Negotiated interactive observation: Doing fieldwork in hospital settings

Abstract

In this paper I discuss the possibilities and limitations of the ethnographer participating in the different on-going activities and events in highly specialised healthcare systems. The concept of participant observation is based on a number of assumptions, particularly that the ethnographer will become one of ‘them’ to be able to follow the steps belonging to the accepted ethnographic research practice of doing fieldwork. The character of fieldwork in highly specialised healthcare systems does not fit well with this assumption. I suggest that we need to rethink the concept of participant observation and I propose negotiated interactive observation as a more appropriate way to describe ethnographic fieldwork in a setting such as the hospital or the clinic.

Keywords:

• fieldwork
• participant observation
• negotiated interactive observation

Notes

Notes

1. There is a fourth possible role in some healthcare settings, though not in Denmark, the role of volunteer. In the ward in the hospital in The Netherlands where I did fieldwork, middle-aged women undertook volunteer work consisting of taking care of the flowers of the patients and helping with the distributing of food and drink.

2. The character of and the relative limited number of possible roles in the hospital makes it difficult to engage in what Otto calls cultural role-plays (see Otto 1997).

3. In the health sciences in general and in medicine especially, qualitative research studies have a low ranking (when ranked) on the highly influential evidence scales (see Sackett et al. 2000; Robson 2002).

4. I had the same experience with the smells and odours of the hospital and the clinic. Working as a nurse I didn’t notice the sometimes bad smells and odours, but now as an anthropologist I was very aware of the different smells. I still though am able to eat with pleasure and at the same time talk about and listen to stories about bodily fluids, wounds, blood etc.