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Following the Yellow Brick Road: the Lived

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Following the Yellow Brick Road: the Lived ABSTRACT Title of Dissertation: FOLLOWING THE YELLOW BRICK ROAD: THE LIVED JOURNEY OF NURSES BECOMING NURSE PRACTITIONERS Kathleen Theresa Ogle, Doctor of Philosophy, 2007 Dissertation directed by: Professor Francine H. Hultgren Department of Education Policy and Leadership In this phenomenological study, I explore the lived experiences of registered nurses who become nurse practitioners. Text for this study comes from narrative sources such as reflective writings, one-on-one conversations, and group conversations with seven new nurse practitioners. The guiding question for this inquiry is: “What is the lived journey of nurses who become nurse practitioners?” Phenomenological philosophers such as Heidegger, Gadamer, and Casey guide this work. Other authors are drawn upon for grounding the study and to draw out the phenomenon for examination. The six research activities of van Manen (2003) provide the methodological framework for the research. The “yellow brick road” traveled by the registered nurse to nurse practitioner is the metaphor that has revealed itself as we reflect on the journey. Literature from the disciplines of nursing and education, poetry, and narrative accounts complement the stories told by nurse practitioners and open up new ways to think about the lived experience. Stories are the bricks that form the yellow road that lead us to a new way of being. Nurses who become nurse practitioners experience the journey from school to beginning practice and finally to comfort in the new place. Conversations reveal the meaning of the journey. The webs of support woven with other students are found to be very important. Before reaching the end of the road, many detours are encountered that slow, but never stop, the journey. During this journey new nurse practitioners find that the nurse part of nurse practitioner is as important as the new skills they have learned. At the end of the journey they find that the greatest source of strength is from themselves. Both teacher and students are transformed as we travel together on the path. A call is made for a revolution in nursing curriculum as narrative leads to a new way of teaching and learning. The journey reveals a new way of living curriculum and being with students as mentor and teacher. FOLLOWING THE YELLOW BRICK ROAD: THE LIVED JOURNEY OF NURSES BECOMING NURSE PRACTITIONERS by Kathleen Theresa Ogle Dissertation submitted to the Faculty of the Graduate School of the University of Maryland, College Park in partial fulfillment of the requirements for the degree of Doctor of Philosophy 2007 Advisory Committee: Professor Francine H. Hultgren, Chair and Advisor Associate Professor Linda Diaconis Professor Charles Flatter Associate Professor Jing Lin Professor Roxanne Moran ©Copyright by Kathleen Theresa Ogle 2007 DEDICATION I dedicate this work to my husband, Pat, without whose love and support this journey would not have been possible; to my children, Keldie, Jennifer, Liz, and Jeff, who have been patient and loving; and to my grandchildren, Briar, Hanna, Raegan, and others yet to come, who have kept me smiling and young. ii ACKNOWLEDGEMENTS A dissertation is never written alone. Each step of the journey is taken with the help of some seen and many unseen supporters. Every person brings something special to the effort and gives generously of themselves. Dr. Francine Hultgren is my advisor and dissertation committee chair. These simple words, however, do not reflect what she has come to mean to me. Our relationship has become one in which she is friend, teacher, mentor, and role model. I could never imagine making this journey without her. The other committee members have each given generously of their time and expertise, making the journey easier with their guidance and support. Dr. Roxanne Moran and Dr. Linda Diaconis were acquaintances when the first step was taken. We are now close friends and their encouragement has been invaluable. I can not adequately express my gratitude and admiration. Thanks go to Dr. Charles Flatter and Dr. Jing Lin who should now be named honorary nurses since they have spent so much time traveling with nurses on the dissertation journey. Their willingness to explore different ways of being with a fledging phenomenologist will always be appreciated. This journey could not have been taken without the generosity of my former students, my co-researchers. Each of them willingly volunteered, spent the time, and was open to sharing their experiences. Their conversations led the way to a new understanding of becoming nurse practitioners and I will be forever grateful to them. Other former students, who were not able to participate, provided continuing support. iii Elayne Crain contributed her poetic thoughts, Greg Grevera was willing to listen over many glasses of wine, and Nancy Calabrese, Tami Becker, and Dianna Davis contributed ideas in their journals. I can never repay the debt I own to those colleagues who traveled with me and who helped me clarify the meaning of teaching and being with in a genuine way. My teaching colleagues, Dr. Mary Packard, Donna Swope, Gary Hicks, Dr. Barbara Fowler, and Dr. Judith Feustle, have offered time, encouragement, and covered for classes and meetings as I became more involved on the yellow brick road. Other colleagues served as my first teaching role models and mentors. Dr. Karen Stevens, Dr. Noel Eller, and Dr. Eleanor Walker continue to provide encouragement, friendship, and support. I have been blessed to share this journey with a remarkable group of fellow travelers. The Wonderful Women Writers were there with food, encouragement, and ideas when someone in the group experienced writer’s block. Dr. Judith Kierstead, Dr. Deb Goulden, Mary Ann Hartshorn, and Dr. Staley Collins were all faithful companions. I must also acknowledge the many friends who have offered indirect support by understanding the missed social engagements and unreturned letters over the past few years. My parents and siblings believed in me before anyone else. The loss of my father, Thomas Jones, is an ache that has not healed over these many years even though I feel his constant support and encouragement from another place. My mother, Margaret, lends support to each of her children in special and unique ways. She is the nursing role model in my life, caring for patients and her family. iv Finally, without the love of my husband, Pat, and the encouragement and understanding of my children and grandchildren, this journey would never have taken place. It is to them, with all my love, that I dedicate this work. ******************************** I also acknowledge publisher’s permission to reprint the following: Oriah Mountain Dreamer’s poem, The Call in The call: Discovering why you are here by Oriah Mountain Dreamer. Copyright 2003 by HarperCollins Publishers. Reprinted by permission of HarperCollins Publishers, New York, NY. Sue Espinosa’s poem, Webs in Every woman has a story: Many voices, many lessons, many lives by Daryl Ott Underhill. Copyright 1999 by Warner Books. Reprinted by permission of Warner Books, New York, NY. v TABLE OF CONTENTS Prologue: Turing to a Call ix Chapter One: The Call of a Journey 1 The Call Back Home 2 Somewhere Over the Rainbow 2 If I Only Had a Brain 4 Changing Places 5 Lions, and Tigers, and Bears: The Danger of the Unknown 6 Off to See the Wizard 9 Follow the Etymological Road 11 The “Heart” of Caring 13 The Heart of the Matter 15 Technology and Care 16 Called to Care 17 Philosophy of Care 18 Caring for a Patient 20 Caught Between 21 Learning and Caring 22 The Journey to Oz 24 The Road Through the Forest: Phenomenological Meanderings 25 Chapter Two: Caught in the Cyclone: Trying to Re-turn 28 Turning From Home: An In-Between Place 29 Going In-Between 30 Turning Between 33 The Nursing Between 34 The Nursing Home Place 37 Turning to Nurse Practitioners 40 Turning Away 42 Saying Goodbye 43 Turning Back 46 Re-Turning Home 48 Turning Toward a New Home: Homesteading 52 One or the Other 54 Betwixt 56 Chapter Three: The Wizards of Phenomenology: Helping Us Find Our Way 61 Opening the Path 61 Following the Path 62 Asking for Directions 63 Questions before Answers 65 Questioning the Journey 66 vi Conversing in the Journey 68 Wands and Words of the Wonderful Wizards: Lighting the Path 71 Coming to Our Place 71 Starting on the Path 76 Turning to the Phenomenon 76 Investigating the Experience 77 Reflecting on Essential Themes 77 Writing and Rewriting 78 Maintaining a Strong Relation 79 Balancing the Research Context 79 Researching with van Manen: Lived Existentials 80 Place 80 Giving through our bodies 82 Time after time 83 Seeing through another’s eyes: Relationality 84 The Journey Begins: My Method of Engagement 85 My Research Companions 86 The Process for Our Journey 87 Chapter Four: Finding Home 89 Storyteller Companions 90 The Yellow Brick School: Competing Pathways 94 Pressing Forward 94 Finding the Right Road 97 Detour: Another Way Home 100 Scared: Facing the Lions and Tigers and Bears 104 Standing Alone 104 Spinning Out of Control 109 Lost and Alone 111 Relationships: Change and Change Again 114 Voyaging in Self 114 Living in Space and Time 117 Keeping a Distance 118 Circle of Support: Being With 121 Weaving the Circle 124 “Noble Friends”: Webs of Support 129 Identity Transitions: The Meek and Powerful 134 “Just a Nurse” 135 Called to Nursing 138 Keeping the Essence – Taking the Power 141 Clicking Your Heels: Arrival Home 146 Telling Stories: Learning from the Past 146 High Hopes: Elevated Expectations 149 Finding
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