Monthly Archives: March 2012

An Ethnography?

Being a novice researcher and a novice blogger I enter into this dialogue with some trepidation! I have been told to write “whatever I wish” and those of you who know me well will understand that I am fundamentally driven by doing as little as possible, so inevitably this entry will be, by most people’s standards, short.

Having given this whole process some thought and discounted many areas of slightly dubious debate I have decided to regale you with some of the incidence whereby my research topic has unintentionally spilled over into everyday life. As you know my topic is considered by some to be a highly personal and private, not for discussion in polite company. This presented my father with a significant problem when I announced that I had received funding to undertake my PhD. I am the only daughter and the first member of the whole family to commence a PhD. My father has a propensity for gushing pride, but was somewhat foxed on this occasion. After congratulating me his first question was “how will I explain your study to my friends?” He obviously continued to give this some thought over the subsequent days, he then saw fit to confirm with me that he was going to say that I was investigating risk factors for heart disease. We agreed that for the preservation of his pride we would stick with that as an overarching theme!

The irony of my father not wanting to explain that his daughter had a greater than average insight into erectile dysfunction was juxtaposed by a very bright ten year old boy. On walking into town with him and his father we bumped into a colleague of his dad’s. We were introduced and I explained to this middle aged lady that I had never met before that I was a full time student and therefore not really “working” as such. To which the ten year old said “yeah she is doing an ethnography of men who can’t get boners”. My immediate response was to exclaim “IT’S NOT AN ETHNOGRAPHY” and his father’s response was to usher him swiftly on his way. Apparently he had been studying the work of anthropologists at school and had been told by his father that I was studying erectile dysfunction, put these two pieces of information together and come up with an altogether inappropriate piece of research!!!

The problem with studying subjects that are considered “socially inappropriate” is that people find them fascinating, and with the assistance of a few alcoholic beverages are very keen to engage in conversation. This is an excellent way to get messages across and bounce ideas around but it does somewhat make me worry about life after the PhD. Will they still want to talk to me on a night out and what will they talk to me about? Will I be known for evermore as the girl who “has a PhD in erectile dysfunction” or the “blue pill expert”? Will my whole career be based on this one rather specific problem? And more importantly, will I ever get to do an ethnography? Only time will tell, for now the more pressing problem is not whether I will have any friends left at the end of all this, but rather how I am going to manage all of the data I have collected, and so I leave you as an initiated blogger…….. wonders will never cease!

How did I end up doing a PhD?

I became a nurse relatively late in life. I had spent sixteen years in local government and it looked like I was going to spend another sixteen (and more) when I had my epiphany. I didn’t want to spend the rest of my life working for the council. I wanted to be a nurse. I was lucky enough to find myself at a point in my life where I could take a chance on a new career move and so I made the break and handed in my notice. It was as terrifying as it was exhilarating!

I managed to get a job in a local nursing home as a carer and I also started work on my application to UCAS for the nursing degree course. I was eventually offered a place by Swansea University and set off to Singleton to make my fortune. What has happened since has been the most incredible journey for me. I have seen a world that I didn’t even know existed, the highs coming as thick and fast as the lows to start with. I will never forget my first shift as long as I live. Scary stuff!

I absolutely loved my training – it was a struggle to start, I will admit. The first year of university was a real challenge – I’d not been in a classroom for over ten years. But once I began to understand what was expected of me in the classroom (and how to write an essay), it became easier(ish). The learning opportunities I had as a student nurse on placement were incredible – so much going on, so many things to get involved in. I spent time in theatres, rehabilitation, orthopaedics, community nursing and much more. That was a chance in a lifetime experience which I like to think I grabbed with both hands. Yes, it wasn’t always smooth sailing and being a student nurse was not always an easy role for me, but the way the course was structured meant that there was always an end in sight if things were a little tough. I learned to take what I could from these experiences, good and bad, and move on a little older and a little wiser (hopefully).

I came to work in Cardiff when I qualified and when I think about my first staff nurse post I still get a warm glow. (However, the cynic in me likes to remind me that perhaps is wasn’t always warm and fuzzy.) As much as I was enjoying my new career, I had also been bitten by the learning bug. I stayed on at Swansea University, studying public health and partnerships in care, while nursing in Cardiff. As that course was coming to an end, I found myself thinking what could I do next?

I was advised me to speak to the PhD programme director at Swansea University and we discussed out my areas of interest and what research ideas I might have. We found that we shared some common research interests and he agreed to act as my supervisor, helping me to prepare a research proposal and make funding applications. The best advice I could give to anyone trying to secure funding for a PhD is to persevere and believe in yourself. It is highly competitive and I experienced setbacks and rejections, but I was determined to get there. That my supervisor had confidence in me (and was experienced in funding applications!) was also a great help. I was awarded a NISCHR Studentship in 2011. A real bonus was that securing this studentship meant that I was able to study my own research topic – patient involvement in safer surgery initiatives.

I started my PhD in Swansea University April 2011 and transferred to Cardiff University SONMS in October 2011. I will be handing in my Big Book in March 2014. If everything goes to plan.

I have to pinch myself sometimes that I have been able to do so much in the last few years. I was hopeful that nursing would present me with some opportunities, but I never thought it would lead to me doing a PhD.

Fieldwork in Malawi

Field experiences that I encountered really required quick decision making with my supervisor who was thousands and thousands of kilometres away in the United Kingdom. It also needed to work within the means of my research participants; I would arrange an appointment but the unexpected often occurred. The fieldwork really taught me that key people in the community needed to be handled with care as they were so unpredictable. It meant literally checking with them on daily basis on when and what time one would meet them.

To get permission to conduct the fieldwork at Mponela Rural Hospital catchment area I had to obtain permission from the  Malawi College of Medicine Ethics Committee (COMREC), the District Commissioner (DC), the District Health Officer (DHO) and the Traditional Authorities (TAs) Mponela, Dzoole, Kayembe and Chakhaza. This took almost two months of meetings, travelling long distances over very poorly maintained dusty and potholed roads to finally get all my permissions to proceed.

It would often take all day to travel to a remote village, often to find that the participants were not there, or other things would happen that changed the whole course of the day. For example, on my way home, I found some women stranded with a child who was having fits; they were returning home from a traditional medicine man that had tattooed the child’s entire  body. However, it was clear to me that the child had cerebral malaria and I took them to Mponela Rural Hospital. Again all the roads were dusty and bumpy and narrow. Fortunately, the child survived.At the time of the data collection, there have been demonstrations and severe disturbances in Malawi. The Malawi citizens are not happy with persistent fuel shortage, shortage of foreign exchange money (Forex) and some governance issues. These had a heavy impact on the plan of the project and dates were changed frequently for the interviews. In addition, to get to the women’s homes to carry out the interviews meant travelling long distances and this became increasingly difficult when Malawi was hit by fuel shortage. Luckily, I only cancelled once and the interview was conducted a week later when I had found fuel.

However, in Malawi, cultural expectations often interfered with the process, for example on one occasion, the interviewee was not available because she was attending a funeral and we postponed the interviews to a later date. We went there for three times without meeting her but at last we met her and booked. She was very eager to be interviewed and the date was set. However, on the set date, she had gone to another funeral of the relative and the interviews were postponed again. Each trip was 70km from Lilongwe and took approximately 3 hours hours.My supervisor in Cardiff was constantly briefed on the progress of the data collection on weekly bases via text messaging and emails. However, email communication was a bit of a problem due to failure of the email system in Malawi and at times due to power outage and off-course, I was working in the rural areas where I could not have time and facilities to communicate by email. The most helpful mode of communication was text messaging because the mobile network is available even in the rural areas. On one occasion, the child was very ill and the child’s mother was part of the study. Naturally, when one is conducting a study, you would not intervene. But on this occasion, I had to intervene because it was a life and death situation of a child and the mother would not concentrate on the study discussions. I had to consult my supervisor in the United Kingdom by text messaging and we agreed to help the child above everything else. The hospital also wanted to stop supplying food supplements to the same child because the child had reached what they called weight limit for the child to continue receiving food supplements. The child was still ill looking and miserable despite reaching the weaning weight. This was communicated to the supervisor in Cardiff and we decided to intervene and the hospital continued supporting the child. When I left for Cardiff, the child had improved and was looking much better and playing happily with friends

Despite these difficulties, the project plan was met successfully and the first phase of data collection finished on 17th July, 2011 and I returned to the UK as planned. There was a lot of hard working in order to meet this date and there was no time to rest and I was leaving my home in Lilongwe for Mponela early in the morning and come back late in the night and although my supervisor asked me to take a holiday for two weeks, it did not happen because of the civil disturbances.   This meant my family were not amused with me because I was always busy with my project and they told me that I was no longer part of them but a member of Cardiff University. I hope to see more of them when I return for my second phase of fieldwork later this year….

What do you do then?

People regularly ask me the same question: “what do you do?”  A simple enough question perhaps, but one that I struggle to adequately answer.  Sometimes I say “a staff nurse”, but this leads on to further questions about where I work and if I enjoy my work and I am forced to admit that actually I work as a “bank nurse”, working on whichever ward is offered to me.  Additionally, saying that I am a staff nurse does not really describe what I do on a day-to-day basis – my clinical work on the ward is limited to two Saturdays per month.  Therefore, I sometimes say that I am a “researcher”, but this seems a little overzealous as in fact the research study I am conducting is my first and realistically I am a researcher-in-training.  Replying that I am “a student” generally conjures up a reply about what am I studying or a quip about attending only four hours’ lectures per week (when in fact I do not attend lectures at all).  Occasionally I tell the truth about what I do.

I am a PhD student, now entering my final year.  A nurse by background, I was awarded funding to undertake a full-time PhD back in 2009, and I am investigating how adults and their families live with home dialysis in Wales.  The fact that I am a nurse and a PhD student appears to perturb people.  My colleagues in the hospital wonder why I wanted to return to university full-time and thus work seldom hours clinically.  Sometimes, people seem to take offence that I no longer work full-time as a staff nurse, asking whether I do not like being a nurse.  A common response from people outside the academic or nursing world is “how can a nurse do a PhD?  I thought nursing was a practical job”.  This question forces me to take a breath and explain that as I have a bachelors degree I too am able to undertake a PhD, the evidence-base behind nursing practice is vital, and I am (hopefully) helping to generate the evidence.  Therefore, I often skirt around the issue of what I do.

However, I am intensely proud that I am undertaking my PhD.  I love it.  It has been an enormous challenge, but one that I have enjoyed at every step of the way.  Undertaking this challenge has enabled me to interact with other PhD students from many different disciplines, giving me insight into the rich and diverse research that is taking place.  I have learned about philosophy and sociology, as well as learning the principles of clinical research and health economics.  Collecting data, which involved me visiting individuals undertaking dialysis at home, has been the most fascinating aspect of the study, and I felt so lucky that families welcomed me into their homes and shared their experiences with me.  Although I started planning this project nearly three years ago, I continue to be enthralled by the topic and moved by the stories told to me by participants.  I feel incredibly fortunate that I was given the opportunity to embark upon my PhD and the process has thus far been rewarding and interesting.

Therefore, I need to find a new way to answer the question of what I ‘do’, which conveys how interesting my work is and my passion for it.  Failing that, perhaps I should make up a fantasy career?  I do like baking cakes…