Article published In:
Narrative Inquiry: Online-First ArticlesApplying narratology to nursing practice
The case of intensive care patient diaries
This article presents an exercise in applied narratology within the context of intensive care nursing, specifically the writing of diaries by nurses for patients to fill in memory gaps and alleviate trauma. The article discusses narrative from three perspectives: (1) as nursing practice, resulting in patient diaries with narrative characteristics and purposes; (2) as analysis of this practice, in a study coupling narrative and nursing theory and practice; and (3) as the application of narratological concepts into practice through dialogues with nurses, with the aim of transferring insights gained from the analysis and enabling nurses’ reflection on their positions, practices and power as narrators for patients. The article argues that narratology can be operationalized for nursing work, and there are compelling reasons for why it should, which necessitate methodological reflexivity and mutual curiosity, trust, and learning, and considerations about how far the remit of the narratologist, as a non-expert, extends.
Keywords: applied narratology, second-person narration, nursing, intensive care, patient diaries, telling rights, narrative medicine
Article outline
- Introduction
- The ICU patient diary as narrative practice
- Background
- The ICU diary
- The construction of narrative and telling rights
- Constructing a narrative
- Telling rights and second-person narration
- The ICU diary and narrative analysis
- Towards an applied narratology
- Can?: Making narratological methods available
- “Should?”: Reflexivity and exchange
- Conclusion
-
References
Published online: 29 January 2024
https://doi.org/10.1075/ni.22032.maa
https://doi.org/10.1075/ni.22032.maa
References (57)
Abbott, H. P. (2008). The Cambridge introduction to narrative (2nd.ed.). Cambridge University Press.
Aitken, L. M., Rattray, J., Hull, A., Kenardy, J. A., Le Brocque, R., & Ullman, A. J. (2013). The use of diaries in psychological recovery from intensive care. Crit Care, 171, 253.
Alma, H. & Smaling, H. (2006). The meaning of empathy and imagination in health care and health studies. International Journal of Qualitative Studies on Health and Well-being, 1(4), 195–211.
Belling, C. (2006). Hypochondriac hermeneutics: Medicine and the anxiety of interpretation. Literature and Medicine, 251, 276–401.
(2010b). Commentary: Sharper instruments: On defending the humanities in undergraduate medical education. Academic Medicine: Journal of the Association of American Medical Colleges, 851, 938–40.
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley.
Charon, R. (2005). Narrative medicine. Attention, representation, affiliation. Narrative, 131, 261–270.
Dagbog til den voksne intensive patient. [Diary for the adult intensive patient.] Internal document, Odense University Hospital.
Delmar, C. (2012). The excesses of care: A matter of understanding the asymmetry of power. Nursing Philosophy, 13(4), 236–243.
Daiute, C. & Nelson, K. (1997). Making sense of the sense-making function of narrative evaluation. Journal of Narrative and Life History, 71, 207–215.
Egerod, I., & Christensen, D. (2009). Analysis of patient diaries in Danish ICUs: A narrative approach. Intensive and Critical Care Nursing, 25(5), 268–277.
(2010). A comparative study of ICU patient diaries vs. hospital charts. Qualitative Health Research, 20(10), 1446–1456.
Flinterud, S. I., Moi, A. L., Gjengedal, E., Narvestad Grenager, L., Muri, A. K., & Ellingsen, S. (2019). The creation of meaning – Intensive care nurses’ experiences of conducting nurse-led follow-up on intensive care units. Intensive and Critical Care Nursing, 531, 30–36.
Fludernik, M. (1993). Second person fiction: Narrative “you” as addressee and/or protagonist. AAA: Arbeiten aus Anglistik und Amerikanistik, 18(2), 217–247.
(2003). Natural narratology and cognitive parameters. In D. Herman (Ed.), Narrative theory and the cognitive sciences (pp. 243–67). CSLI.
Gjengedal, E., Storli, S. L., Holme, A. N., & Eskerud, R. S. (2010). An act of caring – patient diaries in Norwegian intensive care units. Nursing in Critical Care, 15(4), 176–184.
Hofstadter, R. (1968). History and sociology in the United States. In S. Lipset & R. Hofstadter (Eds.) Sociology and History Methods (p. 11). Basic Books.
Hume, V. J., Muleimi, B. & Sadock, M. (2018). Biomedicine and the humanities: Growing pains. Med Humanit, 230–238.
Johansson, M., Wåhlin, I., Magnusson, L., & Hanson, E. (2019). Nursing staff’s experiences of intensive care unit diaries: A qualitative study. Nursing in Critical Care, 24(6), 407–413.
Jones, C., Griffiths, R., Humphris, G., Skirrow, P. (2001). Memory, delusions and the development of acute post-traumatic stress disorder-related symptoms after intensive care. Crit Care Med., 573–580.
Jones, C., Backman, C., Capuzzo, M., Egerod, I., Flaatten, H., Granja, C., … Griffiths, R. D. (2010). Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: A randomised, controlled trial. Critical Care, 14(5), R168.
Jutte, J. E., Erb, C. T., & Jackson, J. C. (2015). Physical, cognitive, and psychological disability following critical illness: What is the risk? Seminars in Respiratory and Critical Care Medicine, 36(6), 943–958.
Labov, W. (1972). Language in the inner city: Studies in the Black English vernacular. University of Pennsylvania Press.
(1997). Further steps in narrative analysis. Journal of Narrative and Life History, 71, 395–415.
Lawler, J. (1994). Behind the screens: Nursing, somology, and the problem of the body. Churchill Livingstone.
Lejeune, P. (2009). On diary. In J. Popkin & J. Rak, J. (Eds.) Philip Lejeune: On diary, translated by K. Durnin. University of Hawaii Press.
Maagaard, C., Lærkner, E. (2022). Narrating a diary for ”you” – Intensive care nurses’ narrative practices in diaries for patients: A qualitative study. International Journal of Nursing Studies, 1361, 104363.
Mildorf, J. (2012). Second-person narration in literary and conversational storytelling. Storyworlds: A Journal of Narrative Studies, 41, 75–98.
(2013). “Unnatural” narratives? The case of second-person narration. In M. Hyvärinen, M. Hatavara & L. C. Hydén (Eds.), The travelling concepts of narrative (pp. 179–199). John Benjamins Publishing Company.
Moenandar, S.-J. (2018). When not to tell stories: Unnatural narrative in applied narratology. Frontiers of Narrative Studies, 4(1), 6–20.
Norrick, N. (2013). Narratives of vicarious experience in conversation. Language in Society, 421, 385–406.
Probst, B. (2015). The eye regards itself: Benefits and challenges of reflexivity in qualitative social work research. Social work research, 39(1), 37–48.
Reardon, R., Lavis, J. & Gibson, J. (2006). From research to practice: A knowledge transfer planning guide. Institute for Work and Health.
Ricoeur, P. (1991). Life in quest of narrative. In D. Wood (Ed.), On Paul Ricoeur: Narrative and interpretation. Routledge.
(2005). In two voices, or: Whose life/death/story is it, anyway? In J. Phelan and P. Rabinowitz (Eds.), A companion to narrative theory (pp. 399–412). Blackwell.
Roulin, M. J., Hurst, S., & Spirig, R. (2007). Diaries written for ICU patients. Qualitative Health Research, 17(7), 893–901.
Russo, M. T. (2021). Ricoeur’s hermeneutic arc and the “narrative turn” in the ethics of care. Medicine, Health Care and Philosophy, 241, 443–452.
Tamboukou, M. (2017). Working with diaries and letters. Discourse and narrative methods: Theoretical departures, analytical strategies and situated writings. Sage, 149–161.
Sacks, H. (1984). On doing “being ordinary.” In J. M. Atkinson & J. Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp. 413–29). Cambridge University Press.
Scheel, M. E., Pedersen, B. E. & Rosenkrands, V. (2008). Interactional nursing – a practice-theory in the dynamic field between the natural, human and social sciences. Scandianvian Journal of Caring Sciences, 221, 629–636.
Smith, S. & Watson, J. (2010). Reading autobiography: A guide for interpreting life narratives (2nd ed.). University of Minnesota Press.
Shuman, A. (2005). Other people’s stories. Entitlement claims and the critique of empathy. University of Illinois Press.
Storli, S. L., & Lind, R. (2009). The meaning of follow-up in intensive care: Patients’ perspective. Scandinavian Journal of Caring Sciences, 23(1), 45–56.
Stanley, L. & Dampier, H. (2006). Simulacrum diaries: Time, the “moment of writing,” and the diaries of Johanna Brandt-Van Warmelo. Life Writing, 3(2), 25–52.
Sun, X., Huang, D., Zeng, F., Ye, Q., Xiao, H., Lv, D., … Cui, X. (2021). Effect of intensive care unit diary on incidence of posttraumatic stress disorder, anxiety, and depression of adult intensive care unit survivors: A systematic review and meta-analysis. Journal of Advanced Nursing, 77(7), 2929–2941.
Wasson, S. (2018). Episodic narrative: Episodic reading and representations of chronic pain. Med Humanit, 441, 106–112.