This narrative inquiry creates a method of researching and presenting an account of difficulties faced by practitioners when assisting a family in the process of preparing children for the death of a parent. It is a self-led practitioner inquiry occurring within a NHS specialist palliative care context and proposes methods that address and overcome inherent ethical difficulties and reveal relational practice. Challenges and impediments for practitioners working with terminally ill parents are important to understand because they are under-represented in the literature, are likely to have a crucial influence on the child's experience at the time of a parent's death, and may enhance professional reflexive practice of preparation for a family facing the imminent death of a parent. Practitioners are expected to provide consistent empirically proven care whilst also striving for holistic, person centred care, tailored to terminally ill patients and family members or carers, both as individuals and as a family. Therefore, research methods are required which respond to the many associated ethical challenges of such practice. This narrative inquiry collects data, including naturally occurring conversations between practitioners relating to one family, with the aim of studying difficulties faced and meaning constructed by those practitioners as close as possible to the time they occur and in depth. The data are used to fictionalise a family account that re-presents actual challenges practitioners confront. Reflexivity unfolds the layers of complex influences and ethical issues practitioners face. The dissertation develops relational research by accommodating complexity, demonstrating collaboration between practitioners, and revealing ethically and with veracity interpretive and iterative processes of meaning-making. Reflexive practice is evident throughout the work with the patient. The challenges of taking a concurrent perspicacious and reflexive stance from inter-subjective, practice and personal perspectives are raised. Even when they have clear understanding of processes and willingness to facilitate difficult conversations, practitioners face tensions between respecting for a dying patient's needs, avoiding undermining the family culture, and meeting children's needs. Contrary to the requirement to practise from an evidence . base, some situations require practitioner intuition and the ability to work with the on-going lived experience of "not knowing". Methods that enable analysis of naturally occurring practices are useful for practitioners who wish to reflect in detail on their work, and thereby contribute to professional and personal development and offer a teaching and learning resource.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:658616 |
| Date | January 2014 |
| Creators | Macpherson, Catriona |
| Publisher | University of Bristol |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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