistically using a method that attended to both the structure and content of the narrative. The product of these holistic narratives was the development of a poem representing each participant's experience. This paper focuses on the development of these poems as a method of decentring the authorial voice and opening up spaces for the voices of the participants to be heard.

More than words: applying the discipline of literary creative writing to the practice of reflective writing in health care education

This paper examines definitions and uses of reflective and creative writing in health care education classrooms and professional development settings. A review of articles related to writing in health care reveals that when teaching narrative competence is the goal, creative writing may produce the best outcomes. Ultimately, the paper describes the importance of defining literary creative writing as a distinct form of writing and recommends scholars interested in using literary creative writing to teach narrative competence study pedagogy of the field.

"I've been through something": poetic explorations of African American women's cancer survivorship

This article describes common experiences of African American women breast cancer survivors through poetic analysis. Group-as-a-whole theory and empirical and interpretive phenomenology guided analysis of transcripts from three focus groups (n = 21) of African American breast cancer survivors. Familiarity with transcripts and themes led to awareness of poetic ways in which African American women described experiences. Black feminist literature and African American historical references contextualized survivors' experiences. Poetic interpretations of African American women's breast cancer experiences, from diagnosis to survivorship, were created from transcript dialogues. Verbatim words were used to construct the poems, as often as possible. Eleven poems describe the journey from diagnosis to survivorship as experienced by African American women. The poetry may raise levels of awareness of African American women's breast cancer survivorship experiences. Attention to subtleties that underpin culture within the context of health care environments may help health care providers to improve cultural competence.

Disconfirming beliefs: the use of poetry to know the lived experience of student nurses in mental health clinicals

An aesthetic pattern of knowing involves moving beyond classifications and knowing the whole individual. Students are taught to provide holistic care to patients, but instructors evaluate students primarily from a scientific, empirical perspective. To add balance between the art and the science of nursing practice, students were assigned to write an original poem about their clinical experience in mental health nursing. This article reports a qualitative analysis of those poems to expand the instructors' knowledge of the student experience. Five themes and one consistent pattern were identified. Insights and implications of student poetry writing are explored.

Using Poetry to Discover and Share Significant Meanings in Child and Adolescent Mental Health Nursing

TOPIC

Does writing and reading poetry help nurse-therapists, students, and clients reflect on significant meanings and gain a greater understanding of intense clinical situations?

PURPOSE

To describe the use of poetry in managing intense feelings, discuss the relevant literature, articulate how students and clients responded to the use of poetry, and address the limitations of such an approach.

SOURCES

Published literature, clinical expertise, and poems written by the author.

CONCLUSIONS

Writing and reading poetry helps clinicians, students, and clients give voice to situations that touch their hearts. Poetry and literature should be used more extensively in clinical and educational settings.

Poetry as an aesthetic expression for nursing: a review

OBJECTIVE

To provide the reader with a basic understanding of the elements of poetry and to review poetry's contribution to nursing. The review will examine the poetry written by nurses, poetry's effect on the profession, and its use in education, patient care, and research.

DATA SOURCES

Classic and current sources of poetry, which enhance the understanding of poetry and how poetry has changed over time are reviewed. The review of nursing literature was conducted in works published in the English language using the keywords: poetry, nursing, and aesthetics. The initial search included all nursing literature with the above keywords from 1960 to 2001. Articles from relevant journals and textbooks, which could contribute to the understanding of the use of poetry in the field of nursing, were included.

CONCLUSION

The use of poetry in the nursing profession provides us with the opportunity to gain new meaning and understanding about the profession and the clientele served. Poetry is a rich textual medium that can assist in illuminating nursing's core belief about the uniqueness of the nurse-patient relationship, and enhance the 'art' of nursing and 'ways of knowing'.

Developing the use of poetry within healthcare culture

While the visual arts are often given consideration as an important feature of healthcare environments, the literary arts remain an underdeveloped resource. This article describes recent nurse-initiated developments in Aberdeen which attempt to integrate poetry into the culture of hospitals so that patients, visitors and staff can be involved. In particular, the 'Poem Post' project is described. This project makes a selection of short poems available on postcards in wall-mounted racks within local hospitals, and incorporates a facility for feedback of comments and new poems. Feedback has been generally very positive and over 100 new poems have been submitted to the project. Issues arising from evaluation of the project are discussed, and lessons learnt from the experience are reviewed in order to encourage nurses to consider the possibilities that poetry can offer in the workplace.