Narrative Practice

I heard an interesting lecture today.  It was about narrative analysis. I won’t delve into detail about this qualitative analysis approach. Rather I would like to focus on the comment made by the professor who teaches medical students.  He teaches ‘narrative medicine’.  Narrative medicine occurs when a physician moves beyond simply attending to a patient’s illness and listens to the patients’ stories about their life and the meaning of illness to them. This process enriches the physician/patient experience and improves care.  This is a fairly new concept in the medical world, but is gaining favour worldwide and is informing medical education and practice.  What struck me was that ‘narrative medicine’ is a description of what nursing has always been. Essentially, medicine is trying to be more like nursing!

Nurses have always sought to know the patient’s experience and perspective and create a plan of care that recognizes and incorporates each.  So much so that people instinctively tell physicians their symptoms, but tell nurses their stories.  When I became a nurse practitioner and took on some of the tasks that had traditionally been part of the domain of medicine, such as diagnosing and prescribing medications, I read articles where concerns were expressed that advanced practice nurses were transitioning into the medical model. Well…that certainly didn’t happen.  I found that there was no way I could simply discard the ‘nursing’, holistic, patient-centered part of my professional identity.  It had become second nature to me and is an expectation of the patients I see.

I think nurses know this about the profession.  The problem is that no one in the room today, other the professor (and me), understood this. Medicine as usual, offers the world a professional definition and the world responds.  Nursing needs to move from critical self-reflection to offering a nursing practice narrative to the world.  Something to easily recognize, build upon and offer legitimacy. Nursing expertise in engaging patients and incorporating their narrative into patient care needs to be recognized.

Roberta Heale

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