After a nursing phenomenon is grasped intuitively, it is desirable to
find as many instances of it as possible for the sake of description.
Keeping the phenomenon in mind and reflecting on it from time to time,
the nurse becomes more alert to its occurrence in her lived world. The
phenomenon may be experienced directly. In which case, it is described
and reflected on and descriptions, reflections, and questions are
recorded. When she observes the phenomenon in others, the nurse may ask
them to describe it and verify her own observations. Some nurses have
involved other staff members in discovering and describing instances of
the phenomenon being studied. Similarly, one becomes more open to
descriptions of it in the literature--any literature--or in any form of
human expression, for example, poetry, drama, art, science. As many
descriptions of the phenomenon are gathered from as many angles as
possible, these are the data to be analytically examined, synthesized,
and described.
The three processes of analysis, synthesis, and description are so
interrelated and so intertwined in reality that it is simpler to discuss
techniques in relation to all three. Some techniques are equally useful
in the analytic examination and the description of phenomena. In a
sense, a person does both at once. And often, it is during this process
of shifting back and forth, analyzing and describing an experience that
synthesis occurs. A person gets a sudden insight, "everything falls into
place," "it clicks." One gets a gestalt, a whole, not necessarily a
whole in the sense of complete and entire, but a whole frame, form, or
structure that allows for further developing and filling in of details.
There are many ways of going about the analysis and description. The
following are some that have been found useful in the explication of
nursing phenomena.
Comparing and contrasting instances of the phenomenon lead to the
discovery of similarities and differences. For instance, in studying
patients' crying it was found that their crying was with or without
tears; loud or silent; expressing pain, anger, fear, sorrow. Or again,
silence may be defined simply as absence of sound. But silence as
experienced in the real nursing world has other characteristics. It may
convey anger, fear, peacefulness, and so forth. It is these nuances or
qualities of silence that are significant cues for the nursing dialogue.
They could be brought to light by comparing and contrasting descriptions
of silence.
Various instances of the phenomenon being studied may be examined to
discover common elements. Characteristics or elements seen in one
instance are sought in the others. For example, when descriptions of
interpersonal empathy were scrutinized, it became evident that in all
cases there were physiological, psychological, and social components.
Examining experiences {83} of reassurance revealed they had elements
such as empathy, sympathy, reality orientation, feelings of hope and
comfort.
One may determine which elements are essential to the phenomenon by
imaginative variation, that is, by trying to imagine the phenomenon
without a particular element. For instance, reassurance without empathy
or sympathy would be false reassurance or, in other words, would not
reassure.
The elements of the phenomenon can be studied to determine how they are
interrelated. One may ask, is there a priority in time? Does one element
develop from another? Consider the phenomenon of reassurance; does
empathy precede sympathy? Or, to take another example, in the empathic
experience, an openness to the other and an imaginative projection into
his place lead to the vicarious experiencing of his situation.
For further clarification of its distinctive qualities the phenomenon
may be related to and distinguished from other similar phenomena. For
example, empathy is similar to and also different from identification,
projection, compassion, sympathy, love, and encounter.
By considering what it has in common with other phenomena, the
phenomenon being described may be classified as being subsumed in a
broader category. Thus, empathy is a human response, a coalescent
movement, a form of relating.
The phenomenon may be described by selecting its central or decisive
characteristics and abstracting its accidentals. For instance,
interpersonal empathy always involves movement into another's
perspective and as a form of movement it has directions, dimensions, and
degrees. It can occur between persons of difference age, education,
experience, sex; these latter characteristics are accidental.
Some descriptions make use of negation. A phenomenon cannot be described
completely by negation but it may be clarified to some extent by saying
what it is not. For instance, empathy is not sympathy; it is not
projection; it is not identification.
Analogy may be used to promote analytic examination and description.
This involves a comparison based on partial similarity between like
features of two things. For example, the movement of empathy is like the
currents in the sea; the heart is like a pump. The advantage of using
analogy is that the comparison raises questions about the nature of the
phenomenon under consideration. However, since the similarity between
the analogues is always partial, one must guard against overextending
the comparison to unwarranted conclusions. The description must always
be consonant with the phenomenon as it occurs in reality.
The use of a metaphor also may enhance description and analysis. A
metaphor suggests comparison of the phenomenon with another by the
nonliteral application of a word. For example, "the between is a secret
place." The use of metaphor may be criticized in regard to its lack of
precision. On the other hand, there are some (for example, Marcel,
Buber) who hold that the intersubjective realm can be described only
metaphorically because it is {84} beyond the level of objectivity. And
to attempt to describe intersubjective phenomena in precise terms
related to the physical world would tend to distort rather than clarify.
Many of the nursing phenomena requiring description occur within the
intersubjective realm. Metaphors could cast some light on these.