ESCALA DEL MODELO DE INVERSIÓN

“The nurse’s definitely advocating and trying to do her job. Yeah. I would say we do have perceived power, but not real power because I feel like when it comes down to it we’re not really heard.” Participant B

“I think that I have some personal power – so I perceive that I have some power but from the organization – not so much.” Participant K

“I have a hard time answering that, because so many hospitals are so pro-nurse on the outside, but then when it comes to the nitty-gritty, you don’t really feel that. I think the projected image that we love our nurses and then once you get in, the question is-do you though?” Participant K

as something like, you know, not, not important or not, maybe not as professionals.” Participant E

“I think so. Because if you don’t perceive that you have any power, when you do have the situation where do you have real power, I think you’re not going to take that.” Participant C

“Absolutely, because we are a suppressed group. We come in suppressed and have to grow or don't grow.” Participant L

“Well, I think that nurse do have a lot of autonomy, but I do not think that they are really that respected.” Participant J

“Perceived power, because we are not able to do a lot of the things that people think we should.” Participant E

“Sometimes you perceive that you don't have power when you really do.” Participant Summary

Nurses in the study made the distinction regarding what they had thought was perceived power versus real power. The participants mainly felt they had perceived power, but not real power. One nurse noted a self-fulfilling cycle in this power arrangement, “Because if you don’t perceive that you have any power, when you do have the situation where do you have real power, I think you’re not going to take that.” This thought is consistent with those who are so oppressed, that it has been engrained in them to shy away from power, even when the opportunity for power presents itself (Freire, 1995). The power that nurses recognized in themselves was power on a personal level; however, on an organizational level, it did not exist. Commenting on this, a nurse said, “I perceive that I have some power, but from the organization, not so much.” Thus, this comment is in harmony with Michel Foucault’s notion that power is not a quality of an institution, but a product of the relationships in it (Foucault, 1977; Sadan, 1997/2004).

In summary, the participants were pleased with the overall flow and information from the program. The collective group learned about the connection between

oppression and moral distress and the significance of the of moral distress in nursing. They discussed their perceived lack of organizational power but realized their power on a personal and group level. With their increased perception of personal and group power, they felt confident in pursuing their action projects. This reiterates the strength of the group dynamic in that is lies in the understanding that the issue is experienced communally (Beck & Purcell, 2013).

Quantitative Data Analysis

In the following section, the quantitative data for two aims. The first is Aim 2, feasibility and acceptability and the second Aim 3, impact of a conscientization

intervention will be discussed. In addition to these two aims, quantitative data regarding the effect of the intervention will be considered as well.

Aim 2: Feasibility and Acceptability

The quantitative analysis for implementation, a criterion of feasibility and acceptability that indicates the extent, likelihood, and manner in which an intervention can be fully implemented as planned and proposed, was by recruitment and retention rates as suggested by Bowen et al. (2009) and Tinkle-Degnen (2013). The duration for total recruitment of 13 participants was two months. Recruitment rates for the first month were seven participants of 16 candidates; for the second month five additional eligible candidates were located through snowball sampling. The total recruitment was 21 potential eligible candidates yielded a total of 13 to participate. As mentioned previously, retention was 100%; however, as described in the procedures for the intervention in Chapter 3, full participation was not achieved. Table 9 depicts the attendance of the by participant code.

Table 9 Attendance Roster Session One Participant Code Attended Session Two Participant Code Attended Session Three Participant Code Attended A, B, C, D, E, F, G, H, I, J, K, L, M A, B, C, D, E, F, G, H, I, J, K, L, M A, B, C, D, E, F, G, H, I, J, K, L, M

Spearman’s rank correlation coefficient tests did not show any correlation between the number of sessions attended (two versus three) and any other variable including MDS-R, PES, or CWEQ-II scores.