title: Narratives, memorable cases and metaphors of night nursing: findings from an interpretative phenomenological study.
abstract: The aim of the study was to explore the experiences of night nurses. An interpretative phenomenological study was undertaken, and 35 nurses working in Italian medical, surgical and intensive care units were purposely recruited. Data were gathered in 2010 by semi-structured interviews, collecting nurses' narratives, memorable cases and metaphors, aimed at summarising the essence of work as a nurse during the night. The experience of night nursing is based on four interconnected themes: (i) working in a state of alert, (ii) growing by expanding autonomy and responsibility, (iii) assuring sensitive surveillance and (iv) experiencing deep intimacy. Memorable episodes were polarised along (i) expected/unexpected events; (ii) positive/negative epilogues; and (iii) life/death issues. Many of the emergent metaphors described working during the night as being in the middle of a space where an apparent calm scene takes place, but unpredictable factors may suddenly change the order of events and the outcomes, creating chaos. Working during the night alerts nurses, who increase autonomy, expanding their role and assuming more responsibility with respect to that assumed during daily shifts. The nurses' clinical reasoning is based on data they carefully listen to, and on the meaning that nurses give time by time to different noises and silence. While in the past a sense of companionships was reported, a loneliness or a 'neutral' experience concerning the relationships with colleagues seems to prevail during night nursing. Working night shifts is a complex task, and specific training must be assured to students/novices.
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Zannini
authors.affiliation: Division of Mellino Mellini Hospital, University of Brescia, Chiari, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Ghitti
authors.affiliation: Division of ULSS 6, University of Verona, Vicenza, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Martin
authors.affiliation: University of Udine, Udine, Italy.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Saiani
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D019365:Metaphor; D008875:Middle Aged; D033262:Narration; D009551:Night Care; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology; D014940:Work Schedule Tolerance / Q000523:psychology
keywords: Italy; interpretative; lived experience; night nursing; night shift; phenomenology; qualitative study