When it was time for me to decide on a career it was not difficult. Nursing seemed the natural thing. I learned of course that there is much more to nursing than taking vital signs, changing dressings, giving medications, assisting the doctor in different procedures and carefully documenting what was done. There was this thing called "caring," the real caring. This was the part that patients most appreciated. It was the part that made the difference between just any nurse and an excellent nurse. However, it was the part that was not so clear cut. The nursing procedure manuals and nursing text books do not describe this part of nursing in nicely defined steps. There are volumes and volumes of standard procedures and protocols for nursing explaining in pictures and in words how to perform a specific procedure, but how does one perform the procedure of "caring"? I discovered that to be able to communicate a caring attitude one must find what is meaningful to each individual patient. One must listen to their stories.
When I became a nursing teacher I realized that for some students both the measurable procedures and the caring part of nursing came easy. These students were a delight to teach in the classroom as well as in the clinical setting and a joy to their patients. They were good at observing, measuring and performing the procedures that had to be done with precision. Giving medications, taking vital signs, performing procedures that require sterile technique was not difficult for them. These delightful students could also observe the patients' behaviors to find meaning and be able to communicate a caring attitude.
My challenge was how to teach the students to whom caring did not come easy that this is an extremely important part of nursing care. Again I realized that it was important for me to listen to the students' stories so I could help them identify what caring meant to them and how they felt caring is communicated to others. I needed to help them understand that the key to caring is understanding the patients' stories and this can be done by careful observation, talking with the patient and his/her significant other to find meaningful experiences and interpret them in the light of his/her health problem. It involved identifying the sweet substances in a patient's life that when mixed with the bitter taste of some experiences would help the medicine go down. It meant helping the client find the inner and outer resources available to him/her that would help deal with the stressors in his/her life. There wasn't a testable and confirmable theory to explain how to do this. It was not possible to measure this reality in the same manner as physical reality. As I listened to the students' stories I came to the realization that caring is a very personal and subjective issue.
Then I became a doctoral student and began delving more into the characteristics of quantitative and qualitative research and became aware of not only the striking differences but also of the need for both kinds of research methodologies in order to broaden our understanding and make meaning of the world we live in.
Conducting good research is like giving quality nursing care. There are certain aspects of the nursing functions that must be exact, that follow specific steps and guidelines and must be assessed and carefully planned before the intervention takes place. The nurse uses specific tools, instruments, and formats for the assessment, measurement, intervention and documentation of the nursing actions. S/he must have the knowledge and expertise for using the tools necessary for the specific interventions. These are very much like the functions of a quantitative researcher.
However, when I think of the "how" of the "caring" aspects of nursing care, I realize the nurse's most important tool is her/his self. This is the tool that will help the nurse find meaning in the patients' stories and the researcher find meaning in the interviewees stories. Therefore, qualitative research is caring about others, listening to their personal stories and sharing the meaning of your caring experiences with them. Qualitative research is interested in helping take away people's 'awies.'
Isn't it amazing that even a child can understand what qualitative research is about? Yet even a child knows that though it is very soothing to be held in mommy's arms and have the assurance that she cares, there are times that in order for the 'awie' to heal it is necessary to take his temperature and give him some bitter medicine. But, oh, it is so much better when this is done with a caring attitude! Yes, a spoonful of sugar helps the medicine go down. Nurses and researchers, don't ever forget that. Nursing is caring. Qualitative research is caring too.
The Color Cartridge
I have always been looking for a better printer. Better quality means better speed, better resolution, and of course less money. This time I have bought a $99 color inkjet printer. In the package only a black and white cartridge is included. Good quality, but black and white.
Qualitative Research is like a color cartridge for a printer. The printer was made to use both types of cartridges, but it is sold only with the black and white one. You have to buy the color one separately. In the beginning you say it is relatively expensive and it not so necessary at that moment to pay $30 extra.
Nevertheless, when you decide to buy it, you realize that you can see the real world in your office papers. It is not a black and white world anymore. The printed pages come back to life. The trees are green, the sky is blue and the strawberries are red.
However, not all papers have to be printed in colors. The color cartridge is more expensive and you have to save your money. Why print in colors if your teachers are satisfied with black and white only?
I like cooking, and I specialize in "inventing" new dishes using the leftovers, although I can also cook from scratch. Sometimes I use recipes, most times I don't. One of the cherished jokes in my family has to do with my cooking: "Don't ask Mom for the recipe!" Although they are not always sure of what I use, they do like the results.
When one of my daughters got married, she wanted to continue our tradition of corn or banana bread for Friday vespers. She called me to ask for the recipe, and I tried, giving her the general directions. She asked: "Is that the recipe?" "Well, no, but I don't need it, I know what to use and how much of it. Now, if you don't have this, you can use this other thing." "Mom," she said, "how can you change the ingredients and the amounts like that and still get good results?" "Well," I said, "the secret is to know the properties of the ingredients. If you know what they can do, then you can change, and substitute as the need arises.
I think qualitative research is a lot like my cooking. The secret is in knowing the qualities or properties of the ingredients - that is, the components and tools used. In that way we can always adjust, substitute, and change the formula and still be confident that we will get good results, whatever they might be.
Submarines: A Metaphor for Qualitative Research
As a young boy raised in the tropical island of Puerto Rico I learned to love the beautiful beaches on the western part of the island. The place is so relaxing and of special beauty is the ocean world with its beautiful scenery and magnificent variety of animals.
One of man's remarkable inventions is the submarine which permits man to explore the fabulous ocean world. The Qualitative Research method is like a submarine that patiently waits to be used as a powerful instrument of investigation. It silently waits to be submerged into the ocean, its favorite and natural habitat. Above sea level it is noisy, hot or cold and one is considered as just another species of existence. Below sea level it is quiet, swift and beautiful. Qualitative researchers abandon the noisy outside world to enter the quiet and sacred realms of his interviewees. The researcher submerges him/herself in the deep waters of the soul, as he likes to go deeper to reach the answers.
Once the submarine submerges himself in the ocean there are so many beautiful things to see. There are so many treasures to find that he can easily lose focus and thus undermine its supplies alluring the possibility of disaster. Likewise, once the qualitative researcher enters the deep world of inquiry and is amazed by the immense possibilities of interest, he can easily lose focus of his theme and lose sight of his purpose. Rather he must strive to keep focused to achieve his goal.
As man created the submarine to explore the unexplored and as he wanted to see the unseen, the qualitative researcher looks to answer what he has questioned and find what others have ignored. Just like the submarine functions on established procedures and follows routes that have been marked by the experience of others submarines, so the qualitative researcher navigates the roads that others have paved to gain more knowledge and insight in his preferred field of study. Failure to comply with procedures could be fatal; thus the submarine captain perfectly understands the immense power of the ocean. He takes detailed measures to use his instrument knowledge wisely and effectively and respects the laws that permit him to enter the immensity of the ocean. In this same way the qualitative researcher understands the immense power of his subject, realizing that inside of him relies tremendous knowledge and wisdom, but to be able to reach the hidden treasures he must be wise and intelligent to follow the correct procedures. Not following these procedures could be fatal for the purpose of the project and could leave scars of injustice in the interviewee.
Well managed submarines always look to establish new routes and ways of navigating the ocean, but there has been a well planned effort of taking into consideration the routes established by previous submarines to visit and arrive at the unexplored. The result has been new and exciting ways to navigate the ocean and the establishment of new routes. For the same reason the qualitative researcher visits the routes of knowledge transited by other scholars, but moved by his wonderment seeks to answer new questions and explore new lands of ideas. Once the submarine has found its treasure and has complied its mission it surfaces above sea level to communicate and celebrate its findings. The qualitative researcher surfaces above sea level to intelligently communicate what he has found as beneficial for the intellectual community and for the benefit of society.
The four week Christmas break was coming up when a friend asked me: "What are you doing this winter?"
I explained to him my need of replenishing our family budget. He then told me, "Let's go tree planting at Silsbee, Texas. I'm taking a group of students to work with a reforesting company where they could make enough money to cover next semester's tuition.
Silsbee, Texas was "established in 1894 by John Henry Kirby as a sawmill town; today it is the home of the giant Kirby Forest Industries." Getting off of the main highway, we took a lesser country road 23 miles into the mountains until we came to vast forests and woodlands.
We finally found the landmark we had been looking for, an old red barn. Then, a little less than a mile down the road, was the narrow dirt road, behind the huge old lightning-struck pine. Just like they had told us. Here, we turned off the paved road and two miles down we found a small clearing where there was a small house made of wood on the left, an empty corral and an old school-bus "coach."
This small tree planting company belongs to Andrew and John, two brothers. Andrew is the youngest of the two. He is tall, quick on the move, has a sharp mind for business, and a slight Texan drawl. He is single and is the one who lives in the house. He takes care of the business side of the company; orders the seedlings that are to be planted, hires the crew and pays them at the end of the week. John, on the other hand, is eight years older than Andrew, three inches shorter and has a heavy Texan drawl. He wears his long hair in a salt-and-pepper ponytail held with a rubber band. He moves in a slower purposeful gait that almost seems slothful. By just looking at him it seems obvious that he once lived in a hippy commune. He still drives an old 1968 Volkswagen van, the ones that were white on the top half and red on the bottom. He and his wife, Betty, live in the converted school-bus coach.
Forest industries must constantly replenish their raw materials. It is an interesting job. A full cycle from felling trees to planting and having them ready to fell again might take around 40 years. In this job, you have to work in various types of terrain and land in various stages of preparedness. For instance, there are places where the land is easy to access, once the trees are felled, the land is prepared for planting. Time and money are poured into it, and as a result, trees grow faster and better. Thus you can cut the harvesting time between four to six years. This new crop of trees may be ready to fell in 35 years instead of 40 or more. Forest Industry's administration tells Andrew to plant one thousand trees per acre. The seedlings are to be planted roughly two yards apart. So it is fairly simple to cover great amounts of land with a crew of eight or ten people and bring new life to what could become barren lands. Generally, Andrew's crew works these lots. Their work is straightforward and efficient, like quantitative research.
Then there is the other kind of land. One where a wind storm brought down some of the trees and they were left there to rot. Other areas had fallen victim to forest fires. Others still are difficult to reach because of where they are situated.
This was John's land. His crew was considerably older than Andrew's students. Because of the roughness of the land, they had to be extra careful not to leave any "J-roots." (A J-root happens when at the time of planting the seedling, if you are not careful, the bottom part of the taproot may curl back up in the form of a J) After five to six days, these mistakes become evident in the form of dead seedlings among the rows.
In "John's land" the administration could also ask for a specific amount of seedlings to be planted, but it is difficult to know exactly how many will finally fit. You have to choose the right spot to plant seedlings in order to give it a chance of survival. For this to happen John and his crew have to crawl over or go around stumps, rocks, thickets of brush and many other obstacles.
This is how I visualize qualitative research. The "terrain" is sometimes rough. The researcher, similar to John, should be well suited for the task at hand. He should care for his/her subjects, making sure that they are not harmed by the process. Anyone can ask questions, record the, transcribe them and go through all the steps. But not everyone wants to take time to deal with others one on one, through difficult topics over extended periods of time. But a good qualitative researcher will enjoy this.
Metaphors by Sallieann Brewer