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Midterm

NSE21A/B Midterm: Week 1 Notes


Department
Nursing
Course Code
NSE 21A/B
Professor
Christine Houston
Study Guide
Midterm

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NSE 21A 1
Charmi Gandhi
NSE 21A Week 1
Narrative
oHow would you define a narrative?
oA narrative or story is defined as “ an account of an individual’s experience to make sense of events
or actions in their live”
oWhat is the use of narrative analysis?
o When we hear someone’s story we have a better understanding of the person as an individual, the
experience they have had, and the effect it has had on them
oUnderstanding individual’s experience helps with collaborating with them to support their health
goals/health needs
oNarrative competence is about the individuals experience as a whole
oNarrative competence is the ability to acknowledge, interpret and act upon
oSomething that a nurse engages in
oGoal is to develop a empathy
oAble to step in someone else’s shoes and consider what that might be like
Narrative Competence (Charon, 2001 as cited in Redman, 2005)
oAcknowledge
oE.g. Repeat back what you heard
oInterpret
oThe interpretation piece is the nurse’s role
oYou are going to interpret the narrative
oMeaning and significant of what the patient is telling you
oUnderstand, be open to, and clarify
o“So what I think your saying is…”
o“Did you mean…”
oAct upon stories presented by patients ( these 3 are characteristics/attributes, MUST HAVE ALL 3 TO ACHIEVE
NARRATIVE COMPETENCE)
oIn collaboration with the patient

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NSE 21A 2
Charmi Gandhi
oGoal= empathy
Article Activity- The Power of Narratives (Redman, 2005)
oIndividually read Redman, 2005
oComplete the exercise in small groups of 8.
oElect a team leader to share your group work with the class.
oEach group to discuss their set of questions for 15 mins.
oGroup leaders report back to the larger group
Frank, 2002
o…experiences are to be lived, not managed…my body is the means and medium of my life” (p.10). What’s
happening to me? Not it, but me? (p.11).
oDiscuss and describe what you can acknowledge about Frank’s narrative from this quote.
oWhat is your interpretation of the meaning and significance of this quote to Frank?
oWhat interventions would you propose for Frank using a narrative competence approach?
Being “not listened” to
Frank’s experiences:
“Illness talk is a story about moving from a perfectly comfortable body to one that forces me to ask: What’s happening to
me? Not it, but me….What I really want to know is how to live with illness. The help I want is not a matter of answering
questions but of witnessing attempts to live in certain ways. I do not want my questions answered; I want my experiences
shared.” (p. 13-14).
Frank (2002) Chapter 1 and 2 (p. 1-15).
oWhat did you understand about Frank’s illness narrative from chapters 1 and 2? (acknowledging)
oHow does Frank view his illness? (interpreting)
oHow does this quote relate to Franks perspective of his illness? (interpreting)
“From that vantage point you are both forced and allowed to think in new ways abut the value of your life.
Alive but detached from everyday living…” (p. 1).
Using a narrative competence approach, how would you respond to Frank’s narrative of his illness?
(acting upon).
Frank (2002), Chapter 1 (p.1-7)
oWhat is the significance of this quote from Frank (2002)?
oWhat is your interpretation of this quote?
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NSE 21A 3
Charmi Gandhi
oHow would you apply a narrative competence approach to Frank after hearing him say this?
o“The ill person as a patient is simply repeating what has been said elsewhere-boring second-hand
medical talk. When ill persons try to talk in medicalize, they deny themselves the drama of their personal
experience.” (p. 4).
Will of the Body Notes
Chapter 1: Illness as a Dangerous Opportunity
Experienced life-threatening illness twice
39 years  heart attack
40 years cancer
Illness is an opportunity through a dangerous one
Critical illness offers the experience of being taken to the threshold of life, from which you can see where
your live could end
Illness take away parts of your life, but in doing so it gives you the opportunity to choose the life
you will lead , as opposed to living out the one you have simply accumulated over the years
To seize the opportunities, offered by illness, we must live illness actively; we must think about it and
talk about it, and some, like me, must write about it
Through thinking, talking, and writing we can begin, as individuals and as a society, to accept illness fully
“ I want to enter into the experience of illness and witness its possibilities, but not so far as to become
attached to become ill”
Seizing the opportunity means experiencing it fully, then letting go and moving on
He is a university professor, a sociologist with additional training and experience in philosophy,
communications, and psychotherapy  these resources helped him put his experiences into words
Hes trying to make sense of his own illness
The hospitals and other special places we have constructed for critically ill persons have created the
illusion that by sealing off the ill person from those who are healthy, we can also seal off the illness in that
ill person’s life  this illusion is dangerous
“ I write to the younger self I was before illness overwhelmed me”
“I want to tell my self-before-illness that his fears are legitimate, but he would be a fool to spend his life
being fearful. He will suffer and have losses, but suffering and loss are not incompatible with life”
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