The Unfamiliar in Familiar Places: A Personal Account of Ethnographic Research in a Hospital

Jordan Babando

 

“Vision is the art of seeing what is invisible to others.” – Jonathan Swift

There is something unsettling about maintaining a presence in a hospital setting when you are neither a patient or a health care worker. Everyone in the hospital has a specific role and ways of seeing the daily unfolding that takes place in health care. A health care worker may focus their attention on the patient and their symptoms, tests and diagnoses, along with the connected roles of the surrounding health care workers. A patient may be focused on their medications, treatments, the odd sounds and screens directly connected to their health care. While visitors might be primarily concerned with the quality of attention and care of their friends and loved ones, along with their expressed emotions and concerns related to their care. Through my presence in the hospital as a sociological researcher, I have found that the goals attached to specific roles in the hospital focus people’s views in a way that hides and obscures daily happenings that should otherwise be obvious.

I’ve visited hospitals in the past, either as a patient or someone visiting a patient. In either of these roles I was not aware or open to the various nuances that were taking place around me. When you take on a certain role you also take on a certain perspective. As Mol (2002) points out, physicians have a perspective and patients have a perspective, and while they can both interact and discuss the same thing, their interpretations and focus can differ. Mol’s study of the multiplicity of how disease is enacted in medical practice is a firm example of social science research being conducted in a hospital setting. Her research found that while physicians all recognize atherosclerosis as a disease, they had not realized that their ways of interpreting and enacting the disease changes from one physician to the next, and between patients and physicians. As disease and other matters of the hospital are familiar to health care workers, how different individuals enact and understand such things are unfamiliar to most. Some physicians of Mol’s study expressed how she presented their enactment of disease in a way that seemed foreign to them. Taking in the perspective of a researcher who is external from the setting in which they study can be strange, foreign and present the familiar in a way that is unfamiliar.

In relation to Mol, my current hospital research also looks at multiplicity, however it focuses on emotions and how they are enacted, experienced and understood in medical practice. I enter the hospital as a trained sociologist and try to specifically look at what Charmaz and Olesen (1997) refer to as a “ward culture”. Heading into the hospital with this research role has provided me with a perspective that is not commonly shared by others in this setting. Throughout my ethnographic study I have been finding that the most commonly experienced and expressed emotions by health care workers change from one ward to another, and are enacted and dealt with differently between professions. The amount and type of available resources, the workload, the extent of patient needs, and the cohesiveness between health care workers change from one ward to the next. These are some of the factors that determine which emotions are prominent and how they are enacted in each ward. As a side note, I have oddly noticed that the way I am treated and perceived as a researcher by hospital workers changes from one ward to the next and between professions. In one ward I was met with interest and perceived as a tool for positive change, while in another ward I was treated with disinterest and perceived as a spy for administration. The hospital is a very familiar place to its health care workers, although, my research and my presence has been presenting them with unfamiliarity.

While physicians and nurses can both understand and experience emotions in their roles, they are often unaware of the ways to which such things are the same or different to those around them. A nurse for example may encounter and experience sadness in her/his role, although they are unaware that nurses in other wards may experience different emotions given a similar context or interaction. Furthermore, experiences and emotions can change from one health care profession to the next, such as between physicians and nurses. In discussing my findings with health care professionals, they have been fascinated and surprized by my observations. Some comments I have received have been “I had no idea”, or “wow that is so strange, but I can see it now”. There are things that regularly happen right in front of us in our familiar places and familiar roles that we fail to see. We tend to approach things with a bias or understanding that direct what we will focus on during events that unfold before us (Sandstrom, Lively, Martin & Fine, 2013). This is not to say that sociology alone has no limits to its perspective, instead what I call upon is for a cross disciplinary analysis. There are things to discover by social scientists in medical or scientific practice that are otherwise hidden from those immersed in such areas. This is not one sided either, as I see the need of having scientific and medical perspectives research the social to bring out the unfamiliar in our own ways of understanding things. Again, what I suggest in all this is that unfamiliar perspectives can uncover the unfamiliarity that should otherwise be obvious to others in their familiar places.

 

Charmaz, K. and Olesen, V. (1997). Ethnographic research in medical sociology: Its foci and distinctivecontributions. Sociological Methods and Research, 25(4): 452-494

Mol, A. (2002). The body multiple: Ontology in medical practice. Durham, NC: Duke University Press.

Sandstrom, K., Lively, K., Martin, D. and Fine, G. (2013). Symbols, selves, and social reality: A symbolic interactionist approach to social psychology and sociology 4th edition. Don Mills, ON: Oxford University Press.

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