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Posts tagged ‘Patricia Liehr’

Catching the Narrative Wave in Research and Practice

The current ANS featured article is titled “Claiming the Narrative Wave With Story Theory” authored by Patricia Liehr, PhD, RN and Mary Jane Smith, PhD, RN, FAAN. The article is available for download at no cost while it is featured. In this article, the authors clarify the nature, the importance, and the benefits of narrative in both research and practice.  Download the article now, and share your comments for discussion here!  This is a message provided by Dr. Liehr for ANS blog readers:

Mary Jane Smith (right) and Patricia Liehr (left_

Near the end of our STORY-WAVE paper, we say: “In order to attend to unique health challenges for those in our care, nurses must embrace the idea that listening to another’s story is as essential as any other vital sign.” Hardly any nursing action occurs without some understanding of the context that has supported an individual’s presenting health challenge. In fact, another’s story can tie together other pieces of clinical data in a way that makes sense; that enables human-centered precision care. Story is a vital sign; story theory proposes a way for nurses to think about, collect and analyze practice and research stories.

Just recently, while talking with a nurse who has spent the last 30 years working in the emergency room, the conversation turned to what energizes her and keeps her passion for nursing alive. In a move to South Florida about a decade ago, she was introduced to the population of Jewish patients who bear the history of the Holocaust, branded onto their wrists. She has invited these older adults to talk about the marking, thereby offering an opportunity to “make visible” what can easily be overlooked in an emergency room visit. “…sometimes they pause and I can see that they are considering what I have asked but almost all of them speak to me about the Holocaust. I LOVE caring for these older adults.”  We believe that stories like these create a context for caring; in this case, infusing advanced ER knowledge and sophisticated skills with recognition of person that makes a difference in well-being.

In 2020, the Year of the Nurse and Midwife and the 200-year anniversary of the birth of Florence Nightingale, it is definitely time to claim the narrative wave. Why????….because story is central to our practice and our research. In the last line of our STORY-WAVE paper we say: “Story theory can help nurses raise recognition of stories from practice and research as valuable guiding evidence, thereby claiming the narrative wave as an integral facet of disciplinary knowledge development.”….that’s why.

Middle range theory in the making: You gotta’ stay with it and you gotta’ pass it on

Our latest featured article from the current ANS issue is titled “Middle Range Theory: A Perspective on Development and Use” by Patricia Liehr, PhD, RN and Mary Jane Smith, PhD, RN, FAAN. Both authors are long-time contributors to ANS and in this article they examine the journey of developing middle range theory that is solidly situated within nursing’s disciplinary persepective and ultimately bringing it to the interdisciplinary table. This article is available for download at no cost on the ANS website while it is featured.  Here is a message that the authors provided for ANS blog readers, followed by a short video that Dr. Liehr and her doctoral students created, talking about the nature of middle-range theory:

We are going to tell you our story as it relates to this paper. Often when we use a story path that focuses on the present…the past….and the future.

At PRESENT, we invite you to read and share your thoughts about “Middle range theory: A perspective on development

Mary Jane Smith (L) & Patricia Liehr (R)

Mary Jane Smith (L) and Patricia Liehr (R)

and use” in the current issue of ANS. We are honored to be in this retrospective issue.

Moving to PAST, we first met and engaged with each other in 1979-1980 as teacher (Smith) – student (Liehr) while Liehr was in her Masters program at Duquesne University in Pittsburgh, Pennsylvania.

During a period of about 20 years, as we began to learn more about middle range theory as a guide for practice and research, we saw the need for a state of the science manuscript. This was the impetus for the 1999 paper published in ANS “Middle range theory: Spinning research and practice to create knowledge for the new millennium.”

The 1999 paper in ANS was the impetus for our textbook, Middle Range Theory for Nursing, first published in 2003. The book was written to create a resource for scholars wishing to use middle range theory in practice and research.

The 1999 paper was also the impetus for this 2017 paper, allowing us to consider middle range theory through the lens set forth nearly 20 years ago.

And now, the FUTURE….the 4th edition of Middle Range Theory for Nursing is in the works and we continue to teach students about the usefulness of middle range theory. We are offering a short video recording of current PhD students at Florida Atlantic University, Christine E. Lynn College of Nursing who are considering the relevance of middle range theory as they immerse in developing ideas to guide their research.

The foremost recommendation in “Middle range theory: A perspective on development and use” is to “stay with the theory”. We believe that persistence and scholarly engagement over time has the potential to effectively shape disciplinary knowledge. Our story highlights and brings to life this belief. Thank you for sharing blog-time with us.

Patricia Liehr and Mary Jane Smith


Translating Research to Reach for Peace

I am delighted to feature this article to introduce the current ANS issue focusing on “Health and Peace.”  The article, authored by Patricia Liehr, PhD, RN; Kate Morris, BA, MA; Mary Ann Leavitt, RN, BSN, CCRN and Ryutaro Takahashi, MD, PhD is titled “Translating Research Findings to Promote Peace: Moving From ‘Field to Forum’ With Verbatim Theatre.”  The background on this research, and the development of the theater play, is a fascinating story that Dr. Liehr has generously shared with us here:

Our manuscript, entitled “Translating research finding to promote peace: Moving from “field to forum” with verbatim theatre” began years ago when I began working with Japanese researchers. The research side of this story has merged with the creative arts side of the story to present With Their Voices Raised, which was first performed in November 2012. The Playwright/Dramaturg note and the Researcher note were in the program for the inaugural performances in 2012. They are included here to provide a context for understanding the origins of the manuscript.

Researcher Note

            The performance that we will watch tonight has its roots in research that began nearly two decades ago when Japanese and American researchers were studying blood pressure changes while talking to Japanese elders who had suffered a stroke. Our study purpose was to understand how the pathophysiology of stroke affected blood pressure recorded during talking. We asked our research participants to talk for four minute about their health; how they were managing the limitations imposed by their stroke…while we recorded blood pressure every two minutes.

Our participants took us down an unexpected path. The stories they shared while speaking wove in how they survived World War II, with the implicit and sometimes explicit suggestion that surviving a stroke was “nothing” compared to their World War II experience. As the research team considered what we were hearing, we decided that we needed to know more about surviving WWII for both Japanese and American elders. The bombings of Pearl Harbor and Hiroshima were selected as points of comparison, where each participant would be called upon to recollect aggressive actions taken by the opposing country.

About the same time the research was launched, we knew that we wanted to share these findings in ways other than traditional scholarly venues, like scientific journals. We wanted to touch people who may never read a scientific journal; wanted to reach youth who may be experiencing aggression in their own lives. We have published our research findings in a scholarly journal. Now….tonight, you are joining our journey as With Their Voices Raised shares the wisdom of our participants through documentary theatre. With your guidance, we will move on to share this wisdom with young people. We thank you for being here.

The Research Team: Patricia Liehr, Chie Nishimura, Mio Ito, LisaMarie Wands, Ryutaro Takahashi

Playwright/Dramaturg Note

When I was first approached in the spring of 2010 by American and Japanese nursing researchers to develop a theatre presentation based on approximately fifty Pearl Harbor and Hiroshima survivor testimonies, I had only a general

Invitation to performance, Miami Dade College, November 13, 2013

Invitation to performance, Miami Dade College, November 13, 2013

understanding of the events leading to United States involvement in World War II. My knowledge of the Pacific theater was based upon a recollection of a grainy photograph in my American History high-school text book of the U.S. Arizona engulfed in smoke and flames at Pearl Harbor on Dec 7, 1941. I had also read Hiroshima by John Hersey, but had no connection with the term hibakusha. I had a lot to learn.

In the winter of 2011 I traveled to Hiroshima, Japan and had my picture taken underneath the Memorial Monument for Hiroshima. Inside the Peace Museum I noticed a pocket watch, forever stopped at 8:15, tattered swatches of blackened clothing, and tiny pieces of concrete that were once buildings and homes. I watched video footage of the atomic bomb, its mushroom cloud of ash and debris rising high into the morning sky. I saw archaic clips of bald hibakusha, their faces covered with red dots, their teeth black and decaying. Finally, I signed the visitor’s book, along with countless others, in a pledge and plea for peace throughout the world.

In the spring of 2012 I visited Oahu, Hawaii. I climbed the steps of the control tower at the Pacific Aviation Museum on Ford Island and listened to the silence of the salt air. I rode a ferry over to the USS Arizona and saw the oil-slick ‘tears’ on top of the water while the ship’s turrets remained below. I took the “Home of the Brave” bus tour and drove past the countless headstones at Punchbowl National Cemetery, all decorated with an American flag. Finally, I signed the visitor’s book, along with countless others, thanking our brave servicemen and women for their sacrifice and service to our country.

Needless to say, working with the Pearl Harbor and Hiroshima survivors’ stories opened up a whole new path to my studies and the way I viewed the world. It also introduced me to documentary or verbatim theatre as a way to disseminate history and perpetuate research outside the textbook and classroom. By presenting With Their Voices Raised it is my hope that together we may learn by listening, by sharing, and by thoughtfully exploring our cultural differences and similarities in the hopes of a more peaceful future for us all. With that thought in mind, I welcome any comments or questions you may have in the talk-back following the performance and written in the survey.

Thank you, Kate Morris

Where do we go from here?

With Their Voices Raised will be performed in Miami on November 13, 2013.  The announcement for the performance has been included above in this blog message, as has a photo from the Florida Atlantic University performance (11-11-2012), capturing a

Voices of Nurses

Voices of Nurses

segment where the script focused on the stories of nurses. (Download a PDF copy of the performance invitation). Also included below is a video clip from the end of the performance at the Morikami Museum and Japanese Gardens on December 6, 2012. Some important terms that are used in the script and will occur in the video clip are:

Genbaku – short for Genshi-bakudan, the Atomic bomb

Hibaku – A-bomb exposed. Being subjected/exposed to the bomb/radiation

Hibakusha – A-bomb survivor. One who was subjected/exposed to the bomb/radiation.

Our next efforts will be directed to taking the script to high school students who will assume the roles of the 8 actors, perform the play, and engage with classmates in a discussion of the meaning of living through aggression. With this research-based creative experience, young people will have a history lesson as well as a lesson about the human spirit that calls for peace.

Patricia Liehr, Katy Morris, Mary Ann Leavitt, Ryutaro Takahashi

To download your copy of this article while it is featured, visit our ANS web site now!  Watch the video clip here!

Liehr: Promoting Peace with Verbatim Theater from Peggy L Chinn on Vimeo.

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