A Phenomenological Investigation Of

The Pennsylvania State University The Graduate School Department of Adult Education “SEE EVERYTHING, HEAR WHAT IS NOT BEING SAID”: A PHENOMENOLOGICAL INVESTIGATION OF INTUITION IN NOVICE REGISTERED NURSING PRACTICE A Thesis in Adult Education by Lisa A. Ruth-Sahd © 2004 Lisa A. Ruth-Sahd Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Education May 2004 The thesis of Lisa A. Ruth-Sahd was reviewed and approved* by the following: Elizabeth Tisdell Associate Professor of Adult Education Thesis Advisor Chair of Committee Edward Taylor Associate Professor of Adult Education Helen Hendy Associate Professor of Psychology Holly Angelique Associate Professor of Community Psychology Ian Baptiste Associate Professor of Education In Charge of Graduate Programs in Adult Education *Signatures are on file in the Graduate School. iii ABSTRACT Knowing is multifaceted and encompasses several different ways to process information. Ways of knowing that lay outside of the rational domain such as intuitive, spiritual, emotional, tacit, and unconscious knowing, have traditionally been ignored and silenced in the traditional obsession with objective, positivistic, and rationalistic knowing. In the field of nursing, it is recognized that in practice expert nurses use many different sources of knowledge too gain a holistic perspective of their patient situation, to guide their decision-making and inform patient care. Inclusion of novice nurses in previous research on intuition has been very limited. Therefore, the primary purpose of this interpretive Heideggarian phenomenological study was to discover the meaning of intuitive knowing to novice registered nurses. Secondly, it was intended to identify how the use of intuitive knowing impacts their practice. Sixteen nurses, twelve females and four males representing a variety of clinical specialties were interviewed. Cognitive learning theory and Women’s Ways of Knowing guided this theory theoretically. The methods of data collection were in-depth interviews using a semi-structured interview guide, as well as documents and artifacts. The interviews were tape recorded and transcribed verbatim. When analyzing the data, a constant comparative technique was utilized. The findings of this study revealed that these novice nurses defined intuition as being a “gut feeling” and identified multiple sources of intuition. They contextualized intuition based on previous life and job experiences and were influenced by intuitive mentors. When accessing intuition the novice nurses felt this was dependent on their self-trust, whether or not they trusted their colleagues and patients, their ability to iv reposition themselves in time and space to connect with their patients and lastly, patient variables. Outcomes of using intuition in practice were noted to be that it guided their decision-making, enhanced holistic patient care, influenced their navigating around and between professional relationships and enhanced their ability to deal with limited hospital and human resources. Lastly, the novice nurses shared that the culture of nursing education and practice continues to reify the medical model and give mixed messages regarding accepted ways of knowing. Many ways the novice nurses dealt with and unlearned fear associated with nonrational ways of knowing as well as the desire to find a balance among intuition, science and other ways of knowing were also shared. Based on these findings that emerged, implications for nursing education and practice are presented. v TABLE OF CONTENTS PAGE LIST OF TABLES..................................................................................................... x LIST OF ILLUSRTATIONS..................................................................................... xi ACKNOWLEDGEMENTS....................................................................................... xii Chapter 1. INTRODUCTION AND PURPOSE ..................................................... 1 Background of the Problem ........................................................................... 3 Purpose of the Research................................................................................. 8 Guiding Research Questions ......................................................................... 9 Conceptual / Theoretical Framework ............................................................ 10 Overview of the Research Methods and Design ........................................... 11 Significance of the Study............................................................................... 14 Assumptions and Limitations of the Study.................................................... 19 Definition of Terms........................................................................................ 21 Organization of the Study .............................................................................. 23 Chapter 2. REVIEW OF THE LITERATURE ....................................................... 24 Section I: The Theoretical Framework: Cognitive Learning Theory ................. 24 Cognitive Learning Theory and Information Processing............................... 25 Theoretical Models of Intuition ..................................................................... 33 Modes of Thought.............................................................................. 34 Neuroscience...................................................................................... 39 Legitimization and Resistance to Intuition as a Legitimate Way of Knowing............................................................. 42 Institutional Resistance...................................................................... 43 Personal Resistance............................................................................ 45 Existing Tools to Measure Intuition .............................................................. 47 Summary........................................................................................................ 50 Section II: The Concept of Intuition .................................................................... 51 Historical Perspective of the Development of Intuition ................................ 52 Ancient Views of Intuition................................................................. 53 The Middle Ages................................................................................ 56 The Renaissance Period ..................................................................... 57 The Nineteenth Century..................................................................... 58 The Twentieth Century ...................................................................... 60 vi Defining Intuition: The Conceptual Chameleon............................................ 64 Intuition the ‘conceptual chameleon’................................................. 66 Defining Attributes and Characteristics of Intuition.......................... 72 Defining Attributes............................................................................ 72 Types of Intuitive Awareness ............................................................ 74 Levels of Intuitive Awareness ........................................................... 77 Voices of Intuition ............................................................................. 78 Characteristics of Intuitive Individuals.............................................. 80 Summary............................................................................................ 82 Section III: Use of Intuition in Various Related Disciplines ............................... 82 Intuition in Psychology and Counseling........................................................ 83 Intuition in Philosophy / Religion / Spirituality............................................. 84 Intuition in Mathematics and Physical Sciences............................................ 85 Intuition in Business, Leadership and Management...................................... 87 Intuition in Medicine and Nursing................................................................. 90 Intuition in Nursing Education....................................................................... 93 Summary........................................................................................................ 95 Section IV: The Concept of Novice..................................................................... 96 Novice Defined .............................................................................................. 96 Expert versus Novice use of Intuition............................................................ 98 Data -Based Studies of Intuition in Novice Practice ..................................... 100 Quantitative Studies Involving Novice Nurses.................................. 100 Qualitative Studies Involving Novice Nurses.................................... 101 Summary........................................................................................................ 106 Chapter 3 METHODOLOGY.................................................................................. 108 Restatement of the Purpose of the study........................................................ 108 Research Questions............................................................................ 108 Research Design Overview................................................................ 108 Overview of Qualitative Research................................................................. 108 Phenomenology

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