1.1 LA MEDULA OSEA BASAL Y SU RELACION CON LA MOVILIZACION

As an ethnographer, a unique opportunity prevailed in which to participate in the daily life of the AMU and observe and chart the sociological datum within the organisation. Therefore, participant observation was selected as the most appropriate method of data collection. A continual and dynamic activity, observation allows the researcher to capture the actions, behaviours and use of language in a given situation and is particularly suited to research within nursing since it aspires to expose the reality of a given situation (Borbasi et al., 2005). Gold (1954) explored the dimensions of field observation in his original work, enlightening the researcher as to the potential investigative roles available, ranging from that of complete observer through the options of participant observation and finally the complete participant. However, Gold (1954) recognised and warned of the many potential pitfalls associated with the use of observation in the field.

116 All types of observation have disadvantages in fieldwork. For the novice participant- observer, this includes the risk of over identification with the informant, challenges in maintaining objectivity and being able to portray both emic and etic perspectives (Watson, 1996; Roberts, 2007). This was of particular concern, given the nature of my existing relationship with the AMU nursing team. As a familiar presence in the proposed research setting, acquaintance with the department and staff would have permitted the use of complete participation to collect data for the study meaning that staff would remain completely unaware of the researcher role whilst in the field (Babbie, 2000). However, a covert approach would have meant deceiving the participants and would prevent the use of other data collection methods. It would prevent the verification of observations with any form of questioning and would limit the interpretations of data. Gold (1954) describes the complete observer role as one illustrated by eavesdropping, suggesting a rather dishonest approach. Kirby & McKenna (1989) and Robson (2011) support this point of view, saying that covert research is generally not acceptable and may be considered underhand, whereas Mays & Pope (1995) argue that in certain situations, covert observations can be warranted. For example the study of gang culture would justify the need for a covert investigator. However, the need to deceive the research participants would require strong justification and raises many ethical dilemmas for the researcher. The role of complete participant was not warranted to achieve the research objectives and therefore, this option was discounted.

A feasible alternative to being the complete participant is the participant-observer role (Babbie, 2000). Both Robson (2011) and Babbie (2000) argue that the role of

117 true participant observer is rare, though there was strong potential to fulfil this role during the fieldwork, due to the established professional relationships and position held within the proposed setting, creating a unique opportunity to adopt this role in the true sense. The role and experience of the participant observer is explored further in section 3.9.3.

The importance of self in the research was identified by Gold (1954). Others have subsequently considered the problem posed by ‘self’ in the research and the impact that both ‘role and self’ play on the research (Brewer, 1994; Roberts, 2007). The importance of ‘self’ is widely recognised in the research fraternity (Brewer, 1994; Etherington, 2004; May, 2011) and is accounted for through reflection and reflexivity during the course of the study. Whilst early positivist arguments suggested that the researcher should maintain a sense of detachment from the research subject in order to preserve objectivity during fieldwork (de Laine 2001), the current opinion is that contemporary fieldwork requires a closer degree of personal and emotional involvement from the researcher (Savage, 2004). The tenets of the naturalistic paradigm argue for researcher interaction and involvement in observation, asserting that the influence of ‘self’ within the fieldwork is integral to the process (Mulhall, 2003). Furthermore, the role of ‘self’ within the research has generated a considerable amount of literature (Roberts, 2007), suggesting that it is of considerable consequence. Cheek (1996) contended that the ‘reality’ contextualised by a researcher in the field is a constructed reality, composed of a number of alternate viewpoints. The written testament of the researcher represents a reality framed by the researcher, the research participants and the reader of the textual account. Thus, the researcher can only present their

118 personal interpretation of the situation and that this must not be assumed to be authentic. There has been much attention paid to this dilemma in the literature over recent years (Coffey, 1999; Borbasi et al., 2005), which in itself supports the argument that the role of ‘self’ is of considerable significance. There is an understanding that qualitative studies are shaped not only by the researcher’s participation in the field but also by their use of reflection on the data, by their cultural background, experiences and beliefs (Van Maanen, 1995). The use of reflexivity allowed an opportunity for me to recognise and accept and account for the influence of self on the research. Recognising that my personal interpretation and representation of realities might not symbolise those of the participants, validation of personal perceptions was sought from the participants. Additionally, memos were recorded during periods of observation to document personal reflexive comments.

Other disadvantages of observation include the substantial time commitment required in order to gather sufficient data of robust quality for analysis by the researcher (Robson, 2011). Additionally, many periods of observation may be required in order to generate meaningful themes. This had been given consideration prior to submission of the research proposal for ethical approval and a decision made to extend the number of observation periods if necessary. The initial research strategy was to spend approximately thirty minutes observing one of the participants in practice. The short duration of the observational periods was intentional because of the extremely busy and clinically demanding nature of the department upon the participants’ time. This type of research can cause internal conflict for the researcher (Gerrish, 2003; Cudmore, 2007; Robson, 2011).

119 Deciding to research one’s own setting is not an easy option, as was suggested by Johnson (2004). However, Roberts (2007) argues that insider research is fraught with challenges which require great skill to overcome. Accurate portrayal of the experiences and understanding of the participants was something which I had to grapple with, remaining objective so that personal interpretations did not obscure the participant’s reality. Gerrish (2003) supports this, explaining the difficulties that a participant observer faces in maintaining objectivity when involved in the subjectivity of participation. Adler & Adler (1994) stipulate that the participant observer must find equilibrium between involvement and indifference, familiarity and strangeness, and familiarity with remoteness. Lincoln & Guba (2000) assert that the human instrument requires extensive training and exposure to function adequately in the research setting. Robson (2011) underlines this opinion, arguing that as the research instrument, the observer must possess great sensitivity and personal skill to obtain meaningful data. Bonner & Tolhurst (2002) identify the potential for role conflict during the research as a further disadvantage for the inside researcher. The researcher may feel conflicting emotions related to the insider-outsider perspective of researching within a familiar setting. As a participant observer, it may be difficult to separate the two roles, sacrificing one for the other through the sheer effort of trying to do two things at the same time (Kite, 1999). This was certainly found to be a personal dilemma during the field work, requiring flexibility in alternating the roles of nurse and researcher as discussed further in 3.9.3.

Other nurses have successfully demonstrated the use of participant observation to collect data. Gerrish (2003) used this approach in an ethnographic study of

120 nursing. As a nurse, I was able to articulate the advantages and disadvantages of the parallel status of a nurse and a researcher. Living simultaneously in the two worlds of participation and research was one of the greatest challenges to be overcome during the experience of fieldwork due to the constant challenge of immersion in the moment which might influence what was captured from the observation.

The recording of the observational data were given much consideration. The writings and documentation of events were critical as this was an observational study. However, Emerson et al. (2007) argue that the researcher must be aware that too much time spent writing notes can negatively impact the ability to become immersed in the experience. The how, why, where and when to write field notes is considered by Mulhall (2003), who provides a schema for researchers to contemplate. It was felt that a preferred strategy for this would emerge once the field work began in earnest. However, the initial plan was to make simple notes of the observations in real time and to add detail as soon as possible afterwards. In order to maintain simplicity, there were no predetermined set of codes devised. Field notes would be recorded using a pad and pen. Each field note would be maintained separately from the others, and would have a set layout with the day and date, and the pseudonym of the participant. The time and general environmental observations would also be recorded. Other such points of interest included the general amount of work pressure, ward layout and number of patients per nurse. It is believed that all of these observations would be valuable and play a role in the overall context of analysis. These were the only ‘rules’ regarding field notes that were made for before entering the field.

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