Practicing Sacred Encounters: A Narrative Analysis of Relational, Spiritual, and Nursing Leadership

169 Pages·2017·5.64 MB·English

Antioch University
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Dissertations & Theses
2017
Practicing Sacred Encounters: A Narrative Analysis
of Relational, Spiritual, and Nursing Leadership
Margaret Woodrow Mark
Antioch University - PhD Program in Leadership and Change
Follow this and additional works at:http://aura.antioch.edu/etds
Part of theHealth and Medical Administration Commons,Leadership Studies Commons,
Nursing Commons, and theOrganizational Behavior and Theory Commons
Recommended Citation
Mark, Margaret Woodrow, "Practicing Sacred Encounters: A Narrative Analysis of Relational, Spiritual, and Nursing Leadership"
(2017).Dissertations & Theses. 381.
http://aura.antioch.edu/etds/381
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PRACTICING SACRED ENCOUNTERS: A NARRATIVE ANALYSIS OF RELATIONAL,
SPIRITUAL, AND NURSING LEADERSHIP

MARGARET WOODROW MARK

A DISSERTATION

Submitted to the Ph.D. in Leadership and Change Program
of Antioch University
in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy

June, 2017
This is to certify that the Dissertation entitled:

PRACTICING SACRED ENCOUNTERS: A NARRATIVE ANALYSIS OF
RELATIONAL, SPIRITUAL, AND NURSING LEADERSHIP

prepared by

Margaret Woodrow Mark

is approved in partial fulfillment of the requirements for the degree of Doctor of Philosophy in
Leadership and Change.

Approved by:

______________________________________________________________________
Jon Wergin, Ph.D., Committee Chair date

______________________________________________________________________
Elizabeth Holloway, Ph.D., Committee Member date

______________________________________________________________________
Peter Vaill, D.B.A., External Reader date
Copyright 2017 Margaret Woodrow Mark
All rights reserved
Acknowledgements
I first express my sincere appreciation to St. Joseph Health, Mission Hospital and all of the
people who so graciously participated in this project. Without exception, every individual I met
demonstrated sacred encounters. I treasure my experience with each participant and will always
be grateful for the openness and authenticity I felt from every nurse leader. Specifically, I would
like to thank Jeff Theis who helped me get started down this incredible road of sacred encounters
along with Cindy Mueller, Diane Drake and Eithne Keegan who were my Mission Hospital
mentors and guides and who I will always consider friends.
The Antioch University PhD in Leadership and Change Program encouraged me to
discover my passion and to go study it. Thank you to Laurien Alexandre and the program
founders along with the entire faculty who designed and implemented a doctoral program that
brings out the very best in people. My cohort became my lifeline throughout this research and
during some very difficult times in my life. I know I would not have completed this work
without you all. Kori Diehl and Beth Valicenti, provided the kind of support that I can never
repay. Thank you both.
I am extremely grateful for the support of my doctoral committee, Peter Vaill, Elizabeth
Holloway and Jon Wergin, each of who taught me so much and expanded my thinking beyond
what I could have imagined. Jon, my chair, what can I say beyond thank you. It was not just the
knowledge, expertise and guidance that you gave to me. You always treated me like a colleague,
with the trust and respect that accompanies that relationship. Your patience and encouragement
were perfect. I could not have had a better chair.
My brilliant, witty editor Norman Dale, thank you. You are truly great at what you do.
You made the long, tedious end to my writing enjoyable and kept me laughing along the way.
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My deepest gratitude goes to my family who provided me with unwavering love and
support. You were my sacred encounters every single day. My husband Joe, you were as solid
as they come. It is not easy being married to a doctoral student during her very long research
project but you were there every step of the way. There are truly no words that describe how
much your support meant to me. You kept me grounded and loved. Thank you.
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Abstract
This research examined one large health system that has, through a stated mission outcome that
every encounter is a sacred encounter, sought to enhance relationships occurring within the
health care environment. Seeking to understand the lived experience of sacred encounters
through the lens of nurse leaders in one acute care hospital settings this study examined how
nurse leaders experienced their leadership role in realizing sacred encounters. Participants were
defined as nurse leaders from one hospital setting and included nurse managers, directors and
one vice president. A narrative thematic analysis framed by situational analysis was the method
of inquiry. Data was gathered through an intensive interview process eliciting an in-depth
exploration of the experience of the participants, along with their personal interpretation of that
experience. Two questions were asked to each participant, the first to gain an understanding
about their personal experience with sacred encounters and the second to allow the nurse leader
to reflect on his or her personal leadership behavior as it related to the realization of sacred
encounters within their primary area(s) of responsibility. A review of research of current
literature focused on relational leadership, spiritual leadership and nursing leadership theory. The
major finding was that organizational culture can be defined from the top of the organization
and, through well-defined and purposeful leadership behaviors, be realized at the point of
bedside care. This study was limited to a one-faith-based hospital. Future research should focus
on broadening the scope of inquiry about organizational culture and how espoused culture can be
translated into action through purposeful leadership behaviors. This dissertation is available in
open access at AURA, https://aura.antioch.edu/ and OhioLINK ETD Center,
https://etd.ohiolink.edu/etd

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Table of Contents
Acknowledgements .......................................................................................................................... i
Abstract .......................................................................................................................................... iii
List of Tables ................................................................................................................................. vi
List of Figures ............................................................................................................................... vii
Chapter I: Introduction .................................................................................................................... 1
The Evolving Health Care Industry ............................................................................................ 2
Health Care Leadership .............................................................................................................. 4
Relational Leadership ................................................................................................................. 7
Positionality ................................................................................................................................ 8
Sacred Encounters ..................................................................................................................... 11
Summary and Outline of Subsequent Chapters ........................................................................ 15
Chapter II: Review of the Literature ............................................................................................. 18
Complexity Leadership ............................................................................................................. 19
Relational Leadership ............................................................................................................... 21
Nursing and Leadership ............................................................................................................ 40
Spirituality and Leadership ....................................................................................................... 43
Chapter III: Methodology ............................................................................................................. 49
Choosing the Research Case and Setting .................................................................................. 49
The Researcher and the Research ............................................................................................. 53
The Research Method ............................................................................................................... 56
Narrative Inquiry ....................................................................................................................... 57
The Research ............................................................................................................................. 63
Study Limitations and Use ........................................................................................................ 70
Ethical Considerations .............................................................................................................. 71
Summary ................................................................................................................................... 71
Chapter IV: Results ....................................................................................................................... 72
Setting the Stage ....................................................................................................................... 74
Situating the Research .............................................................................................................. 78
Summary ................................................................................................................................. 112
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Chapter V: Discussion and Implications ..................................................................................... 114
Background ............................................................................................................................. 114
Brief Overview of the Situation .............................................................................................. 116
A Story of Sacred Encounters ................................................................................................. 116
Brief Overview of the Findings .............................................................................................. 119
The Four Themes Arising From Nurse Leader Narratives ..................................................... 124
Conclusions Regarding Themes ............................................................................................. 132
Implications for Practice ......................................................................................................... 132
Limitations .............................................................................................................................. 133
Implications for Future Research ............................................................................................ 134
Appendix ..................................................................................................................................... 137
Appendix A: Antioch University IRB Approval Letter .............................................................. 138
Appendix B: Mission Hospital Letter ......................................................................................... 139
Appendix C: Invitation Letter to Nurse Leaders to Participate in Study ................................... 140
Appendix D: Study Participant Consent Form ........................................................................... 141
References ................................................................................................................................... 143

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List of Tables
Table 4.1 Social Arenas Factors Influencing Mission Hospital ................................................... 82

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