Meeting spaces: crafting conversations about suicide in nurse education

Rebair, Annessa Charlotte (2019) Meeting spaces: crafting conversations about suicide in nurse education. Doctoral thesis, Northumbria University.

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Abstract

The care of suicidal people has featured consistently in government policy over the last two decades with continuous reference to educating frontline health care staff to notice and respond to those in need. However, until recently (May 2018), none of the fields of nursing in the UK (apart from mental health nursing) were required to meet competencies in suicide awareness or prevention. There continues to be a gap between what is being suggested from a governmental position to what is happening in preregistration nurse education and practice. It is arguable that all nurses should be able to ask about and respond to suicidal persons, given the tenets of the Nursing and Midwifery Code of Conduct. Given this gap and evidence from literature (mainly concerned with risk and negative attitudes) it was evident that engaging in conversations about suicide was an area of tension in nursing and in need of further understanding.

The aim of the research was to gain understanding of student nurses’ and suicidal persons’ experience of engaging in conversations about suicide. The research question was: what is needed to support and engage in conversations about suicide? As the aim was to understand social reality grounded in the subjective experience of meaning, an interpretive methodology of grounded theory was used. This was underpinned by the theoretical perspective of symbolic interactionism.

Data was collected via semi structured interviews, focus groups and field notes from those who had been suicidal (n=9) and student nurses (n=16). Of those who had been suicidal, seven participants were female and two were male with ages ranging from twenties to sixties. Sixteen nursing students were interviewed across three years of an undergraduate nursing degree programme; of these, fourteen were female and two male.

The importance of space emerged as a theme throughout the data analysis. The core category was Meeting Spaces. For those who were suicidal the three categories were: 1. Lost in uncharted space; 2. Cycling in distorted space; 3. Emerging in illuminating space. There were distinct areas of overlap with nursing students. These were categorised as; 1. Limiting space; 2. Distorted space and 3. Illuminating space. Meaningful conversations about suicide were co-created in illuminating space in what was considered a human pivotal encounter. A specific kind of space is required to support meaningful conversations about suicide, as the experience of the encounter incorporates more than just words. Reflecting on Martin Buber’s teachings on spirituality, the formation of a meeting space requires fully embracing the other with awareness and intention, energetically extending boundaries of physical self into the surrounding space. It is here, in the space in between, the borderlands, that an authentic experience can be co-created. The grounded theory was constructed into a theoretical framework: The Meeting Space Framework; crafting conversations about suicide in nurse education. This offers a novel approach to preparing students to be genuine and human with themselves and with suicidal persons

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