Narrative Remedies

In this episode, Monica and Danica explore the concept of ‘narrative repair’ and how it relates to nursing. Monica shares nurses’ stories of how they engaged in ‘narrative repair’ with patients and their families to create meaningful memories and keepsakes (e.g., hand mold) as testimony to the child’s life after they died. Monica shares her experiences of vicarious trauma when bearing witness to the nurses’ stories, and Danica joins her in reflecting on strategies for navigating such experiences and conducting trauma-informed qualitative research.   Content Warnings  (18:18 – 19:26): Story of caregiving told with both humour and sadness  about doing legacy building activity with patient in anticipation of their death from cancer (22:42 – 26:00): Story shared of caregiving that involved providing a good death for a patient and their family   (30:53 – 32:02): Story shared of child dying   References  (03:11): Arthur Frank’s conceptualization of ‘narrative repair’   Frank, A. (2013). The Wounded Storyteller: Body, Illness, and Ethics (2nd Edition ed.). Chicago, IL: University of Chicago Press.

In this episode, Monica shares how the nurses’ stories consistently assigned value and meaning to relational caregiving activities they performed (e.g., talking with families, providing emotional support), which involved them being in close physical proximity to patients and their families. Danica and Monica reflect on and discuss two stories to illustrate situations where the nurses were unable to enact what they viewed as their moral responsibilities to patients and families because they were stretched thin by competing caregiving tasks and priorities.  Content Warnings  (33:12 – 34:23): Story shared of infant needing transplant (38:00 – 38:42): Story shared of nurse supporting family as child was dying References  (25:00): Elizabeth Peter & Joan Liaschenko on ‘moral distress’  Peter, E., & Liaschenko, J. (2004). Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity. Nursing Inquiry, 11(4), 218-225.  Peter, E., & Liaschenko, J. (2013). Moral Distress Reexamined: A Feminist Interpretation of Nurses' Identities, Relationships, and Responsibilities. Journal of Bioethical Inquiry, 10(3). DOI: 10.1007/s11673-013-9456-5  (27:53): Ruth Malone on ‘physical proximity'  Malone, R. E. (2003). Distal nursing. Social Science & Medicine, 56(11), 2317-2326.

In this episode, Danica and Monica are joined by Monica’s colleague and former PhD supervisor, Dr. Jessica Polzer. Together, Monica and Jessica speak to the theoretical origins of ‘moral distress‘ as a concept within nursing scholarship and discuss the role of ‘counter stories’ as a way to diagnose moral distress as produced by institutional constraints.  Content Warnings  (37:26 – 38:51): Story of nurse in distress while caring for a patient who was septic and in need of critical care References  (17:15): Andrew Jameton’s definition of ‘moral distress’   Jameton, A. (1984). Nursing practice: The ethical issues. Englewood Cliffs, NJ: Prentice-Hall.  (17:30): Elizabeth Peter & Joan Liaschenko’s perspective on ‘moral distress’  Peter, E., & Liaschenko, J. (2004). Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity. Nursing Inquiry, 11(4), 218-225.  Peter, E., & Liaschenko, J. (2013). Moral Distress Reexamined: A Feminist Interpretation of Nurses' Identities, Relationships, and Responsibilities. Journal of Bioethical Inquiry, 10(3). DOI: 10.1007/s11673-013-9456-5  (47:34): Monica Molinaro and Jessica Polzer on ‘counter stories’  Molinaro, M., Polzer, J., Laliberte Rudman, D., Savundranayagam, M. (2023). "I can't be the nurse I want to be": Counter-stories of moral distress in nurses' narratives of pediatric oncology caregiving. Social Science & Medicine. DOI: 10.1016/j.socscimed.2023.115677

In this episode, Monica shares her story about what brought her to conduct research on pediatric oncology nurses' caregiving narratives. Danica and Monica further discuss what it means to do narrative research from a critical perspective, the analysis process involved in narrative research, as well as the role of the narrative researcher in ‘bearing witness’ to the stories of their study participants while reflecting on two stories Monica shares from the nurses she interviewed. Content Warnings  (38:22 – 40:32): First story shared care situation involving death of child  (41:52 – 43:10): Second story shared care situation involving death of child References  (11:44): Molinaro, Monica L.(2021). “I can’t be the nurse I want to be”: Stories of moral distress in pediatric oncology nurses’ caregiving narratives." Doctoral Dissertation. Download to read at: https://ir.lib.uwo.ca/etd/7994   (30:59): Emmanuel Levinas’ theory of ‘witnessing the face’  Levinas, E. (1979). Totality and Infinity: An Essay on Exteriority. (A. Lingis, Trans.) Boston, MA: Martinus-Nijhoff Publishers.  Levinas, E. (1984). Peace and proximity. In A. Peperzak, S. Critchley, & R. Bernasconi (Eds.), Emmanueal Levinas: Basic Philosophical Writings (pp. 162-169). Indianapolis, IN: Indiana University Press.  Levinas, E. (1998). Entre Nous: On Thinking-of-the-Other. (M. B. Smith, & B. Harshav, Trans.) New York: Columbia University Press.  (31:13): William Cody’s view of ‘nursing and bearing witness’   Cody, W. K. (2001a). Bearing witness-not bearing witness as synergistic individual-community becoming. Nursing Science Quarterly, 14(2), 94-100.  Cody, W. K. (2001b). The ethics of bearing witness in health care: a beginning exploration. Nursing Science Quarterly, 14(4), 288-296.  Cody, W. K. (2007). Bearing Witness to Suffering: Participating in Contranscendence. International Journal for Human Caring, 11(2), DOI: 10.20467/1091-5710.11.2.17.  Cody, W. K., Bunkers, S. S., & Mitchell, G. J. (2001). The human becoming theory in practice, research, administration, regulation, and education. In M. Parker (Ed.), Nursing Theories and Nursing Practice (pp. 239-262). Philadelphia, PA: F. A. Davis Company.

This podcast, brought to you by Danica Facca, Monica Molinaro, and Jessica Polzer, explores the role of narrative, or storytelling, as a way to unravel the complexities of the personal, social, political, historical, and moral dimensions of health, medicine, and health care. As critical health researchers who are entrusted with the stories of others, and who re-tell those stories in our own writing and presentations, we aim to not only create a window of understanding into a situation, personal experience, or event, but also to diagnose systemic failures and moral dilemmas and illustrate their effects on patients, families, and care providers. In this podcast, we offer these re-tellings of stories as narrative remedies that assist us in re-scripting care by provoking thought and actions that strive to relieve suffering and redress unjust conditions. Let’s listen, and learn from, Narrative Remedies. Host: Danica Facca is a PhD Candidate at Western University in London, Ontario, Canada Co-Host: Monica Molinaro, PhD, is an Assistant Professor in the Institute of Health Sciences Education at McGill University in Montreal, Quebec, Canada Guest: Jessica Polzer, PhD, is an Associate Professor in the Department of Gender, Sexuality, and Women’s Studies at Western University in London, Ontario, Canada