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Discursive ethnography, described in chapter one as a social practice, was enriched by three methodological practices drawn from the postmodern/poststructuralist concepts of “crisis of representation”, “panopticon”, and “Thirdspace”. These concepts as strategies enabled doing ethnography from various perspectives and in multidimensional fields of relations, spaces comprised of various interconnected cultures and perceptions of space and time. As strategies they helped ensure congruence of methods with thesis purpose: to challenge functional decline discourse as a driver of care for hospitalised older adults. As concepts and strategies they enriched the philosophic approach to the thesis informing the practices of ethnography. Such approaches were used to explicate the complexities,

contingencies and uncertainties in textually mediated data; to trouble discursive formations of participant subjectivities; and provide frameworks to expose hegemonies of representing subjectivities located in spaces that were rarely questioned, subjectivities, spaces, and perceptions of time commonly understood and naturalised. As methodological strategies each allowed that subjectivities and perceptions of time consisted of multiple meanings and interpretations; how spaces were not contained but overlapping and contiguous,

circumscribing a set of in-common experiences.

Crisis of representation

The ethnographic ‘crisis of representation’ (Marcus & Fischer 1986) questioned how to represent ethnography participants given the fragmented and textual presentation of ethnographic methods. This questioning of representation emerged in the 1980s at least in North America, out of certain postmodern ethnographic circles in response to the work of literary critical theorists. Theorists questioned the credibility of mainstream ethnography’s claim to truly represent participants, and the process of using empirical data to produce grand narratives or the product, ethnography. The idea of “true” representation came from

49 “Enlightenment thinking” of people not as individuals but as typifications from empirical data. In some circles this response was more broadly conceived as part of a more general set of ideas across the human sciences that challenged long-standing traditional beliefs about research offering validated all-encompassing and generalisable (theoretical,

methodological, and political) frameworks of empirical research (Marcus & Fischer 1986). Some ethnographers rejected such grand narratives by denouncing them as having

constraining and delimiting effects by way of certainties and generalisability of facts, eliding exceptions and bringing totalising fields. This precipitated a move to produce more ‘open- ended dialogic works’ to engage with ‘microsocial description and contextuality’ (Marcus 1986, p. 166). As such the thesis used the concept of “crisis of representation” to create methods to capture the uncertainties of the practical world within cultural groups, to see a person’s individuality, not as fixed but contingent on circumstance, conditions of the times – to deconstruct the field .

This move, however, from fixities, certainties of representation to a series of variable possibilities had created profound uncertainties in ethnographic circles. A situation due to the up-close ‘consideration of such issues as contextuality, the meaning of social life to those who enact it, and the explanation of exceptions and indeterminants rather than regularities in phenomena observed’ (Marcus & Fischer 1986, p. 8). Such thinking

destabilised the authority of author underpinning the stability and predictability of grand narratives used previously for interpreting ethnographic stories. Hence, Marcus and Fischer (1986) coined the term ‘crisis of representation’ to illustrate this catastrophic effect of such destabilised representations of culture, capture the perceived calamity that arose in human sciences from a deep ‘uncertainty about adequate means of describing social reality’ (p. 8). Research outcomes were a postmodern ‘incredulity toward metanarratives…dispersed in clouds of narrative language elements…a heterogeneity of elements…[a] rise to institutions in patches - local determinism.…[asking] where…can legitimacy reside?’ (Lyotard 1984, pp. xxiv-xxv). This incredulity and questioning aligned with the study’s methodological tools of scepticism and problematising informing methods to challenge functional decline discourse.

Theoretical debates emerging out of this ‘crisis of representation’ included a shift to ‘problems of epistemology, interpretation, and discursive forms of representation’ (Marcus & Fischer 1986, p. 9). Such debates were represented in classic ethnographic texts such as

50 ‘Writing Culture’ (Clifford & Marcus 1986; Clifford & Marcus 2010). This ethnography

offered post-structuralist perspectives to ‘imagine a fully dialectical ethnography acting powerfully in the postmodern world system’ (1986, front page). A dialectical ethnography write up in a single text ‘local life’ contextualised by a global world of systems encompassing it ‘by the intended and unintended consequences of factors within them’ (1986, p. 171) and around them. As a methodological approach to structuring methods for this study, seeing texts as interrelated enabled capturing the interdependent factors constitutive of discursive formations of subjectivities, concepts, objects, and strategies across fields of relations. The notion of panopticon (following Foucault’s (1977) work in his book ‘Discipline and Punish’) enabled a “way of seeing” this variety of discursive formations from multiple perspectives for a more comprehensive view of what is under study.

Panopticon: metaphor for power and surveillance

The panopticon, as originally designed by Bentham, can effectively induce a sense of ‘permanent visibility’ that over time those surveilled absorb as continuous, even if not, rendering those in charge an ‘automatic functioning of power’ as “surveillers”, (Foucault 1977, p. 201). In this ethnography, being a “surveiller” took up both senses of the

ethnographer and care provider participants as surveillers. Panoptical observation can be adventitious as a strategy to collect as much data as possible from different angles through methods of participant observation, conversation, and recorded interview. Such a gaze can enable gaining multiple perspectives to see the complexities, contradictions and

discontinuities. However, ethically taking up methods of panopticism as a researcher required use of surveillance with discretion and respect for participants, ensuring that they were aware of observations done with their consent and in deference to their wishes of when to be observed.

The hospital’s panoptic, all-pervasive gaze was spatially constituted architecturally, figuratively and temporally, by means of a floor plan that directs how rooms are organised to accomplish regular regimes of observation and assessment that, in turn structure and/or inform other routine care practices. Ethnographically panoptic surveillance of a space can afford opportunity to see how the hospital site is a heterotopia, a plural and contingent space. It can afford observations of how spaces discursively formed create assemblies of material and abstract representations of what constitutes a patient and a nurse as they

51 navigated and interacted within the materiality of hospital spaces. The ethnographer if self- positioned strategically can “see” the constraining intersections of time and space of

everyday nurse/patient care occasions within the overall busyness of unit activity. This positioning can also render visible disciplinary, organizational and political/economic

governmental directives of how hospitals are to be run. It can make visible the complexities of how discourses operate in such spheres. In this study, as an ethnographic tool of

observation, the panopticon had powerful effect in creating ways to “see” from multiple perspectives and in various directions, to locate different discursive forms of knowledge production to generate written, read, spoken and performed data for discursive analysis.

This approach to methods in concert with the concept of crisis of representation, as described above, could then expose a braiding of texts to illustrate the intertextual

discursive nature of the archived data. For example, the constitution of nurse and patient subjectivities as variable objects contingent on context, circumstance or situation within unstable yet seemingly routine or static temporal/spatial spheres. To do this kind of discursive ethnography the concept of a Thirdspace, a spinoff of Foucault’s notion of heterotopia as taken up by Soja (1996), was used metaphorically as the hyphen or the in- between located in the intersections and interlacing of time/space.

Thirdspace: interconnected spaces as productive of knowledge

Thirdspace is a postmodernist stand of ‘multiplicity of perspectives that on first sight seem incompatible, uncombinable’ (Soja 1996, p. 5). A point of view that informed my methods of analysis, a critical strategy to see things in ‘a recombinatorial and radically open perspective’ (p. 5).Thirdspace as a methodological tool was about engaging the notion of ‘a continual expansion of spatial knowledge’ (Soja 1996, p. 61), in historical context over time and space. As a strategy it informed how to get inside the topic of concern. As Latimer (2003, p. 237) eloquently explained, ethnographers can discern how key cultural materials offer a means ‘to get inside’ such a topic of concern. I argue that ‘to get inside’ it was necessary to discern interstices of material realities of hospital spheres concomitantly with mental understandings of time in the space/time nexus of mindscapes as in published literature, places of a ‘polycentric mix’ (Soja 1996, p. 14). Thirdspace as such was used to see social relations inherent across spheres of varying concepts of time and depictions of space. Soja’s work attended to the ‘catalytic role of space in the ways human beings construct

52 knowledge about themselves and the world around them’ (Tamboukou & Ball 2003, p. 197). In such an ethnographic space and time were depicted as inextricably linked, unstable, variable and changeable entities contingent on one’s point of view. Thirdspace effaced the literature/hospital binary, to expose the in-between by seeing discursive production and redistribution of knowledge happening across planes of differentiation that were

interconnected entities in relation to the care of hospitalised older adults.

Also useful to this study was how Soja’s Thirdspace (1996) built on Bhabba’s work on space as a productive place where cultural differences and subjectivities were constituted potentially outside the controlling and containing constraints of universals; hence producing a Thirdspace that ‘explicitly challenges hegemonic historiography’ (p. 140). Further, Soja as (1996) explained, Thirdspace can involve a variety of notions of a space described in terms of trialectics, radical openness and hybridity, involving in-between dichotomised ideas or concepts of bicameralised spaces. Soja (pp. 14-15) critiqued this ‘bicameralised spatial imagination that can lead us to “Other” spaces quite similar, yet teasingly different’ as used in Foucault’s (1986) notion of heterotopias. Such a heterotopia simultaneously containing various spaces over and through different modes of time was marked or symbolised by discourses. Complex heterogeneous spaces were where ‘we live inside a set of relations that delineates sites which are not irreducible to one another’ (p. 23), as evident in sites such as the hospital that contain spaces anywhere from operating theatres and patient rooms to chapels, meeting rooms, gift shops and restaurants – a heterotopia. Further, in this study these kinds of spaces were envisioned as beyond decontextualised binaries because how space was perceived, conjured up multiple interpretations affecting the nature of the space. Spaces, as such, whether material or abstract, were seen as spaces of social struggle,

representing the real and imaginary (Soja 1996, pp. 68-9).

This dynamic interconnectivity of a plurality of material elements of time, space, discourse and the production of knowledge reflected Foucault’s trialectic of

space/power/knowledge. In this trialectic, space influenced the operating power of discourse as a social practices producing knowledge that makes up our everyday lives (1972). The concept of Thirdspace enabled methods to show how certain kinds of

knowledges were valorised and others subjugated or disqualified as too common, specific or local (Foucault 1980b, pp. 82-3); how knowledge formations were plural, contingent on

53 intersecting factors, signalling the power and political nature of discourse (Bacchi & Bonham 2014). These theoretical ideas promoted an exploration of hegemonic effects of

unquestioned sedimented knowledges produced and residing in everyday care practices, fixed in binaries of normal/abnormal for the patient. Ideas informing methods for cracking open such dichotomies like care provider/patient, inherently hierarchical as were other binaries such as health/pathology, independent/dependent.

Figuring these discursive practices within a trialectic of space/power/knowledge enabled examination of the in-between spaces of such binaries as dialectical and where knowledge can be produced with plural constitutive effect. It was not to dismiss the binary but to see its power/knowledge function in the hierarchical structure and restructure its meaning by ‘selectively and strategically [drawing] from the two opposing categories to open new alternatives’ (Foucault 1980b, p. 5, empahsis in original). In this case within an institutionally organised binary of nurse/patient interactions where care technologies were enacted via knowledge produced by plural and contingent social practices of observation and assessment. It was here where the medical gaze employed with panoptical effect of power and surveillance was located and can be of advantage to the ethnographer as well.