Donna Frost

Chapter 6 192 a kind of ‘a-ha’ moment, or, ‘Yes! That’s it’, or a quiet feeling or realisation that ‘something’ had been resolved. The kinds of remarks noted, for example on or in relation to the creative expressions, during the critical reflective conversations held after a practice episode reflect these two qualities. For example, ‘Acts tentatively’, ‘Where’s it going?’, ‘hm, looong silence?!’, and ‘I couldn’t follow you here’ illustrate the observer feeling uncomfortable. The second aspect is revealed by remarks such as, ‘Hits the nail on the head’, ‘Aha!’, ‘Gets to the point’, ‘Acknowledges’, ‘Accepts’. While engaged inpractice, theperiod inwhich theobserver felt a littleuncomfortable was often the moment when the practising nurse ‘pricked her ears up’ or felt like she couldn’t or shouldn’t be doing anything else than what she was doing. Sometimes the nurse being observed noted afterwards that ‘it seemed so obvious’, or, ‘as you would have noticed’ even when the direction or essence of the situation had been something of a mystery for the observer. This was followed for the nurse in practice, by a feeling of ‘a-ha’, or ‘there you go’. The feeling of resolution was thus similar for both the observer and the observed. When the observer also knew the patient well, or was very familiar with the area of practice, they sometimes had their ears pricked up at exactly the same moment as the nurse being observed, but often, as shown in the example with Anna, Pieter and Mrs M, the connection and potential energy between the nurse and the patient did not include the observer. Residents and patients often described the nurse or NP as being like a guide or forest ranger; someone who knows the way (see Figure 6 . 7 ). Figure 6 . 7 Metaphors and similes used by patients, residents and their family members to describe working with the nurse or NP.