Value-Based Mavericking

Maureen P. Molinari, Saybrook University, USA Kara Vander Linden, Saybrook University, USA Abstract This classic ground theory (CGT) study presents a theory to explain a four-stage process for resolving moral distress encountered in professional environments. Value-based mavericking explains that misalignment between personal and professional values may lead to moral distress and burnout and, that while coping strategies may ease symptoms, the underlying problem still exists. Value-based mavericking presents a process that includes evaluating professional alignment and values and then choosing if and how to continue working in the current professional environment. Following the CGT method, data from primarily healthcare professions were collected. Data were analyzed using coding and constant comparative analysis to develop the theory. Value-based mavericking presents a different way of approaching moral distress and burnout that has not been previously addressed in the literature. Keywords: classic grounded theory, moral distress, burnout, values Introduction Burnout has been recognized as an occupational hazard and widely researched since the mid-1970s, when psychoanalyst Herbert J. Freudenberger first coined the term (Freudenberger, 1977). Freudenberger (1977) observed a concerning trend in some of his patients.  People who were once enthusiastic and dedicated employees began reporting fatigue, boredom, or feelings of being overworked despite the fact that no other factors in their lives seemed to have changed.  Since burnout was recognized and the term coined, numerous researchers have been trying to determine ways to lessen the burden of burnout in the professional environment.  Consequences of burnout are pervasive, including affecting physical and emotional health and organizational loss (Awa, Plaumann, & Walter, 2010; Marine et al., 2006).  The economic impact of burnout is challenging to quantify and is often measured in terms of absenteeism and turnover (Jacobson et al., 1996; Raiger, 2005).  Some of the suggested causes of burnout at the organizational level include “insufficient time, skills, and or lack of social support at work” (Marine et al., 2006, p. 1).  Due to significant consequences for individuals and organizations, numerous researchers are searching for ways to ease the effect of burnout. Throughout the literature, moral distress and burnout are recognized as potential threats to wellbeing.  People experiencing moral distress and burnout may not experience optimal wellbeing or experience job satisfaction. This study began by looking at the relationship between healthcare practitioners and their clients. However, the main concern of participants that emerged from the data of this classic grounded theory study was the impact of moral distress and burnout on their professional and personal lives.  This occurred as the first practitioner interviewed discussed the role that one client had in becoming her champion as she modified her career path.  The main concern that emerged from this interview and the ones that followed was related to moral distress and burnout experienced by healthcare professionals when various aspects of the healthcare system prevented them from being able to best serve the needs of their clients.  Thus, moral distress frequently leads to burnout.  Value-based mavericking presents a process that includes evaluating professional alignment and values to then choosing if and how to continue working in the current professional environment. Methodology This classic grounded theory study was performed by a doctoral student studying Mind Body Medicine at Saybrook University. To arrive at a theory based on “an integrated set of conceptual hypotheses” (Glaser, 1998, p. 3), the authors were guided by six stages, many which occurred simultaneously throughout the research process. The stages of a CGT study are preparation, data collection, constant comparative analysis, memoing, sorting and theoretical outline,...

Manipulative Dominant Discoursing: Alarmist Recruitment and Perspective Gatekeeping...

Debbie Garratt, Notre Dame University Joanna Patching, Notre Dame University Abstract This paper is a grounded theory explaining the main concern of practitioners in Australia when interacting with women on the issue of abortion.  Based on a broad data set including practitioner interviews, professional notes, and discourse data, collection and analysis were undertaken using Classic Grounded Theory research design. The analysis led to the development of the grounded theory, Manipulative Dominant Discoursing: Alarmist Recruitment and Perspective Gatekeeping. Keywords: Classic grounded theory, alarmist recruitment, abortion, perspective gatekeeping Introduction This paper presents a grounded theory on manipulative dominant discoursing developed as a research project undertaken for a Doctor of Philosophy degree.  The theory provides a conceptual model of the way in which a dominant manipulative discourse can be identified, is maintained, and is perpetuated.  Alarmist Recruitment and Perspective Gatekeeping work together to create an environment within which the thoughts, beliefs and actions of those exposed to the discourse are controlled in some way. The theory was developed in the context of abortion discourse in Australia. The study began with the researcher seeking to understand the knowledge and practises of practitioners interacting with women who disclose an abortion experience or concern. Responding to the expectations of the dominant discourse became the primary concern of practitioners who came into contact with abortion disclosing women.  Practitioners are defined as any professional who may encounter women who have ever had or may be considering, an abortion. Abortion is considered one of the most common procedures undertaken by women in Australia with an estimated 80,000 per year (Chan & Sage, 2005).  Current research demonstrates that up to 20% of women can suffer serious, prolonged mental health disorders following abortion (Coleman, 2011), the number of women negatively impacted by this, and other adverse effects is cumulatively very large over time. The impetus for undertaking this study was sparked by almost two decades of working with women impacted by abortion and in the provision of resources and education to the community and professional sectors on the impact of abortion on women’s mental health and wellbeing.  Talking with hundreds of women and practitioners through conferences, education and private consultation suggests that women are generally not effectively supported after abortion. The motivation for the study was to identify practise issues that may inform the development of practitioner education which in turn could enhance their ability to more effectively support women.  It became clear very early in the data collection that knowledge about abortion or its adverse impact was not the main, or even a minor identified concern of practitioners.  It became evident that practitioners’ concern lay predominantly in what they felt they were expected to communicate, or not communicate to the women. This article briefly describes the methodology, introduces the main concern, and resolution of practitioners within the context of the broader theory of dominant discourse and includes relevant data as quotes throughout. Methodology and data collection Classic Grounded Theory as developed by Glaser and Strauss (1967) was the chosen research design for this study. Initial data were derived from 12 practitioner interviews, with further practitioner experiences drawn from the literature after the core category of the dominant discourse had been determined.  Using the dictum that “all is data” (Holton & Walsh, 2017, p.59), data were also collected from mainstream media articles, political documents, professional organisation policy documents, journal articles, and my own professional notes gathered over many years.  To ensure I was absolutely true to the methodological process, I...

About the Authors

Andrew P. Carlin, Ph.D., is a Visiting Fellow at the University of Macau, SAR China. His central concern is the social organization of scholarly communication. This has provided him with specific research interests including disciplinarity, disciplinary contexts for teaching, the problem of what constitute data for sociology, the history of sociology, information, methods and methodology. He teaches qualitative research at Manchester Metropolitan University, and Library & Information Management at Ulster University. His current projects are on teaching and learning in the higher education sector at undergraduate and postgraduate levels; and in online environments. He has published in a range of international journals. Email: acarlin@um.edu.mo Debbie Garratt, PhD Candidate, Notre Dame University, Sydney is a clinical nurse consultant, qualified counsellor and adult educator, and founder and Executive Director of Real Choices Australia, an organisation established to provide quality research and education on reproductive health issues.  As part of this work, Debbie also consults to community groups and the health sector on professional standards and organisational development for services for women experiencing challenges during the perinatal period. For 20 years she has divided her time between the provision of education and clinical supervision to practitioners and clients locally through her private practice, and research, education and speaking engagements both nationally and internationally. This paper is an abridged version of her thesis prepared for a Doctor of Philosophy Degree (post examination and awaiting review: December 2019). Email: dgarratt@realchoices.org.au Karen Jagiello, PhD, RN, CNE, has served as an Assistant Professor and RN-BSN Program coordinator in the School of Nursing at James Madison University in Harrisonburg, VA. She has shared her passion for women’s health with undergraduate students for the last 13 years.  Prior to moving into academia, Dr. Jagiello practiced at the bedside with more than 20 years as a labor and delivery nurse. Her research interests include women and infants, breastfeeding, and rural health. This publication is portion of her dissertation research completed through West Virginia University School of Nursing. She wishes to thank the participants without whose help this work would not have been completed. Email: jagielkp@jmu.edu Rúni Johannesen comes from the Faroe Islands recently finished a master’s degree in Social analysis and planning at the University of Faroe Islands (Fróðskaparsetur Føroya).  In Rúni Johannesen’s words, “I have been working with classic grounded theory for three years and have been working with three different subjects in regard to my education and in regard to my own independent research.” The subjects are grounded theory methodology, political economics, and global ideology. Global ideology, rhetoric, and social group-dynamics are the areas of this particular grounded theory. Email: hr.johannesen@gmail.com Younhee H. Kim, Ph.D., is an Assistant Professor in the Department of English at the University of Macau, in Macau SAR China. She has a research interest in the teaching of qualitative methods. Her main research interests are (second) language acquisition/learning and teacher education, and she has been exploring these areas using qualitative research methods. Most recently, she has been examining parent-child interaction using longitudinal Conversation Analysis. She teaches Qualitative Research Methodology, Discourse Analysis, Second Language Acquisition, and Language Acquisition Studies at the University of Macau. She has published in a range of international journals including Applied Linguistics, East Asian Pragmatics, Journal of Pragmatics, Journal of Teacher Education, and a few other book chapters. Email: yhkim@um.edu.mo Maureen P. Molinari, PhD, RDN, LDN, CDE, NBC-HWC is a faculty member in the Integrative and Functional Nutrition Department at Saybrook University, College of Integrative Medicine and Health Sciences.  In addition to her...