PRESENTATION AND ANALYSIS OF THE MAIN FINDINGS
4.3 THE RESULTS OF THE STUDY
4.3.1 Conceptualization of the process of establishing Communities of Practice
4.3.1.3 Collaborative and purpose driven working “Sisonke…together we can!”
Emerging from the data, it was expressed that the CoP contributed towards a collaborative and unified practice of nursing. Participants accounted their new way of working together to solve commonly shared HIV related problems as being a characteristic of the learning and interaction within the CoP. Participants used the expression, “Sisonke”, an isiZulu term which denotes togetherness, to refer to the shared interactions of the CoP and the bond of sisterhood which had been created in the context of nursing HIV/Aids. Their new found way of working together was a common thread that emerged and they likened it to “uBuntu”, a term denoting community spirit. The following selected excerpts presented below highlights this.
“we come together as a group...and we work towards making a change in our units...err...because as we are together...we can make a difference because we are all working towards this common goal...yabona’ iSisonke...where we come together in this spirit of togetherness...because we want to make a difference in how we nurse...” (Urban FGD, participant 1)
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“Participant 7...we are like this big family...err...and as we have started to grow and learn in pur nursing...err...i can say there is more unity in us as nurses...we want to go out there in our wards and make a difference...Participant 1you see how we are one like this uBuntu in our community...we are this same family here...and we are using all our efforts together to work to make a difference...” (Urban-FGD)
Data sources reflected that the, camaraderie among the participants created a greater work ethic and desire to move forward in ways to bring about change in their institutions regarding HIV/Aids practice. It was noted that this camaraderie contributed towards the development of inter-collaborative working relationships with other members of the multi-disciplinary team and that the collaborative approach empowered the participants to take control of their nursing practices. They were able to reaffirm their role of care provider, and the space of the CoP became synonymous to a platform for administering fair treatment to patients in the context of HIV/Aids nursing care. The following excerpts presented below highlight this.
“...I can say because we came together in this group...we were able to get that confidence...and you get that control again to be a nurse...to seek fair treatment for our patients...and to take care of them....so you learn how to be part of a group...err...not only in this group but how to work with others in the hospital... to speak out for things we could see were not going right ...like having meetings with different teams of the hospital to make sure we make a difference for our patients...’(Urban, FGD, participant 1)
“...when you approach other people because you are not alone...like you are in a group...so it makes it easier for your voice to be heard....and for change to happen soon...it was also easy for us to get information...like how we noticed this one testing kit was just giving us a problem...so it was easier to approach the PMTCT co-ordinator and share our experiences...so that something can get done...so if it wasn’t for the group....we was going to be alone...and not strong like when we are now like this...” (Urban, FGD, participant 10)
4.3.1.4 A space that fostered self-determination and self-reliance “staring to feel in control again…like a nurse again”.
It emerged that participants saw the CoP as a space which fostered a transformed way of nursing.
Participants acknowledged that the culture of learning, inquiry and support which underpinned
109 the CoP gave rise to a new self determined way for their nursing practice in the context of HIV/Aids. It was noted that the identities of participants matured and transformed parallel to the continuum of the learning trajectories of critical reflective development which occurred in the the evolving CoP. Expressed in the reflective discourses, it was noted that a deeper understanding of self was illuminated through the dialogue and discovery of hidden assumptions, beliefs and values regarding HIV/Aids and nursing. The following selected excerpt illustrates this further.
“ ....I can see in how I think...and how I see nursing again...I can say I have taken charge of my nursing again...before...I used to feel so overwhelmed...you know err...i used to feel so lost and to think sometimes....if I am still doing the nursing I wanted to do when I first started my training....err...now I have taken charge of how I practice again...and I feel confident...because as I was growing in this reflective practice...I could see that even how I think and work with the rest of the group was changing....” (Rural individual interview)
“...err...when we come and share...you even start to see things about yourself...and how we are towards people with this HIV...and even in myself...I can say that I am feeling changed...how I used to nurse is different now...err...if I can say that I can see that I look at the bigger picture...of how I can help as a nurse...and even together as a group...I can see we are more in control...we don’t let the problems take over us....” (Rural FGD participant 6)
Another attribute that was noted from the participants was that of a professional identity that grew over time within the CoP space. Participants spoke of the learning that the CoP had cultivated and how it had led to self actualization of learning outcomes, such as critical thinking and skill development. For example, many of the nurse participants had not been familiar with the use of computers prior to their engagement in the CoP. This fostered an identity of self worth and empowerment in terms of their identities as a nurse and their professional development. The selected excerpt presented below highlight this.
“....learning new things like how to use the computer...and how to read these documents and even my thinking it has changed me...I can now see the value in learning....to grow...before even
110 when we did this in-service training on things like PMTCT counseling in the hospital...err....like it was part of the in-service training...but it did not make much of a difference in our nursing practice...but now....I can say we have this skills and it makes you to feel different of how you think...” (Urban FGD participant 5)
“...being in the group helps you to change you as a nurse...before it was like you feel ashamed of nursing...even your neighbours who know you are nursing...it was like you are beneath them...especially because of this HIV...because there is this shame that comes with it....and now you too get that same feeling...because you are not confident in what you know...but now...we come here...we grow and learn from one another...even new things like how to do this group discussions....and the reflection...it changed your thinking of being a nurse...now you are proud....again to be a nurse....because we are stronger in what we know...” (Rural individual interview)