The aim and research questions from this study emerged from the conceptual position being adopted, the extant literature in the area and from my own personal experiences. The aim was to investigate the experiences of men working as nurses in Ireland, how they relate to masculinities and how they negotiate a gendered identity.
Research questions:
What are the individual experiences of being a man in nursing in Ireland?
How do these experiences shape individual men’s personal and professional relationships?
To what extent is hegemonic masculinity an identity resource for these men?
What gender performances and subjectivities are apparent in individual male nurses?
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In keeping with the conceptual framework the research questions reflected a belief that there is value in employing an eclectic approach to the study of masculinities and that the tension between poststructuralist and materialist positions in particular is creative of a valuable empirical lens.
4.5 Methodology
The methodology adopted, based on the conceptual position outlined above, and in an effort to address the research questions, was a qualitative interpretive approach drawing on (pro)feminist epistemologies and methodologies (see Denzin & Lincoln 2005 p 22). This section will outline the justification for the chosen methodology and outline the methods and inquiry process.
In tracing the historical development of qualitative inquiry Denzin & Lincoln (2005) delineate eight moments, characterized by epistemological and methodological turning points, not all of which are discrete or distinct and within which there is much overlap and concurrence. Qualitative methods they contend emerged in the 1970s from a growing recognition of the deeply moral and political nature of scientific inquiry obviating the need for critical interpretative approach to inquiry which rejected the ‘Gods eye view’
propagated by quantitative scientific inquiry (Denzin & Lincoln 2005). Initially this development occurred within the positivist framework but positivist ideas themselves however soon became the focus of challenge and led to the development of multiple methods and paradigms which rather than neatly substitute positivist inquiry with another solution, gave an array of alternatives to traditional quantitative type research. Qualitative
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inquiry rather grew within a number of traditions and epistemologies and is multiformed and diverse. This plurality however has led to tensions within and between paradigms with questions of legitimisation, representation and praxis defining the challenge (Denzin & Lincoln 2005) particularly in light of poststructural thinking. The present period, or eighth moment, is Denzin & Lincoln (2005) contend, defined by continuing contestation of qualitative methods in these areas, with issues of representation (particularly the role of the researcher, voice, reflexivity, race and gender) being to the fore. This multiplicity of approach is however the strength of qualitative inquiry and despite the slipperiness of definition a number of authors agree broadly on the key characteristics of all qualitative work (Creswell 1998, Patton 2002, Flick 2006, Denzin & Lincoln 2005, Silverman 2005). First, it is naturalistic and situated in the everyday world of human experience. Second, it seeks to interpret the broad spectrum of human experience asking how and what rather than the reductionist why which is most often posed in quantitative research. Third, it rejects the premise of positivist and postpositivist methods that there is a singular truth that can be discovered or approximated using one particular method. Qualitative inquiry
critiques this position and favours multiple possibilities in which postpositivism may be an aspect in a broader picture of many aspects. Qualitative inquiry does not therefore reject quantitative methods but rather rejects the premise that they are the only method of research. Within qualitative inquiry itself therefore, a broad range of possibilities coexist. Fourth, qualitative inquiry embraces the political, moral and often emancipatory nature of research and is as much about social change as investigation (Lather 2004). This allows for the unheard voice of minorities and the other to emerge, a voice actively removed by traditional positivist inquiry in an effort to control bias. This premise, particularly the political and moral aspect, calls for the voice of the researcher to be heard in the research process resulting in reflexivity being a key characteristic of many qualitative projects.
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Fifth, qualitative inquiry values a rich detailed description of findings in a variety of forms. This is in contrast to the tightly controlled format of reporting in positivist inquiry which seeks to generalise rather than give detail and draw out diversity.
In the light of these points the nature of the research questions being posed in this study point towards the appropriateness of a qualitative approach. The multiple meaning and non-essential ideas on masculinities points to the need to explore it from an interpretative viewpoint (Peterson 2003). This inquiry sought essentially to explore issues around masculinities and men who are going about their professional roles as nurses and is therefore naturalistic and requires the various voices of the participants to be heard.
In exploring the diversity within qualitative research Denzin & Lincoln (2005) suggest that there are four main interpretive paradigms; positivist and postpositivist, constructionist interpretative, critical (Marxist, emancipatory) and poststructural feminist. Given the epistemological assumptions as outlined above, this study draws on poststructural feminist interpretative style while acknowledging values in constructionist interpretative analysis. This is rooted in scepticism as to the existence of singular explanations and a recognition of the subjectiveness of meaning while acknowledging the pervasiveness of gender
constructs in contemporary society. This allowed for an open and wide angled approach to the interpretation of data in the study. Denzin & Lincoln (2005) contend that such
approaches are, by their nature, naturalistic, which is appropriate here given the analysis of men in their everyday working and personal lives.
In considering the appropriate methodology for this study consideration was given to both discourse analysis and interpretive phenomenological analysis given that the research questions point to the need to look at the discourse around masculinities and men in nursing and also to look at men’s individual experiences. I feel however that both
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approaches, while valuable, would be limiting in their respective concentration on discourse and experience. The approach adopted allows for a broader interpretative framework.
4.6 Methods
4.5.1 Data Collection
Single in-depth interviews were conducted with 16 male nurses, working at staff level grade, in an Irish general hospital setting. In an effort to keep a broad perspective,
interviews were carried out with male nurses who work in a number of different hospitals and in geographically different areas of Ireland. Participants were invited to participate on a personal basis and not on a hospital representative basis. Nurses who work at staff nurse level (the entry level into the profession in Ireland) were approached to participate so as to sample nurses who are involved in traditional nursing work and not management or other fields. Men who work in psychiatric nursing were not included in the sample as they are not in a minority position and come from a different tradition (more closely aligned historically with prison wardens) than general nurses. At the beginning of each interview participants filled out a brief demographical profile (see appendix I) which sought basic information such as age and length of time working as a nurse. The profile of the sample is outlined in detail in Chapter 5.
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4.5.2 Sampling
A purposeful sampling method was utilised for this study. Purposeful sampling allows the researcher to target those who will be best placed to answer the research questions (Patton 2002, Creswell & Clark 2007). The recruitment of participants from different hospitals in different geographical locations increased the variation in the sample, however it is not suggested that all the possible variables in relation to men in the nursing profession were taken into account. As has been mentioned above the participants were all included due to their working in direct patient care situations. This was done in an effort to access the views of those working in what would be seen as the coalface of nursing and the area that is seen as typical and most representative of what the common perceptions of nursing work are. Many managerial and specialised posts in nursing do not involve direct patient care and men working in these areas were therefore excluded. The sample was generated through my own contacts in nursing and hospitals in Ireland. Emails and telephone calls were used to request participants to take part in the study and following agreement, times and locations for interviews were arranged. None of the participants were known
personally to me prior to the study. Participants were working in a range of hospitals mainly in the greater Dublin area but also in the provincial areas of Northwest Ireland and the Midlands.
4.5.3 Interviews
The purpose of interviews in qualitative research is to ‘allow the researcher enter the other person’s perspective’ (Patton 2002 p. 341). Interviews attempt to access that which cannot
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be easily observed such as feelings, perspective or events which have happened in the past. Given the subject of this study, interviews were considered to be the most effective way of answering the research questions.
The interviews were conducted in various locations, suitable to the participants, including some in participants own homes, quiet areas in their place of work and some in hotel lobbies or quiet area of public houses. The interviews were semi-structured guided by an interview schedule (see appendix II) generated from the literature review, the research questions and from the experience of two pilot interviews which were carried out prior to the main data collection. Interviews were typically of one hour to one and a half hour duration. The order of questions was broadly based on getting the participants to recount their history of how and why they chose nursing as a career followed by a probing of their experiences of training, the reactions of others to their career choice and their own
perceptions of choosing to become a nurse as a man. This account of their history with nursing prompted a reflection and review of their careers to date which was actively encouraged throughout the interview. It is important to note that in the early stage of the interviews I found it useful and important to relay the fact that I myself was a nurse and to demonstrate a sense of understanding of their histories. This was useful in making the participants more comfortable in the initial stages of the interview but was however done carefully and as the interviews progressed I minimised any input of my own experiences which may have influenced the interviewees in a certain way. Following an account of their history with the profession, questioning sought to uncover their experiences and views about their current lives as nurses on both a professional and personal level. The professional level was orientated around their current jobs and experiences thereof and the personal around their on-going perceptions of how they are perceived as men and nurses by families, friends and others. Finally, the men were asked their opinions and views of
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gender relations in nursing in Ireland generally and about masculinities in particular. The loose chronological nature of the interviews helped to make participants more comfortable and forthcoming in telling their stories from the past before having to reflect on their current situations. While this is broadly how the interviews were conducted, guided by the interview schedule, inevitable divergence took place in the order of questions according to how participants told their stories.
Patton (2002) points out that the quality of data obtained in qualitative interviews depends largely on the expertise and abilities of the interviewer. Having some prior experience of interviews but considering my novice researcher status, the interviews were carried under guidance of texts such as Patton (2002) and Fontana & Frey (2005). Every effort was made to allow participants air their views while at the same time probe and investigate their comments. In this regard particular attention was given to the type of questions that were being asked in an effort to allow for open and broad responses.
Fontana and Frey (2005) point out that interviews while once considered to be a neutral and objective method of data collection, are now in many traditions seen as variously emancipatory, political and historically and contextually bound. I approached the interviews with the assumption that total objectivity is an impossible aspiration and was not desirable. My own experience as a man in nursing influenced the interviews and the intention was to carry out the interviews in an open and reciprocal manner in the feminist tradition (Lather 2004). I considered this to be morally and ethically important but also methodologically as it was more likely to yield richer data. I am however conscious of the difficult balancing act between reciprocity and my position as researcher. Fontana and Frey (2005) point out that it is never possible to be equals in the research interview process but continuing reflexivity on behalf of the researcher can help bridge this gap.
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Interviewing men particularly about conceptions of masculinities, presents particular methodological challenges (Davison 2007). The presentation of the researcher as male or masculine can affect the presentation of the interviewee and can lead to a difficulty for men interviewing men. Traditional conceptions of masculinities may result in men being reticent about appearing weak or overly emotional to other men. Davison (2007) suggests however that by the interviewer acknowledging the contradictions in masculinities,
progress can be made in allowing participants to present themselves with more comfort. By disclosing my own background as a man in the nursing profession and relating to the participants a small amount of my own experience I endeavoured to make them more comfortable in the interview process. The men interviewed were invited to contact me in the days and weeks after the interview to add or clarify any points they wanted, none chose however to relay new information.
4.5.4 Data analysis
All interviews were digitally recorded and transcribed verbatim. Analysis of the transcripts was carried out subsequent to each interview individually. Initial common categories and themes in relation to the research questions were formed after a number of interviews had been carried out. This draws on the theoretical interpretations I have made as result of studying the literature in this area. In an effort to disrupt my voice as the only voice in the analysis and as an exercise in increasing validity, these initial categorisations were used in subsequent interviews. Contact was also made with participants by telephone to seek clarification where necessary. This is a method that had been used successfully in other qualitative work (Lather 2005).
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For the purposes of data analysis the software package Nvivo 9 (QSR International) was used. The process of coding involved an initial process of free or open coding whereby a large number of themes (see appendix III) were generated. Through multiple readings of the data the second phase of coding involved a collapsing and merging of the open coded into thematic area as represented in chapters 5, 6 and 7. The thematic areas varied and evolved as further reading of the data took place in conjunction with the literature in the area. In an effort to disrupt my own voice in the process my research supervisor was used to consider the validity and truthfulness of the process.
4.6 Ethical issues
Ethical approval to carry out the research was sought and obtained from the Keele University Ethical Review Panel in June 2010 (see appendix IV). All participants were given an information sheet (see appendix V) and asked to sign a written consent to
participate in the study (see appendix VI). All participants were further verbally reminded of their right to terminate the interview at any time and withdraw from the study.
Participants were further advised that the content of the interview would be anonymised, in the reporting of the findings, and that recordings and transcripts would be kept private and under lock and key. Digital sound recording and transcription files in soft copy were held in a password protected computer which is owned by me. No hard copies of transcription files were made. Real names were removed from transcription and replaced with
pseudonyms in order to protect anonymity and appear as such in the findings and discussion chapters.
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Christians (2005) points to four main areas of concern for researchers; informed consent, absence of deception, the protection of privacy and confidentiality and lastly accuracy of data and interpretation. On first consideration it may seem relativity straightforward to put strategies in place to fulfil obligations in these regards. In practical terms difficulties can emerge.
In the context of this study, all of those interviewed did so from an informed position, will not be identified, did not have their privacy invaded and were not deceived. The subject matter of the inquiry may however be intensely private to those being interviewed and while their interviews will not be publicised, the very act of talking about certain matters may be construed as an invasion of privacy. These concerns were addressed in practical ways by offering participants opportunities to discontinue at any time but remained a dilemma and concern throughout the study. In the event of participants becoming upset or distressed during or after interviews, provision was made to provide contact details for support organisations. These were also detailed on the information sheet (appendix V) which participants had to take away with them after interviews. No such issues did arise during or after the interviews.
Accuracy of data and of interpretation is also an issue which is somewhat difficult. As has been discussed above, participant checks were used in an effort to increase accuracy of representation and disrupt my singular representation of the data. In reporting findings the use of direct quotations from participants in the description of results is used which demonstrates actual participants views and not just the interpretation of them.
While I made attempts to carry out this research in a participatory manner which does not seek a distance and objectivity from participants, I am conscious that I was always in a relatively privileged position as a researcher viz a viz the participants and ultimately I
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stand to gain much more then they will on successful completion. While this dynamic could not be changed it was borne in mind throughout. I also sought input from my supervisor in this regard as a more independent arbitrator of fairness and natural justice.
4.7 Summary
This chapter has detailed the methodology adopted for the purposes of this study. Drawing on both materialist and poststructural profeminist theories of masculinities it is argued that a qualitative interpretative approach was the most effective way of addressing the research questions posed. The procedural elements of the study are discussed followed by a
discussion of the ethical concerns arising and how these were dealt with. This chapter sets out the basis for the reported findings and discussion of the next three chapters.
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