Section Three — Findings and Discussion

3.1 Introduction

This section consists mainly of the findings from the research. It is divided into sections relating to the topics specifically targeted in the interviews and to any other topics that emerged incidentally from the discussions.

In an Action Research study, it is important that the voices of the participants are heard as well as the voice of the researcher (Lather 1991) so, here, the comments of practitioners will be used to illustrate and validate the findings. Some voices will be heard more than others. There are two reasons for this. First, some speakers sum up succinctly what others are taking longer to say. Second, some quotes could not be used because the speaker could be clearly recognised. However, where a useful quote is available but would be likely to identify the speaker the words are paraphrased to uphold confidentiality. Similarly, there are places where just one or two words would reveal the speakers identity so these are replaced with four dots. Three dots are use where, for the sake of brevity, words that do not contribute to the meaning of the quote have been omitted.

Thus, much of what follows is from extracts from the transcripts of the interviews and consists of quotes from the experienced nurse participants on the scheme. However, also included are some of my own comments relating to those quotes but only where it is relevant to the context or when some explanation for conflicting views is required.

To provide an easier flow to the reading of this section on the findings of the study, my main comments have been reserved for the concluding section where various arguments and explanations are developed. In consequence, should the reader come across quotes that surprise them but which appear not to have raised comment, he or she is requested to note them in anticipation of what may be encountered in the concluding section.

It should be noted that the Experienced Nurse Job Rotation Scheme arose because some of the management stakeholders involved in the earlier planned and implemented D/E rotation schemes referred to above, requested it for themselves. Thus it is a spin-off from the main action research process; one that demonstrates the added value that can arise when an Action Research approach is used.

3.2 Progress through the scheme

(See Appendix 3 for accompanying table)

3.2.1 Negotiation

At the planning stage of the Experienced Nurse Job Rotation Scheme it was agreed, by all the stakeholders including the experienced nurses who were joining the scheme, that during the first twelve months of the scheme the participants would identify the type of employment that they wished to rotate into e.g. from CMHT to specialist worker in dual diagnosis. The ‘experienced nurse’ would negotiate with current and future managers to ensure that a formal arrangement was made. The possibilities were as follows:

• a secondment
• a job application
• to have the key components of a job substantially alter within that job

For clarity, and for future use, it is useful to explain at this point how the concept of ‘job rotation’ developed as the scheme progressed. This development arose as the participants began to make their rotational choices. These choices will become apparent as Section 3 unfolds.

Initially job rotation was seen as changing one’s job and type of service (e.g. ward manager/elderly to CPN Adult mental health) within the organisation (in this instance the Trust). However, it gradually became clear that it was also possible to rotate by changing the nature of the post/responsibilities within a service and that job rotation may or may not result in a return to a previous job or service. It also became clear that it was possible to rotate out of a Trust and into another organisation e.g. another country’s health provision, or different type of organisation ( e.g. a university), or different type of health provider (e.g. a charity). In short, there could be planned movement of personnel within the health and social care arenas.

It was also agreed that during the first year, and following the completion of the RAL module, the ‘experienced nurses’ would develop programme plans with projects that enhanced their capability to meet the requirements of their new job. The ‘experienced nurse’ would have completed the rotation scheme when he or she had changed his or her job in the manner described above and had completed the education required for the new post.

The fact that the rotation was accompanied by the acquisition of a degree was incidental except when that degree came with a shortlisting requirement for a post. Indeed, in some cases a degree was not required for the career development undertaken but, as will be seen from the following subsections, all but one of the participants indicated that they benefited from the experience of the RAL module of the degree and those who completed the scheme appear to have also benefited from the research modules. Table 1 in Appendix 3 provides details of the progress of each participant.

3.2.2 Achievements from completion and non-completion of the scheme

Four of the seven people interviewed had completed the course and they made no comments about having done so. The other three had much to say on the matter and, in each instance, not completing the scheme was a matter of great regret to them. Since it would be very easy to look on a non completion rate of this size as being some form of failure it is important that the reader should be informed of the very varied circumstances leading to non completion and helped to be aware of both what those concerned, namely Jonathan, Kevin and Judith, had nevertheless gained from the scheme as demonstrated in what had happened to them since that time and the nature of their regrets about non completion.

Kevin explained,

“I did the RAL and I was getting near to doing my research proposal and then, about that time, my career had actually taken a change for the better. I had taken on an acting up role managing an area liaison service and that had led to me becoming a service manager for a .... service. I’d never dreamed of doing something like that before; it was quite a career change. I took on that job and my project was going to be doing an evaluation of a new .... service and my boss was supporting me doing that. It was incorporated into my current work and organisation so it would have been very useful. I got the support of my organisation to do the project but about the same time I decided, for personal reasons and for my family, I’d a one year old child at the time, that we’d move back to .... It meant going against everything careerwise that I’d got but for personal reasons I had to come back up here. So that led to me coming back to .... but, having said that, I used a lot of the work on the project and the RAL stuff that I had done to try and look for jobs up here.”

I asked,

“How far had you got in this project?”

Kevin responded,

“I was writing up the proposal for the project; what I planned to do; what skills I had; what I’d learned and how I was going to plan what my project was going to be. I hadn’t submitted it but from what I remember it was pretty close to being finished but everything went on the backburner when I decided to come back to .... . It was a shame really.”

He added,

“I came back to .... and I couldn’t get any work. I was unemployed for about four months and I got a job doing bank nursing in an addictions unit. That was a step down for me. But that got me back into having a work routine. I was doing a lot of night shifts and long days which I’ve never done for seven or eight years. I did that and then a job came up for the .... . They were working for the .... who put the funding into appointing a .... service project manager for the whole of .... . .... hasn’t got any decent .... services and the Government was looking at getting a couple of pilot services and they needed a manager to project work them. So the remit is a national remit to develop pilot .... services but also to look at .... development in .... . I was managing the setting up of a service in London, one service for one borough, and now I’m looking at setting up lots of .... services all over .... . I’m just organising an international conference, again to promote and develop .... services in .... . That was a big project taking up the last six months and the conference was last week and it was very successful.”

3.2.3 Work based learning/job rotation — an alternative to traditional education

Jonathan did not get as far into the scheme as either Kevin or Judith. He had previously completed a course in psychosocial interventions but was disappointed because he was unable to use his skills within the Trust. He had considered trying to use those skills elsewhere. He said,

“I was in a quandary because I had a rough idea of what it was I wanted to do but I couldn’t understand how to get there. So I came on this course. It took a while for me to collect my ideas and to think about what experience I’d had. Collecting those things actually helped me because it gave me a little bit of confidence when it came to interviews. Up to then I had been starting to apply for the odd job that came up because the jobs in my field are very, very few and far between. What I was lacking a lot was confidence. I felt that I’d been knocked back concerning what I’d been learning. Clinically my confidence was quite low and my self esteem was quite low. Of course it didn’t change overnight.”

He added,

“I think the course helped me to start to think about what I’d done. I suppose what happened was that when I started doing the course, it came about at a time when I had given the Trust the two years that I said I would give them when I finished the Thorn course. I gave them two years and they still hadn’t done anything and then I started to think about moving on. That was what people had said I would probably have to do. I was at a cross roads anyway where in my head and my heart I wanted to change from London. I felt I wasn’t going to get what I wanted at .... anyway and unfortunately, I suppose, the course came about then. If it had come about maybe a year or two earlier I probably wouldn’t have been leaving. I suppose what happened was that in my head, beforehand, I was going to be looking to move but when I started to do the course I thought, ‘Well at least if I do the course, if I stay for at least another year and a half, then at least I’ve got this under my belt.’ But then, of course, this job turned up in .... I’m an opportunist and I thought, ‘Well, go for it’. So, the whole thing about where it arrived in my life, after being fifteen years in London, was that family wise we were thinking of moving out of London and career wise I was getting completely demoralised. I wasn’t burnt out, I wasn’t being utilised. I was frustrated, under motivated, and wasn’t doing things and it seemed like, ‘What’s the point’. The only glitter that appeared on the hill top was the course. That was the only thing at that time, professionally, that came about in my life that actually gave me something to grasp. That was important about the course but, unfortunately, looking at the timing and everything, everything else was against it. I could have been looking for a job but I had decided that I would see the course out and sods law says that when you decide something like that it goes wrong.”

Jonathan then talked about his present job that came up soon after he had joined the scheme saying,

“The course helped me, from that point of view, to start to think about what I’d done. What happened was that just at that point in time I’d got a phone call to see if I was I interested in this job in .... . I applied for it and, luckily, I got it and I was hoping to continue the course because the whole idea of work based learning still appealed to me. It made me get up and get started. I don’t consider myself academic and that’s probably why I hadn’t got a degree or an MSc. That was my other reason for doing the course because I knew that I needed to get a piece of paper as well. I got this job and I was told that I could do the course and then when I got here I found that it wasn’t actually viable to take time out. The manger, the director of mental health, said that she would be happier if I gave up the course because she felt that I needed to get settled in. I was working at two new institutions, both with their different cultural backgrounds and it was taking me a while to settle in.”

Jonathan then explained some personal problems that had arisen and then he said,

“So, unfortunately, there were a number of things that came about that made it difficult to continue to do the course. The thing is, I’ve still got it in my head, but how I’m going to take it forward is difficult. If something with work based learning came up I would very strongly consider it.”

3.2.4 Intervention of personal problems and work pressure

Almost immediately after starting the scheme Judith experienced personal problems that could well have led to her giving up on the scheme immediately but she valued the experience enough to try hard to keep going.

She explained,

“I’d actually had some personal situations and there was also the service that I was working and managing. We were developing another unit and there were a lot of difficulties with the closure programme and reopening the service. Then I got back on track again. I still hadn’t completed my APEL piece of work but I’d actually been meeting up with Alan (the course tutor) and been through it all. By then we were opening the service and I knew there was a lot of work to do around staff recruitment because the service needed to be up and running before April. So, I had all the recruitment of staff to do. Looking back now I don’t actually know how I put the work in. I was on auto pilot. I just did not have the energy and the mind to actually sit down and reflect on my learning development over the years, how I’d put into practice my skills because some of the work that I’d done it was very… I’d actually done a lot of soul searching and I’d started to write up from my childhood, through my schooldays; right the way through and this was running in parallel so there was a lot of personal information coming out and I just couldn’t open my books. I spoke with Alan again and said that I needed to come and see him. I really, really wanted to continue with it. It was hanging over me. We’d already moved on to the research module but I hadn’t completed because I’d been delayed with my personal situation and I was still working through that. The other members of the group had moved on but I knew there was another colleague who had also been struggling and he and I were at the same level in December of 2002 so I didn’t feel so bad at that point. But he had actually continued and moved on to his research module. In the meantime I was in the process of developing this new service and there was a lot of work involved so I needed to put in a lot of time there. The year passed and in amongst that, the service that I was working on for .... became part of the .... service which meant I had a new line manager and there was a position for operational manager for that service for which I was in the position as scheme manager as the service was developing. So, I needed to consider if I would apply for that post of operational manager or stay in the post I was in and how that would work for the new operational manager. So I applied and I got the post of operational manager which came with a lot of headaches because, as it had grown, there were a lot of historical issues and things that had never been sorted and worked through and a lot of functional stuff that hadn’t been developed or looked after. So I needed to put in a lot of work and energy into that. So, to date, in relation to the programme and the course, I’m still at stage one.”

In answer to my question as to whether she was continuing with the scheme Judith responded,

“I really don’t know. I haven’t gone back to the university. The last time I spoke with Alan was a year ago and it wasn’t until this Christmas, November, December that I’ve actually started to get back to myself. The last two years have just been crazy.”

I asked,

“Do you think you could still do this?”

Judith replied,

“I want to. It’s part of me and it’s something for myself. As I was looking at my reflective piece of work, it’s always that I’ve always been sorting out everything for other people and supporting other people to develop and progress and I haven’t actually spent time on me. I spoke with Alan about a year ago now and he said that the funding had finished so it’s a question of how to take this forward, whether I am still on their books at Middlesex or not. So, it’s a matter of going back and starting again.”

She added,

“I am sad that I haven’t completed and I would like to be able to complete and I will need to follow up as part of my appraisal when I eventually get one. I need to speak with my current line manager as to whether I could resubmit to actually do the RAL and then see where I go from there.”

As can be seen from the above extracts, all three respondents had good reasons for non completion of the scheme and would like to have completed it or to complete it in the future. Furthermore, whilst they did not obtain their degrees, they all gained greatly from the time spent on the scheme. Judith is still with her Trust in a senior and demanding position. Jonathan and Kevin have moved on and are no longer employed by the NHS. Nevertheless, they are both employed by public sector organisations where they are working as leaders and the Health Service still benefits from their skills which, both claim, were largely facilitated by the Experienced Nurse Job Rotation Scheme.

Hopefully, the above extended quotes from the experienced nurses who did not complete the scheme will persuade readers and those who would be in a position to rekindle the scheme that failure to complete is not necessarily an indicator of the failure of the scheme itself. However, it would benefit the Trust if they could be confident that they were sending people onto the scheme who would be likely to remain with the Trust for a reasonable period of time.

3.3 Emerging modes of job rotation

3.3.1 Introduction

All but one of the experienced nurses on the scheme went into new jobs by way of normal interview procedures. Chris originally went on secondment but the job turned out to be other than he had hoped for so he returned to his original place of work and did his research there. Furthermore, in view of the explanation at the start of the subsection 3.2, (Progress through the scheme), it is somewhat misleading to claim that Jonathan rotated because although he had hoped to continue with the scheme he moved to his next place of employment without developing a programme plan with a project. The possible types of rotation were detailed in 3.2.1.

The possibilities for rotation were explained best by Colin who said,

“I suppose the emphasis was on you to decide what you wanted to do but options were explained. I could have done a secondment into a post and somebody could have come into my post and done a swap as it were. Or I could have created a post in a particular area of interest or applied for an existing post. So, I decided to apply for an existing post and went through the normal interview procedures and I’m still here as a CPN at the .... Community Mental Health Team.”

Since any of the above options were open to those involved, any of them could be seen as a form of rotation. However, the participants do not appear to have interpreted it this way. Richard said,

“I didn’t do any rotation at all. What I did do, I changed jobs from being a lead nurse to being a service manager so, in effect, I did what was planned.”

Richard was simply making a statement of fact but Tania had interpreted things differently. She argued,

“We were recruited into something where they’re saying you can rotate and we’ll support you in that rotation and then the support wasn’t there and you had to influence a lot; you had to persuade; you had to go for job interviews. I think everybody rotated because they got a job not because of the rotation if you know what I mean. The rotation might have spurred them on to decide which area they wanted to rotate to and the fact that they needed to rotate but they applied for jobs. But on the lay out it said you will rotate and some of you may be seconded but getting that to happen was nigh on impossible.”

I asked who Tania felt was to blame for this and she replied,

“The organisation. It was meant to be backed by the organisation and then when you came down to it, the middle managers, when you were saying, ‘Well, I want to do this’, were saying, “No”! It just wasn’t easy! I understand the organisational structures and contexts and what you have to do and not do and even with that it was difficult, with the lack of support, to achieve what the programme had set out to do.”

3.3.2 Negotiation

Tania’s comment about understanding the organisational structures and contexts and knowing what has to be done is very important both in the present context and in the context of any future Experienced Nurse Job Rotation Schemes. The operative word here is ‘experienced’. Nurses would not have been and should not be selected for such a scheme unless they had the experience that Tania referred to and were well capable of negotiating their rotation as explained in the first two paragraphs of 3.2.1 (Progress through the scheme).

Because they weren’t asked, the others did not indicate why they had moved as they did. It may be that they considered one or other of the possible forms of rotation and then, like Tania, found their way blocked. It is possible that government guidelines on equal opportunities and selection and their implementation by the NHS are involved here. This will be discussed further in the concluding section.

Although only one form of ‘rotation’ was used by all but one of the participants it is not clear that this was in any way detrimental to the scheme. Indeed secondment, as experienced by Chris was less than useful as was returning to his original place of employment. However, Tania’s experience suggests that this is an aspect of the scheme that would need careful consideration in the future. It should be borne in mind that this was a pilot scheme and, as such, it was intended to provide evidence which would assist future managers and leaders in the construction of their own job rotation schemes.

3.4 The Experience of reflection

When data was being collected for the initial experienced nurse job rotation scheme study (Lucock, R. & Coyne, P. 2003, Experienced Nurse Rotation Scheme: Phase one evaluation), the participants were actually undertaking the RAL module and coming to grips with the somewhat unusual experience of reflection. This was discussed in 3.1.5 ‘Recognition and Accreditation of Learning’, of that initial study. All the experienced nurses found reflection difficult although in varying degrees.

It should be emphasised that RAL was not a superficial career activity. Rather it was very personal; they were being asked to reflect on how they made various life changing choices over a long period of time and it will be seen from what follows that this was sometimes a painful experience. Furthermore, they then had to expose their new understanding to the gaze of others.

Colin had taken to it most easily because it was something he was fairly used to doing but at that time it was Richard who managed to deal with it most effectively. In what follows there is a retrospective discussion of the experience of reflection. There are some surprises!

It should also be remembered that the scheme was planned essentially to retain experiences nurses in the health arena by providing a work based learning approach to a first or master’s degree and that the RAL (Recognition and Accreditation of Learning) module was part of the means to that end. These were highly experienced nurses who had undertaken numerous roles and had a variety of qualifications short of a degree. The RAL module, with its intensive reflective process was designed to reflect their experience and qualifications in a way that allowed the participants to gain their qualification without ignoring what they had already achieved. However, judging by the comments made, some of which are quoted below, this turned out to be a remarkable and life enhancing process in itself.

3.4.1 Appreciating one’s own capability and worth

The value of the reflective process is best summed up by Kevin to whom I mentioned that people spoke of the RAL module almost as if it stood alone and he responded,

“I know! I suppose the rest of it was to justify getting a degree. I think it was getting the assurance that what you’ve done in your career is worth something. People don’t actually say, ‘You’ve done really well’. You just go to work and you’re tired and you think, ‘Well, I’m glad that at the end of the day nobody died’. Hopefully your experience makes services safe and that’s the criteria; you have to have a good day. So, I think being able to say, ‘I’m actually a valuable asset to this organisation because I’ve got this that and the other’; that to me was an incredible self realisation, that you’re actually worth something and your experience is worth something. People have actually been listening to you. You’ve got supervision and my supervision was alright but I think supervision doesn’t really give you the best sort of feeling for you. A lot of it is managerial stuff; that you’re doing stuff wrong. Now I’ve got a folder, a document that says I’m good at this that and the other. This is based on my experience and my learning over a certain period and it’s good to have that. I look back on it now and again. I get out my folder and say, ‘What have I done? I ought to update it and how have I changed from then. But a lot of this stuff is still very relevant to what I’m doing.”

3.4.2 Working with regret/ distress/ confusion

Even in retrospect, the experience of undergoing the reflective process was not a happy one for most of the experienced nurses. For example, Chris said,

“I had difficulty in doing the RAL. The difficulty was in translating my previous experience or conceptualising it into the RAL criteria. I had great difficulty. I did manage it eventually but it was a struggle and difficult. I did spend a lot of time on the RAL module.”

Tania, indicated her feelings about reflection when she was talking about the difficulties she had experienced on the scheme, She said,

“It was just badly organised. I’ve got the degree. My marks got better as the assignments became work related. All that stuff at the beginning; all that RAL and frustrating stuff, I got atrocious marks and then my literature review and my research is what I got the good marks for.”

I asked,

“Looking back at the RAL, can you think why it was so difficult?”

and Tania responded,

“I can’t really because I’m quite good at what I’m good at and what I do. I think it’s probably because of the way the university wanted it written. It just didn’t fit.”

In response to this I asked,

“It didn’t fit nursing or it didn’t fit you”? and Tania replied, “It didn’t fit me.”

Tania, like the rest of those on the Experienced Nurse Job Rotation Scheme except for Jonathan, had successfully completed the RAL module. It should be remembered that this study relates to the perceived views of the participants and this could explain the dichotomy between what was achieved and the perception of that achievement. Any research of this kind inevitably reflects the temperaments of the people involved.

Richard was somewhat more positive, at least in retrospect, arguing,

“The RAL was a really, really difficult process, a really difficult process. I’m not very sure if that was because it was the first module back into learning or if it was about giving an awful lot of yourself because you have to really dig deep if you want to benefit from that. And I did find that a really, really difficult process in terms of having to understand why I didn’t go into higher education and I had to understand why I was so reluctant to go back into it and in some ways that was, not a painful experience but it was an experience that you realise in the middle of it why you didn’t do it. So, it was that sort of insightfulness…”

I interrupted here and asked,

“Was that cathartic?”

Richard replied,

“On reflection, yes but not at the time. At the time it was, ‘I don’t particularly want to do this and I don’t particularly want other people to read it’ but it was certainly useful and then I whizzed through the other two modules. They were research planning, project planning and there was another one in the middle to do with research techniques or something; and project planning as well. I did research and, as I say, I took a break for a year and I’m quite relieved I did that. But I didn’t sit and do nothing for the year. I relaxed, used my brain and did the things I should be doing and feeling positive about myself. I don’t feel anymore that I’m a person that can’t do things. I feel much more confident of who I am, not about what I can do but who I am. And I think the course has done that; the reflective part has done that. And I also feel that I can go off and get other jobs because I feel much more confident that I can do it. So I think that that experience, for me, has been a positive one.”

From Richard’s comments we can once again appreciate the highly personal and sensitive nature of the RAL module. His words also demonstrates the difficulties faced by a researcher when trying to capture what the transcripts demonstrate whilst at the same time recognising that a high degree of confidentiality is required with experienced professionals who were putting themselves into a highly dissonant state.

However, it is also notable that his comments also indicate that Richard had become more motivated, more self aware and happy in his work.

3.4.3 Gains from reflection and the RAL

The others commented only on their reflection of what they had gained by doing the RAL module. Kevin argued,

“What I think the RAL had helped me identify, was what my strengths and my weaknesses were and I think it probably helped me to identify what my career pathway had been; what my skills are and what I had learned. What Alan (the course tutor) said to me was, ‘Don’t just end up places because you end up there. There’s a stream running through wherever you’ve ended up and what you’re good at and what you’re bad at in your job’. So I think I recognised that there were various attributes that I had around leadership and managing systems and being innovative. There was a lot of stuff that I’d identified in my RAL and those were the qualities that I’d taken for granted. I knew that I was good at some things but I wasn’t really sure and that helped me to straighten my thoughts out. You certainly become able to identify what your strengths are. I’ve been able to identify what I’m good at and that certainly helped me to be more assertive and it got me to take my career to another level.”

I knew from the first interview that Kevin had struggled with reflection in the RAL module so I asked,

“Was it that all of a sudden, you had it?”

Kevin answered,

“I think so! I think I was very conventional in my outlook and I didn’t really look out of the box. I started to do that and things began to fall into place a bit. And you could be more imaginative. I use a lot of that in my work. Once things fall into place intellectually you go with it and you take things away and you believe that what you’ve done is good. But before, I didn’t imagine that I could just take things and take them as far as they would go but now I use that in my work and that’s how I began to feel when I was doing the work for the course.”

Jonathan said,

“There was the issue of my making the best of what I’d done. And the course helped me because I was able to realise that I had done these things. I suppose it was that when I actually wrote the things down on a CV it was there but it didn’t feel like it was real. When I started the course I really began to believe it and because I began to believe that what I was writing was the truth, even though I’d known it was the truth because I didn’t make it up, the course enabled me to start to realise that what I was actually writing was the truth and with that, once I believed it was true I then started to build more self belief about myself, if that makes sense. You’re not going to have a self belief if you don’t one hundred per cent believe that what your writing down on paper is true. I was writing these things down but they didn’t make me think, ‘Oh, cor Jonathan, aren’t you great’. Does that make sense?”

I responded,

“It does! But when you reflected on it you realised that it was there?”

Jonathan replied,

“Yes! I mean, I was there for just a very short time so this was just the starting of things.”

I asked Jonathan if the RAL module and reflection had helped him to get his present University job and he replied,

“It did, it did because I already had things gathered. You know, just the fundamentals that lay in front of me because I had this file of all the things that I’d done. But it was also because I’d actually started the process of thinking a little bit more what I had got out of it. It was part of a bigger thing. It made me feel a bit more confident.”

At this point Jonathan explained about a number of problems that had arisen in his personal life at this time and added,

“I suppose underneath it was the course that gave me a little bit of stability.”

Judith explained,

“It had me starting to think about myself and my career in a way which up until then I hadn’t and I started to look at how I had become the person that I am. What had happened through my life to have brought me to where I am and the type of work that I do and the way that I resolve situations and work through situations and the way I communicate with people. So what I was really doing was actually putting down on paper lots of thoughts that, at times, passed through my head because I’d never a time to actually catch up with them. I did struggle with it; even with the first part which was actually the learning, consolidating how I learned, and putting it into skills… to experience. I wasn’t looking at one particularly small area. I was actually looking across the whole of my work and I had quite a range of activities that I’ve done.”

3.4.4 Becoming ‘unstuck’ through reflection

In discussion of what she had gained from the scheme, Judith had referred to ‘it’ and I asked,

“What is it? Is it the reflective process?”

Judith replied,

“Yes I would think so because I didn’t really move on from that area. That was where I was still stuck. I stopped at the reflection and I had started to write it up. I think what it probably did, from a personal point of view, and I would put it that it’s more useful for me personally than professionally maybe, was that I was actually able to, one, put down on paper a lot of things that had been tied up inside me for a very long time and that was good because it was starting to get me actually looking into myself. Then with the …., the second part of looking into myself I could draw on what I had brought out previously because the personal side came into the professional side or how I came about being where I was. But I could link the two together and so, in a way, it’s actually helped the results of my personal context, inside myself. From a professional point of view it’s helped in being able to reflect on putting together an application form, being interviewed, and how I introduce my learning.”

I asked,

“How do you mean, you introduce your learning?”

and Judith answered,

“If a question comes up I can actually draw on my experiences whereas previously I wouldn’t necessarily have remembered something that I’ve done and how that can interlink with what I’m currently doing.”

I then asked,

“When you say ‘you’re learning’ you mean you’re learning on the job as it were, as things go along?”

Judith’s response was,

“Yes! For example, how I managed a situation… because I was drawing on my managerial skills to resolve conflict. ‘How does that that come about to resolve conflict’? Through my reflection I was thinking about, ‘Well, what situations have I resolved and how did I come about doing that? What knowledge did I have, what skills did I have and what experience? How did I come about where I am today? Where did I get the first knowledge and skills’? So, when it came to an interview and I was asked, ‘How do you resolve conflict between multi-agencies?’ I could actually say, based on my experience, ‘I have been able to do this and this and it’s come through my learning’. I could actually expand on my interview questions. So, yes, I suppose it helped me to go in with more confidence.”

Judith’s comment here suggests that, at least in her case, the scheme certainly released her from being ‘stuck’ and led to increased employability.

Colin had said that the main things he got from the scheme were the education side and reflecting. I asked,

“Has it made you more reflective than you were or were you like that anyway?”

He replied,

“I was like that anyway but I think it’s given me a framework to work within that has been helpful.”

I asked,

“Did the framework come from suggestions from the university staff or just the experience of doing it?”

Colin’s response indicates the pleasure to be had from the link between the projects and everyday work. He said,

“I think, both! I think it does make you more disciplined so what I got out of this essentially is that I discovered what areas of the work interests me most because you have to make decisions about what areas you are going to do your research project in. Before I wasn’t as aware that education is the thing that I was interested in, particularly around .... . So, that’s been useful. I think I’m more confident as well as a result of doing this course because the work you do is recognised and accredited and that’s helpful.”

Kevin’s demonstration of the enormous power of reflection is most impressive but it is also remarkable that the three who did not complete the scheme gained so much from the experience of reflection. This is particularly the case with Jonathan who was with the scheme for such a short time.

It might be tempting to suggest that the above extracts imply that there are many who would value the opportunity of learning how to reflect in this way and would do so without it being linked to a degree course. That would be a mistake because the reflection has to be for a purpose and in this instance that purpose was an integral part of this Experienced Nurse Job Rotation Scheme. However, the extracts that follow do demonstrate that where work based learning and accreditation of both prior learning and prior experiential learning are incorporated into a degree course the value of reflection goes well beyond the instrumental value of accreditation.

3.5 — How reflective practice has been used