Exploring Transitions: Working in "the Space Between the no Longer and the Not Yet"
This thesis uncovers a personal journey of reflective practice in Aotearoa / New Zealand. The focus for reflection is on my emerging role as a nurse facilitating transitions using a dialectical approach in the context of a private nursing practice. Transitions encompass: life changes, loss, and adjustment to changes in function. Dialectical nurse facilitation of transition (DNFT) is a way of exploring self in the transitional space between "the no longer and the not yet". In this facilitated process people potentially discover paradoxes, tensions, and creative energy, as they search for a way forward. The research design details a dialectical heuristic quest through journaling and reflecting on practice supervision and peer review, over a two year period. Exemplars written after reflecting on case notes reveal the lived experiences of participants Sophie, Grace, Rose, Faith, Lilo, and Charles (pseudonyms). These case reviews show the complexity of patterns for people undergoing transitions and nurse facilitation. A relational pattern for DNFT encompasses compassionate engagement, catalytic mirroring, and interconnectedness. A transitional pathway from impasse to transformation shows itself as the people I work with search for clarity about the nature and meaning of self. The transitional pathway is mirrored in practice supervision and peer review in my search for professional clarity and grounded-ness. This reveals a mutual transformational process going beyond the boundaries of feelings and reason, into the regions of the human energy field and spiritual essence of self. This integral approach finds resonance with nursing, Buddhist, and psycho-social philosophies and theories that posit human beings as the embodiment of spiritual energy. An exploration of literature encompasses nursing theories, facilitation, dialogue, loss, grief, spirituality and transition. These show how the patterns that I find, both resonate, and are divergent from extant knowledge. This thesis sheds light on the often hidden aspects of reflection and nursing practice and may support professional and personal growth. It also provides a basis for evaluative research on the effectiveness of DNFT in health care settings in the future. Discussions regarding the expansion of these reflective and praxis genres are included which may be of interest to nursing education and practice contexts.