The dance of discoveries

Maria de Fátima de A. Silveira, Dulce Maria Rosa Gualda, Vera Sobral, and Ademilda Maria de S. Garcia

Maria de Fátima de A. Silveira, RN, Doctoral Student, School of Nursing, University of São Paulo, and Instructor, Nursing Department, State University of Paraíba.

Dulce Maria Rosa Gualda, RN, PhD, Associate Professor, School of Nursing, University of São Paulo.

Vera Sobral, RN, PhD., Professor, School of Nursing, Fluminense Federal University .

Ademilda Maria de S. Garcia. RN, Master in Public Health, Instructor, Nursing Department, State University of Paraíba.

Abstract:

The authors present the methodology used for collecting data developed through the use of the metaphor of dance. The tools were the workshops run in an Extension Course in Brazil given to nurses caring for women. The process is described as a meeting where the main objective reached was the collective construction of knowledge about the body of the women cared for. The socialization of experiences, the debate of ideas, the reflection about care permeated by solidarity and humanization, caring for the care-givers, reducing the asymmetry between researchers and researched — the dancers — went beyond merely generating data towards research.

Key words: Methodology, Workshops, Creativity, Body, Care.

Acknowledgement: Funding for this project was from CAPES — Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior.

Citation information:

Maria de Fátima de A. Silveira, M. F. A., Gualda, D. M. R., Sobral, V., & Garcia, A. M. S. (2002). The dance of discoveries. International Journal of Qualitative Methods, 1 (1), Article 7, Retreived DATE from http://www.ualberta.ca/~ijqm/


 

Translate the unsayable, but not impossible. Report the emotion, the glee, the joy, the fellowship, the exchange — a process marked by discoveries, often painful but always affectionate. Difficult? Here is our challenge, the limitation of exposing in words that which was lived. However creative we try to be, we know the difficulty of writing that which we live, as much by the almost technical impossibility as by the ethical-affective limit. But, then, what are we going to talk about? We can begin saying that it is a description of a methodological process to collect data for a doctoral thesis. Is that all?

The process occurred through sensitivity, creativity, and expressiveness workshops, where the horizontality of the relation of the researchers to the researched, the care to the caregivers, and the exchange of knowledge were the main mottos. Unusual? From some aspects, not so much. There are some stories — few, it is true. The novelty? The workshops involved an Extension Course in Brazil offered to nurses who provided care for the women.

How did we consider presenting the experience to them? Using a creative and poetic resource: the metaphor of dance. The inspiration? The anthropologist and dancer Valerie Janesick (1994).

So, would you give us the honor of this dance? Come and dance with us!

Why dance?

We agree with Janesick (1994) when she says that dance is an interpretative form of art and the design of qualitative research is as interpretative as dance. For us, well... the research, as carried out by us, looks like dance for other reasons too: the rehearsals; the soundtrack which drives us; the uncertainty of knowing whether we will set up suitable choreographies; the inventiveness and flexibility to wait for our, literally, partners/participants’ steps; the doubt if our performance will please those who evaluate us; and, finally, the risk of "slipping up" if something goes wrong.

Every dance, Janesick (1994) says, makes a declaration and begins with a question. We declare we care for the body, we teach care with our body and we care in/from the body. However, the concept that a nurse has of the patient’s body she cares for was a silence in the theoretical and practical discourse of Brazilian nursing.

We ask: What is the symbolism that the nurses attribute to the body of the women cared for? What are the patent (profane) and latent (sacred) aspects that nurses identify in the patient’s body?

We chose ethnography, which is based on the idea that a group of individuals create a culture which guides the view of its members and the form in which they structure their experiences (Polit & Hungler, 1995). That explains the choice of method: because it is coherent with the technical support of the study, based on the cultural construction of symbolism and given the fact that nurses as professionals are a collective. And also, as stated by Canevacci (1990), "the body is a cultural map."

We develop a choreography — the workshops (5) — which articulates the body of the participants as producers of subjectivities and the source in the process of knowledge while, at the same time, providing an effective participation of the researchers in the dance, breaking down the inequality, involving the group and the coordinators in a relation of trust and informality.

Such a relation is in harmony with the use of ethnography, since for Gualda (1995) "the ethno-methods enable the researcher to learn and experiment with the people studied in their natural environment." This is a promising relation, especially when the coordinators and participants of the workshops are nurses dealing with the same language and the same symbolic system.

The account of the "workshop participants/dancers" Silveira and Garcia (1997, 1998) supports the workshop as a privileged space to understand the phenomena of nursing in undergraduate teaching, which often means the possibility of sensitive reflection and creative action on the training and professional practice of nurses. The authors validate this route as a possible path to the creativity and sensitivity demanded by health care; valuing feelings and emotions in collective living, permeated by support, commitment and mutual feeling/learning/action.

Based on these premises and experiences of the authors, in this study we believe that the meeting between researchers and nurses during a piece of research should not be lived as a one-way path where the first part "gains" while it obtains data, constructs hypotheses and elaborates theses. We based ourselves on the experience of Tavares (1998) and set up the Extension Course "Daily Routine in the Care of Women: routines and transcendencies" in order to provide a certificate that can integrate and enrich the curriculum of the participants, as well as moments of debate and reflection during the workshop meetings.

To collect data from workshops was a daring step and an effort in overcoming "methodolatry," as Janesick (1994) defined the reign of method as the apex of a research process, and seek to find a way of apprehending reality that can produce collective knowledge, but also share moments of pleasure and joy with all those involved, breaking the painstaking "via-sacra" that almost always marks this route.

Preparing a dance

In spite of the experience, we had to adapt "choreographies" developed by ourselves and others, in order to adapt the techniques to the objectives of the dance. We then carried out a "courtship dance," with some authors who fed into the theses project: Eliade (1991, 1996, 1998, 1999) and Ortega y Gasset (1967).

Later we rehearsed a dance with a pilot project made up of nursing teachers to adjust technical details, link to the proposed objectives, generating data necessary, the timing of each choreography workshop, sufficient materials and space.

The research was carried out in Campina Grande, the second largest city in the State of Paraíba, one of the poorest in Brazil. With about four hundred thousand inhabitants, the city has basic health services which were extended beginning in 1995, with the implementation of the Family Health Program (based on Cuban experience) and a wide hospital network in various specialties, which servicing not only the municipality but all the surrounding regions. The main sources of income are commerce, informal economic activities, and tourism.

The invitations to the participants were printed and delivered personally to the nurses at public and private health institutions, in order to get the widest possible range of representation at the levels of primary, secondary and tertiary health care for women. Ten nurses accepted the invitation to participate in the "dance."

The "dancers" are between 25 and 61 years old, having qualified as nurses between five and twenty-three years ago, and their employment is widely varied: municipal women’s health service (2); the Family Health Program (4); a family planning service linked to a teaching hospital (1), a program for care of adolescent mothers (1); the head nurse in a private hospital and maternity (1); and an intensive care unit (1), also private. They chose the names of flowers for themselves for the publication of results: Orchid, Dahlia, Carinho-de-Mãe, Geranium, Lily, Jasmine, Tulip, Daisy, Violet, and Carnation.

The venue could not be better suited for a dance hall: the Exhibition Gallery of the Assis Chateaubriand Arts Museum adapted for the ball — all comfortable and cozy with mattresses, fans, sound systems, tape recorders, curtains. Making up the set, the decoration of the environment, of course, had flowers, plants, mobiles.

A worthwhile party which marks the participants should have an unforgettable soundtrack, assisting in the moments of sensitive reflection, informality and relaxation — meeting. Unable to have a live orchestra, edited cassette tapes and CDs played the part. The music helped create the environment, introduce issues, register emotions, record memories, express feelings/knowledge.

To prepare the body for the dance also demanded a feeding ritual. The snack, present at every meeting, went beyond the flavor of the food itself, meaning moments of socialization and exchange, where affections were symbolized, expressed and represented. It was a ritual of offerings among participants, moments of care, pleasure and attention.

In order to have a "social column" to record "our moments," that which the group gave meaning to and expressed affection, we set up the Group Memories, inspired by Nora (1984): "memory is something that can weld the collective." We used the entry to the hall to display important phrases, complaints, questions, materials used in the activities, photographs from each meeting, making up an album. The record of the whole event was kept on several cassette tapes and some videos, to make it possible to look back, even at a distance, at moments such as these.

For our dance, we followed the ethics standards of the National Health Council in Resolution 196/96, through the Term of Free and Understood Content.

An "immodest party"- a ballet in three acts, multiple choreographies

1. First steps — visualizing the nurse’s body in health care

Our experience in coordinating workshops with very different groups made clear, at the beginning of the work, the need to take as a starting point the establishing of a space/process where the participants can talk about themselves, see themselves and feel accepted by the group and by the leaders. Any theme could be used.

We began this first workshop introducing the course coordinators, the objectives (collecting data for the thesis that would be carried out simultaneously), and the methodology. Since this kind of methodology raises and expresses feelings, emotions, personal and professional conflicts, we established a "contract" with the participants, so that all of them should keep secret all that happened during the Meeting, as a way of assuring mutual trust and respect.

We started! At the beginning, shy. Barefoot, sitting on mattresses. Doubt: what now? Happiness of meeting people. The expectations, different. Fear of being different from the group. Nice climate, indispensable help from fans in autumn, in the Brazilian northeast. Incense in the air. Soft music, probably jazz. Flowers and fruit laid out in baskets on a table cloth on the floor in the middle of the room, looks like a picnic, indicating a modern dance to introduce the participants — eating fruit.

The choreography begins when we choose fruit which we identify with, because of color, texture, flavor, smell. When dishes were prepared and interactions occurred between all, exchanges, sharing, literally, fruit.

While eating fruit, when we were allowed to get sticky, we said our name, where we worked, personal and professional features associated to the fruit. Nice! Good, huh? And we also fed our bodies in a light and natural way in order to continue the dance. Integration? In the words of one dancer: "This is fellowship!"

We lay down, we relaxed. A low, steady voice told us to visualize how we felt our bodies when caring for women in our professional practice. Leading the relaxation also relaxes the coordinator, helps her with her breathing and slows her heartbeat, which races wondering if we are going to make it.

These dances included more and more elements of expression! In our case, body shapes, 1 blank sheets of paper, glue, scissors, color pencils, pens. We built our bodies, cutting, painting, writing, from the molds, integrating parts from one and another, in our capacity to invent, model, modify or absorb the armor that our institutions impose on us.

A pause for a snack. More meetings between people.

We now have individual performances by the dancers. Each one, from her place on the mattress-stage, developed her own spontaneous performance, with her reading of her own body as an instrument of care. This moment was followed by the progressive integration of similar, different opinions: examples were mentioned, complaints reported, emotions shared and, gradually, a pace was set and the group identity was being built.

Such a dance demands a lot from your body, mind and spirit. A pause for auto-massage, feeling each part of the body, touching, identifying points of tension, relating to your body in another way now, widening the perception of this body.

A very tribal choreography was introduced for a more effective and affective approximation. Seated in a circle on the floor, one behind the other, like a train, we massaged the back of the dancer in front of us: the arms, hair, caressing and recognizing in that body the body of a woman, a caregiver like us. The cycle then inverts; then the one who massaged was massaged by the other, a mix of respect, thanks, exchange.

We concluded that meeting together with the sun, which also left the scene at the window, in a circular dance that celebrated the body that cares, works, sustains the family, which receives and gives pleasure.

2. Symbolizing the body of the woman cared for

The entry hall to the main dance hall had a mural prepared with the material produced the day before, the photos, some flowers. A nice surprise! "What did you prepare for us today?"

For this presentation, the scenery provided symbols understood by the group (the Brazilian flag, symbols of man and woman, the dove symbolizing universal peace, Cupid, and the lamp of Nursing) and a vase with red roses.

The warm-up with the symbols was a strategy to assist in a lecture about symbolism and to evolve, choreographically, toward a symbol the dancers chose to represent the body of the woman we care for.

Before beginning the dance, we relaxed our bodies, so that reason gave way to sensitivity and imagination could fly, allowing us to associate an object to the body of the woman we care for. This object would transmute itself until it became a symbol. Sounds of water and wind helped on this trip.

Now there is a great altar on the stage, and it has objects, elements from nature and materials that reveal some facet of woman, with those associated with caring about one’s appearance, self-care and modern life and those taken as "women’s things," even materials used by nurses in the health institutions to care for women.

During the initial part of the choreography, each one went to the altar to choose, initially, three objects to represent the body. Each one, when performing, used different times and strategies for their choice. Comings and goings to the altar, mattress, exchanges with friends to enrich the performance. So many uncertainties. Unusual steps, to think and represent a body that is never spoken of at the dance course, at the University, but which is our site for care. We presented our objects, interpreting the symbolism we found there.

Fortunately, a break came to release so much. So much what? Emotion — that best describes it. Coffee, cake, sandwiches help us to be informal and talk about ourselves in a different way.

Back to the stage. This time in small groups. The material of the dance is already among us, the same as the previous stage. It is much easier to dance in the group. We eliminated materials and got down, again, to three objects. A new round and we spoke about our choices.

Then we moved on to collective dance. The whole group gathered, so many similarities! We were tuning up as a group, they say symbols have this power. We classified and grouped objects and materials. At a given moment, it looked like a big confusion and not the preparation of one more stage of the choreography. But we laughed so much, sang, whispered! Some mystery is necessary. Finally, we decided.

The resources of dance, however, were not sufficient for expression, because, finally, we got to the moment of the great discovery. We used theater to assist us. Our master of ceremonies introduced us and each one presented a feature of the symbol from our personal features.

Euphoria and fellowship. A moment of recognition: "flowers for the three women who are caring for us so well." Time to celebrate all the women of the world. Now each one went to the center of the ring, making her own dance, receiving homage also.

A lot awaits us still. We take home the text with the metaphor of the forest (Ortega y Gasset, 1967) to guide us in the final act. We had to read it many times. Philosophical inspiration for dance is so hard!

3. Finalizing the party: entering the forest of the body

The scenery, simpler this time, was made up of a heart-shaped basket full of purple and mauve flowers, our colors. A cauldron full of medicinal herbs, an emphasis on our discovery that "it was also in the cauldron of the witches that nurses were made" as one dancer said.

An initial bodily movement in relaxation led us to wander in our own personal forest. We should go in, seeking to notice what we have inside and what we feel on this trip, and then reflect: "are there trees, forests in the body of the woman I care for?" Some of us did not go very far on this trip. We went back to where we had started.

The scenery had changed rapidly. The stage-hands were fast, although not always very quiet. When we opened our eyes, after relaxation, two large cloth panels made a backdrop: one had a tree-woman and the other, forest women. Surprise and delight. The work of a talented artist from the State of Paraíba.

The floor of the stage covered with images and words. Apparently simple, the choreography was developed with difficulty and some pain. To see and express with images and words what there is, for us, of trees and forest — appearance and essence — in women’s bodies. The call to a snack relieves us from these moments of chocking and tripping.

Finally, we get there! And there was much more, as always.

A graduation ball closed our MEETING-DANCE.

***

Three months later, we met again to discuss and evaluate all that had happened and to validate, after looking at the full transcripts of the tapes, that which could be published in the thesis.

The bread and wine finally shared.

To those of us who coordinated the whole process, we must say that the methodology used to collect data for the doctoral thesis went well beyond our expectations, in every sense. We reached the objectives of the research in an impassioned, pleasurable and surprising way. We believe it would be very difficult to achieve this with any other methodology and involving both the subjects of the process.

The workshop approach allowed us to articulate and bring out not only the nurses’ concepts about the body of the woman cared for, but gave the participants moments of self-evaluation, confrontation with the theory of professional training, connecting their personal life with the care given to the women, and chances of advances in building daily work full of compassion, solidarity and humanization.

Our intention in socializing experiences, debating ideas, reflecting on professional practice, reducing the distance between the researchers and the researched, reception and care to the caregivers, went beyond our expectations. We exchanged knowledge — that is certain. But what was most important for us is that, together, WE BUILT KNOWLEDGE, elaborated concepts, redefined or canceled norms, marked other spaces, and built other possibilities of being and doing nursing, where there was room for the provisional and co-existence of temporalities, which includes a way of being a nurse marked by institutional submission, conformation to a practice which annuls the body of the caregiver, which blocks the visualization of the body cared for and which contains the steps in the dance of life and the game of work.

The feedback provided by the nurses during the process tells us how they felt and the importance they gave to the course, in statements such as "I am anxious because it is going to finish" and "I am going to use what I am learning here from this methodology in the work with my community."

In fact, we can feel even further the scope of these words when, for example, the group was asked to present a symbol of the client’s body and they presented a performance for this, although it had not been solicited. They used the "language" developed in the methodology, which shows they "got into the swing" of things and validated the proposal. They also inserted part of the memory they had developed into the collective memory mural.

The meeting which was supposed to have, a priori, on the one hand participants in a piece of research, and on the other hand faculty researchers, transformed all into women, nurses — dancers! And the methodology put us into a horizontal relation, hierarchy lost importance, and inequality was substituted by difference. We never felt so equal! In fact, bread and wine finally shared.

Notes

1. The molds used were taken from Gorezevisk and Franzói (1993), and show a mechanized body, symbolizing the institutional body, and another containing silhouettes and body parts which are to be put together.

 

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