Rethinking ethnography: reconstructing nursing relationships

Aims of the study. Critical ethnography is being adopted increasingly by nu rses as a legitimate form of research methodology. This paper explores the research practices and dilemmas that emerge from this methodology using a r ecently completed ethnographic study of nurse-nurse and nurse-doctor intera ctions in a critical care hospital setting. Background. Critical ethnography provides a useful methodology that facilit ates mutual dialogue among participants. it may be limited, however, by the central role of researchers and by a tendency to negotiate participants' r ealities according to a particular 'truth'. These concerns have been strong ly critiqued by poststructuralists using concepts such as discourse, subjec tivity and power. By incorporating the notion of a poststructural analysis into critical ethnography, researchers are in a position to examine critica lly the tensions in their own practices, and their struggles with documenti ng and analysing ethnographic accounts. Design. Six registered nurses comprised the participants of the research gr oup. Through the method of professional journalling, the first author of th is paper explored her professional interactions with doctors and other nurs es in her role as a nurse in the critical care setting under investigation. Other methods included participant observation, and individual and focus g roup interviews with nurse participants. Issues of methodological concern, This paper considers three issues of meth odological concern: researcher/participant subjectivity; the movement from empowerment to reflexivity and the construction of one form of ethnographic 'truth'. These issues are discussed in reference to the research relations hips with the nurse participants and the process of analysing ethnographic accounts. Conclusions. In working with critical ethnography using a poststructural an alysis, we were able to generate valuable insights about previously hidden areas of relationships among nurse participants in a research group during all stages of the research process. It also provided a means of informing t he analysis of ethnographic texts.