Understanding Hope in HIV Care: A Narrative Inquiry into the Experiences of Nurses in Ghana

In this research, I sought to understand how nurses working in HIV care in Ghana live and work with hope. I tried to make visible how hope enhanced their work over time. Over several months in the summers of 2015 and 2016, I lived alongside five registered nurses as we explored how hope had shaped us. In this dissertation, I consider my narrative beginnings, review hope theories and the nature of hope in nursing practice alongside a narrative conceptualization of hope. My research puzzle was to inquire into what sustains nurses’ hope when working with people living with HIV in an acute care setting. I wanted to understand the experiences of nurses in Ghana and the ways that hope is intertwined with their experiences in HIV care. In this study, I invited five nurses from a tertiary hospital to make sense of their experiences of working with hope practices. The five participants—Eva, Lana, Berth, Jude, and Joy—and I attended to their stories to live by [a narrative conception of identity] using the commonplaces of narrative inquiry: temporality, sociality, and place. As we moved from field texts to research texts, we co-composed narrative accounts of their experiences. After looking across their narrative accounts, I identified four resonant narrative threads: becoming a nurse for people living with HIV over time; experiences of practicing with hope, despite hope threats; faith in God from which they gained strength; and learning to live with hope from childhood. By engaging in this inquiry, I learned that hope matters, but that it needs to be nourished. The commonplaces of narrative inquiry inspired an understanding of a narrative conception of hope, and made it visible that hope is an embodied lived experience. Calling on a Deweyan-inspired narrative conception of hope (LeMay, 2014) made it possible to live alongside nurses’ experiences of hope. I also learned that in order to sustain my 1hope I needed to stay wakeful to my hopeful practices