'Unsaid' voices of middle-level women nurses’ experience of Western Australian public hospitals : an integrated feminist postmodern ethnography

The context for this research was the socio-political, culturally constructed, lived experience of eight women nurses who held middle-level positions in two Western Australian public hospitals. Glass and Davis’ (1998) integrated feminist postmodern model for nursing research framed the design for the ethnographic investigation. The researcher used an innovative self-developed trifocality method: realist; critical feminist; and feminist postmodern to critique ethnographic data against the research aim and objectives and reflexively engaged with the women nurses to reveal unacknowledged individual and collective insights. Participant observation, critical conversation, and reflective field/journaling were used as triangulated data collection methods. The methodology revealed the local, particular, historical, taken-for-granted and traditionally gender-biased subjugated voices of individual women nurses as legitimate sites for the production of knowledge and insights. The trifocal data analysis revealed multiple intersecting layers of meanings and insights. The participants unacknowledged ‘unsaid’ experiences were viewed as exemplar ‘states of being’, or subjectivity positions, of their multiple and temporal realities. Inherent within the subjectivity positions was their personal, professional and corporate efforts, assumed as self-managing strategies and implicit knowledge, to enact work roles. Deeper critique, applying feminist poststructuralism (Lather 1991b) and postmodern notions of power/knowledge networks of relationships (Foucault 1980b) revealed three competing socio-political culturally constructed discourses. Firstly, the participants’ were embedded within an empowering ‘Discourse of Values Attributed to Nursing/Between a Rock and a Hard Place’. Secondly, they were influenced by, and resistant to the patriarchally dominant ‘Discourse of Bureaucratic Managerialism Discourse/Absence of Care’. thirdly, they functioned within the influence of the disempowering ‘Discourse Medical Science/Working the Margins’. This research contributes to the knowledge base of scholarly work that exists about nurses, women nurses specifically, concerning the meaning of the experiences of practicing in the confluence of corporate and professional responsibilities. At the personal participant level the insights contribute to emancipatory consciousness-raising. The insights also positively contribute to the recommendations made in The Report of the Western Australian Study of Nursing and Midwifery (Pinch & Della 2001). The insights may evoke wider awareness of the disempowering influence of managerialism upon professional practice and inter-professional relationships. Finally, the unique trifocal data analysis method contributes to the body of nursing and social science research knowledge.