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Evidence suggests that hospital patients receive the medical treatment they need but are sometimes left feeling depersonalized and alienated with their overall treatment. This New Zealand study explored the lived experience of hospitality among adults during their recent hospital stay. A hermeneutic phenomenological methodology was used to design and conduct the study. Seven participants, aged 22 to 65 years, who had spent at least three days in a hospital for elective surgery were purposively recruited. Data were gathered using semi-structured, conversational-style individual interviews. Participant-validated, coherent stories were drawn from the transcripts and analysed. The findings revealed that hospitality showed itself in different ways to the participants. When present, they experienced feelings of comfort, of being at ease and of being healed. The implications for health care practitioners are that offering often small, yet heartfelt acts of hospitality may evoke powerful lived experiences that benefit the patient, suggesting that caring about the patient is an important element of the healing process.
HOSP 6 (2) pp. 113–129 Intellect Limited 2016
Hospitality & Society
Volume 6 Number 2
© 2016 Intellect Ltd Article. English language. doi: 10.1386/hosp.6.2.113_1
lived experience
New Zealand Aoteroa
Auckland Institute of Studies
Auckland University of Technology
Hospitality in hospitals: The
importance of caring about
the patient
Evidence suggests that hospital patients receive the medical treatment they need but
are sometimes left feeling depersonalized and alienated with their overall treatment.
This New Zealand study explored the lived experience of hospitality among adults
during their recent hospital stay. A hermeneutic phenomenological methodology was
used to design and conduct the study. Seven participants, aged 22 to 65 years, who
had spent at least three days in a hospital for elective surgery were purposively
recruited. Data were gathered using semi-structured, conversational-style individ-
ual interviews. Participant-validated, coherent stories were drawn from the tran-
scripts and analysed. The findings revealed that hospitality showed itself in different
ways to the participants. When present, they experienced feelings of comfort, of
being at ease and of being healed. The implications for health care practitioners are
that offering often small, yet heartfelt acts of hospitality may evoke powerful lived
experiences that benefit the patient, suggesting that caring about the patient is an
important element of the healing process.
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114 Hospitality & Society
Historically, hospitality centred around offering physical comfort in terms of
food, beverage and accommodation as well as psychological comfort offered to
others by a host (Burgess 1982). Hospitality was not only offered to the travel-
ler but also to the sick; indeed, care of the sick was considered to be an act of
hospitality in religious times (King 1995), and it is from the monastic hospitality
given to the sick in the Middle Ages that the first hospitals evolved (O’Gorman
2006). The connection between the church and hospitals has eroded over the
centuries and today hospitals are mostly either privately or publicly managed,
although there are still some examples of religious orders working in hospitals
(e.g., Mercy Hospital in Auckland). This study will investigate the lived experi-
ence of hospitality among adults during their recent hospital stay.
Within the health care literature it is suggested that hospitality in health
care is an important emerging concept (Bunkers 2003; Gilje 2004). However,
much of the research surrounding patient experience in hospital has focused
upon the delivery of customer service through the implementation of service
delivery systems that measure quality through a battery of systems and proce-
dures (Descombe and Eccles 1998; Randall and Senior 1994; Severt et al.
2008). Although this is important for the effective management of much of the
daily functional aspects of running a hospital, it has been recognized that other
factors including hospital amenities and interpersonal relationships play a
significant part in meeting the expectations of the patient (Jenkins et al. 2011).
Some of the existing literature suggests it is the interpersonal relationships with
health care professionals that influence a patient’s overall care experiences and
their sense of well-being (Patten 1994; Wright-St Clair, 2001). However, when
providing care to a patient the interpersonal relationships between hospi-
tal management, staff and patient may be fraught with tension (Cockburn-
Wootten and Brewis 2014). This suggests a need to explore those interpersonal
relationships surrounding the patient experience in an attempt to understand
more about how a patient is feeling and thinking. Such an approach would
be a departure from the dominant discourse that has tended to use quantita-
tive approaches aimed at analysing customer satisfaction surveys (Severt et al.
2008). Such a logical positivist approach has not allowed for a more in-depth
understanding of the thoughts and emotions of the patient.
Hospitality is not easily defined, leading to a contradictory debate among
academics in recent years (Brotherton 1999; Hepple et al. 1990; Lashley 2000).
Yet, to pursue a construct of hospitality and its impact on care within hospitals
it is necessary to define its meaning in the context of this study. Hospitality is
subjective and not a ‘matter of objective knowledge’ (O’Gorman 2007a: 201),
which therefore allows for many interpretations of hospitality. A common, yet
simplistic definition suggests that hospitality is associated with the offering of
food, drink and accommodation between the guest and host in a hospitable
manner (Brotherton 1999; Hepple et al. 1990; King 1995; Lashley et al. 2007).
A broader definition suggests hospitality is rather more than a brief exchange
between two people concerning food, beverage and accommodation; instead,
it entails many components and is interpreted in many ways:
1. It is conferred on a guest who is away from home.
2. It is interactive, involving the coming together of a provider and a receiver.
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Hospitality in hospitals 115
3. It comprises a blend of tangible and intangible factors.
4. The host provides for the guest’s security and psychological and physi-
ological comfort.
(Hepple et al. 1990: 308)
Brotherton (1999) implies that these definitions confuse hospitality with
hospitable behaviour, which sets hospitality apart from other service indus-
tries. He suggests that accommodation is more than a bed offered within a
commercial or private dwelling; rather, it is any space where hospitality is
offered. Although he is concerned more with constructing hospitality around
its management within a commercial capacity, the idea of accommodation
being viewed as a space is significant. In a spiritual context Nouwen (1976)
proposes that hospitality should encompass a free and friendly environment
offering physical, emotional and spiritual space to strangers.
The interpersonal relationship between guest and host may create
hospitable behaviour that is often associated with true hospitality. Indeed,
it has been suggested that genuine hospitable behaviour requires a motive,
and these motives include a concern for the welfare and pleasure of the
guest (Telfer 2000), although Derrida (2000) argues that pure hospitality is
unachievable because of the power distance relationship in existence between
the guest and the host, which creates what he calls ‘hospitality’. Telfer (2000:
47) describes one motive as being to care for those in need, which she terms
‘Good Samaritan hospitality’, and it is perhaps this definition that has most
relevance to this study as it is arguably those individuals who are lonely and
need to feel valued and recognized as an individual who are particularly well
served by hospitable behaviour from others.
This notion of genuine hospitality described by Telfer (2000) being linked
to caring may be due to the historical roots of hospitality and religion, in
particular monastic hospitality where monks were both practising hospitality
and writing about it under St Benedict’s Rule (Lashley and Morrison 2003;
Nouwen 1976; O’Gorman 2007b). A traveller was invited into a monastery,
where hospitality was generous and freely given, yet meeting the physical
needs of the guest counted for little if not carried out in a sincere manner
(O’Gorman 2006). It was the emphasis on offering a genuine act of hospi-
tableness that was of significance, and monks would often perform acts of
symbolic kindness to the stranger – for example, washing their feet. Monks
were also reminded that it was the poor, rather than the rich, who had the
greatest need and should receive special care (King 1995; O’Gorman 2006).
It was the care offered to the sick during religious times that was consid-
ered true hospitality (King 1995), and it was from the hospitality given to the
sick in early monasteries that the first hospitals evolved in the Middle Ages.
The connection of churches being associated with caring for the sick has
mostly eroded over time, to be replaced by public hospitals that are run by
local municipalities or private health care (O’Gorman 2006).
Lugosi (2008) and Hemmington (2007) argue that much defining of hospi-
tality continues to focus on a rather narrow set of transactions, involv-
ing food, drink and accommodation, often ignoring the significance of both
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116 Hospitality & Society
entertainment and social interactions. Emphasis is placed upon service deliv-
ery and service quality, which fails to capture any of the excitement or vibran-
cies of the commercial hospitality industry (Hemmington 2007), with much
of the ‘essence’ of hospitality found in its earliest forms, in monasteries and
in the home, being lost among the impersonal exchanges within commer-
cial hospitality (Lynch et al. 2011; O’Gorman 2008). It is suggested that the
consumer experience is essential when delivering hospitality products because
this creates memories, and it is this concept of a ‘memorable experience’ that
Hemmington (2007) argues is so important because it is this that the guest
will take home – much as a patient does from hospital.
Lugosi (2008) emphasizes the significance of the relationship between
entertainment and hospitality exchange and, like Telfer (2000) and King
(1995), the word entertainment is used interchangeably with hospitality.
Including entertainment as part of the hospitality concept enables a distinc-
tion to be made between different forms of hospitality transactions and
hospitable behaviour (Lugosi 2008). Furthermore, hospitality transactions
may provide the basic economic, social or political needs for a guest, but ‘a
hospitable interaction is an acknowledgment of the other’ (Lugosi 2008: 141).
In his model pertaining to three manifestations of hospitality Lugosi (2008)
describes hospitality in its highest form as meta hospitality. At the centre of
the encounter is an emotional experience. It requires those involved to dispel
preconceived ideas and judgements with regard to the other so that mutual
well-being and joy is created in a shared experiential space.
It is perhaps this deeper sense of knowing the other that creates an emotional
connectedness, which may form the basis of understanding caring in health
care. Wright-St Clair (2001: 189) argues, ‘When attuned to a client you feel it
in your heart, not just the head. You are drawn to caring. This level of caring
is somehow related to having a holistic perspective and seeing the whole
person’. It is when a carer shows compassion, sometimes in the smallest of
acts, that not only does the patient feel cared for but the health care profes-
sional may also feel more positive within themselves (Youngson 2012).
Yet the concept of hospitality within the health care literature is still
seen as one that is emerging (Bunkers 2003; Gilje 2004), despite academics
suggesting that ‘hospitality issues must become a greater part of today’s nurs-
ing management’ (Patten 1994: 80a). Investigations of hospitality in a hospi-
tal setting over the last 25 years have failed to critically examine the social
and dimensional forms of hospitality (Hepple et al. 1990; Severt et al. 2008).
Patten (1994) supported this idea, and produced a nursing framework with
three levels of hospitality – public, personal and therapeutic – which appear to
mirror that of Lugosi’s (2008) manifestations of hospitality. Public hospitality
may be described as a brief personal exchange, involving politeness, prob-
ably occurring at reception during an enquiry or admittance procedure for
the patient. Although brief, the exchange sets the foundation for the patient’s
stay, and the initial welcome leaves a lasting impression. Personal hospitality
has some emotional involvement, perhaps a sharing of interests and opinions
between the hospital professional (host) and the patient (guest). The thera-
peutic level of hospitality (comparable to Lugosi’s meta hospitality) encom-
passes a more ethical and moral dimension, which may create the basis for
healing, and includes the therapeutic use of self (Patten 1994). Patten relates
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this to Nouwen’s (1976) concept of hospitality where he discusses the human
situation as being one of pain and loneliness, which may be altered when a
friendly space is created by others, enabling them to reach out and tell their
own stories. This approach is also referred to as humanistic nursing, charac-
terized by concepts such as holistic, individual, empathy, intimacy, coping,
caring and choice to create a humanistic rather than dehumanizing experience
(Paterson and Zderad 1976).
The models of hospitality presented by Patten (1994) and Lugosi (2008)
would seem to show similarities in their interpretation of hospitality, suggest-
ing it involves a significant emotional connection between the host and the
guest. It is the emotional experience that is at the centre of the encounter, a
hospitable act that abandons rational judgement to offer complete acceptance
of the other and which in turn creates mutual well-being for both parties. It is
this openness, recognized as being only a ‘moment’, a temporary exchange,
that is regarded as true hospitality. It is also described as acting with true pres-
ence, of attending to others and acting with a spirit of hospitality (Bunkers
2003; Lugosi 2008; Patten 1994).
‘Presence’ emerged in the nursing literature in the 1960s, and it was
conceptualized as a philosophical model that was derived from the existen-
tialism of Gabriel Marcel and Martin Heidegger (Stanley 2002). Presence has
been described as a ‘gift of self’ characterized by availability and openness
(Paterson and Zderad 1976). Stanley (2002) regards the paradigm of nurs-
ing presence as crucial in order to enhance the patient’s lived experience.
Nurses have described experiences of presence as being both meaningful for
them as well as for the patient, provoking feelings of comfort and peaceful-
ness while diminishing anxiety and vulnerability, often when no words exist
to fill the emptiness patients feel. In contrast, when a nurse shows little inter-
est in the lived experiences (van Manen 2001) of a patient and treats them
merely as an object for analysis, a patient feels alienated and not cared about.
Patients recognize that nurses are busy but describe a yearning for someone
to show some interest in them as human beings, to connect with them on an
emotional level (Renzenbrink 2011).
Previous studies in health care have focused upon analysis of customer satis-
faction surveys to assist management in the application of service models
to improve service delivery for patients as well as operational efficiency
(Descombe and Eccles 1998; Fottler et al. 2006; Randall and Senior 1994).
Yet it is suggested that patients are often more concerned with how they are
spoken to and communicated with rather than with elements of their medi-
cal care (Patten 1994; Elliott et al. 2010). Research into the service quality in
hospitals highlighted three key elements – technical care, interpersonal rela-
tionships and the quality of hospital amenities and environment – with the
non-medical dimensions recognized as being critical to meeting patients’
overall expectations. Improving the delivery of support services has been
found to promote patient safety, treatment, recovery and a sense of well-
being (Jenkins et al. 2011).
Patients want to experience feelings of ‘at homeness’ (Hepple et al. 1990:
309), of being welcomed and connected to nurses, which then creates a sense
of feeling at ease with oneself and with others in their surroundings (Gilje
2004). The physical environment is considered an essential element of the
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patient experience, with some hospitals using hospitality-inspired designs
within a hospital setting to appeal to and reassure patients (Wu et al. 2013)
and to ensure they are ‘treated with dignity and respect’ (Annunziato 2000:
55). It is recognized that the surrounding environment can have a significant
impact upon a patient, affecting their emotional, cognitive and psychological
states (Bitner 1992; Jenkins et al. 2011). Indeed, upon launching a project in
2004, HRH The Prince of Wales commented, ‘It could not be easy to be healed
in a soulless concrete box with characterless windows, inhospitable corridors
and purely functional wards’ (Renzenbrink 2011: 35).
The patient experience is impacted by the many relationships, power
struggles, organizational demands and expectations that are at play in a
hospital context, which can create tensions between health care profession-
als, management and other patients (Cockburn-Wootten and Brewis 2014).
In addition, some health care professionals find themselves in a work envi-
ronment that is aggressive and violent, which leads to burnout and in some
instances post-traumatic stress (Rippon 2000; Vaez et al. 2014). Instances of
violence and verbal aggression towards health care professionals from patients
may lead to a lack of enthusiasm and to depersonalization of work (Gascon
et al. 2012), which is likely to impact the ability and desire of nurses to act
with true presence and connect emotionally with patients. The tensions that
exist in health care are acknowledged but it is beyond the scope of this article
to draw conclusions on their impact upon hospitality and care.
Although many studies have been conducted within hospitals and
customer service, there is a gap in the literature surrounding the contribu-
tion of hospitality to inpatient care (Gilje 2004; Severt et al. 2008). Relatively
few studies have explored hospitality in a nursing and hospital context
(Gilje 2004; Paraschivescu et al. 2011). Within the health care domain much
emphasis is placed upon medical treatment for patients, but there is evidence
to suggest that other factors also play a part in the treatment plan and care
of patients. This study will investigate the impact of hospitality on caring
for the patient by developing an understanding of the lived experiences of
hospital patients.
A research approach was chosen that would stay close to the participants’
experiences to provoke thinking and point to a more authentic understanding
of what is lived hospitality for a hospital patient. This study used a herme-
neutic phenomenological (Heidegger 1927/1962) approach, which is recom-
mended as a method of enquiry when trying to understand more about the
nature and meaning of the lived experience (Laverty 2003). While phenom-
enology is not so commonly used by academics in hospitality, it is widely used
within health care and nursing research because of its focus on the human
lived experience (Smith 1998). Phenomenology does not seek to solve prob-
lems it asks ‘meaning’ questions, so that a situation may be better understood
(van Manen 2001). It is this style of research that enables the researcher to
uncover what it is to be human, ‘what it is to be’, and to uncover the what ‘is’
(Smythe et al. 2008).
Phenomenology attempts to uncover the essence of a phenomenon by
using descriptive language in such a way that it uncovers new and deeper
meanings of a particular experience. ‘Phenomenology asks for the very
nature of a phenomenon, for that which makes a some “thing” what it is and
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Hospitality in hospitals 119
without which it could not be what it is’(van Manen 2001: 10). The phenom-
enon of interest is ‘experiencing hospitality’, with a focus on the ‘being there’,
an approach used by Heidegger, referred to as ‘Dasein’, to signify human
existence as situated in a mode of ‘Being-in-the-world’ (1927/1962: 65).
Heidegger firmly believed that consciousness is not separate from the world
but it is a part of our historical lived experience (Laverty 2003), and as such
a person’s ‘Dasein’ will always influence their thoughts, their ideas and who
they are as a person. Indeed it is this very construct that Heidegger believes
to be important, a ‘fore-having’ that grounds a researcher’s interpretations
(Pernecky and Jamal 2010). These pre-understandings are described meta-
phorically as ‘a fusion of horizons’ by Gadamar, who describes a horizon as
a vision from a particular vantage point. It allows for seeing far beyond what
is close at hand (Laverty 2003). An enquirer is then challenged as they move
backward and forward in their thinking during interpretation, allowing hori-
zons to move with them (both theirs and the participants’), which eventually
fuse together to uncover a deeper understanding of a lived experience (Koch
1999). It may be construed as a limitation that pre-understandings will influ-
ence interpretations, but within interpretive phenomenology the researcher
and participant are regarded as being interactively linked in the creation of
meaning, and the idea of being value free would result in the loss of certain
kinds of knowledge about the human experience (Laverty 2003).
The phenomenon of interest is the ‘lived experience of hospitality within a
hospital setting’. As such it was important that participants had been admitted
to the hospital for a period that enabled them to have had a lived experience.
It was decided therefore that the inclusion criteria would be hospital admis-
sion for a minimum period of at least three days in the last two years for an
elective surgical procedure, and patient age between 25 and 55 years. Ethics
approval was granted from the Auckland University of Technology Ethics
Committee. Participants were not interviewed while in hospital but after their
discharge from hospital but within this specified time period so that they still
had a good recollection of their lived experience. Participants were recruited
using purposive sampling and snowballing. Seven women volunteered. It was
unfortunate that no man volunteered who met the criteria, which is clearly a
limitation of this study. Some had been admitted to a private hospital, while
others had been in a public hospital, for a variety of surgical procedures. The
specific medical procedure was not relevant to this study, but elective medical
patients were recruited because they were expected rather than being emer-
gency admissions, which may create a very different expectation or experi-
ence. The participants were from various cultural backgrounds, including born
New Zealanders and Indian-born New Zealand citizens, of a broad age range
within the inclusion criteria.
Data were gathered through semi-structured, individual interviews at the
participants’ own homes, not in a hospital setting, lasting 5090 minutes, using
a conversational-style technique. Congruent with hermeneutic phenomenol-
ogy, questioning was designed to gently probe participants to evoke stories
about particular moments of being in a hospital, as well as exploring their
understanding of their experiences. Interviews were audio-recorded and tran-
scribed verbatim. The data were first analysed through immersion in the tran-
scriptions, rereading the text until coherent stories were drawn of the ‘ah ha’
moments (Smythe et al. 2008: 1390) in which stories evocatively described
hospitality experiences. Participants’ stories were returned to them, with
participants experiencing ‘phenomenological nods’ confirming that the stories
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accurately captured their lived moments as a patient the way they had expe-
rienced them.
Using Koch’s (1999) method, stories were interpreted through immersion
within the hermeneutic circle, to uncover a deeper meaning of the impact
of the hospitality experience for the hospital patient. The highly illustrative
stories were clustered together into those that had similar themes, and then
interpreted by the author to understand the meaning and implications of the
text, a critical approach referred to as a ‘hermeneutic of suspicion’ (Koch 1999:
27) aimed at uncovering that which is hidden at first. It is these notions that
have been uncovered that will be discussed further to explain the ways in
which hospitality revealed itself to patients. Illustrative stories taken from the
participants’ original transcripts are presented. Each participant has a pseudo-
nym to protect his or her identity.
This section outlines the key themes to emerge from the hospital stories of
participants. A common theme centred around hospital staff being involved
and connecting with the patient, often by simply taking the time to walk
with the patient in their journey of healing and recovery. Patients were clear
about the importance to them of being respected as an individual by the
hospital professionals and support staff who were caring for them. Caring
‘about’ rather than merely caring ‘for’ the patients led to hospitality being
truly present (Stanley 2002). The absence of this and a sense of being ignored
impacted very forcefully on the patients’ hospital experience. The phenome-
non of hospitality revealed itself to the participants in different ways; however,
the notion of being cared about (or not) was a recurring theme within the
data. Highly illustrative stories that were extracted from the interview tran-
scripts are offered, followed by interpretive text uncovering the many ways
hospitality plays out within a hospital setting.
Participants spoke of the ways in which hospitality led them to a sense of
being healed, and it was often a small action of the health care professional
that evoked a special moment that left them feeling healed. Tina’s story
uncovers a ‘wow’ moment during her hospital stay when a midwife took the
time to get involved and really connect with her:
There was one really amazing midwife who bathed the baby. She rang
Mum; she wanted Mum’s phone number; she wanted to ring her; she
wanted me to give her my phone so she could ring her, so that Mum
could come in and help her bathe the baby. She said we will wait for
you, so you can help with baby’s first bath. At first Mum and I were
taken aback; we thought it a bit weird. But she wanted Mum to be part
of it. She had been counselling me a bit; she knew we had issues with
the in-laws, that whole family thing, and Mum was feeling left out. The
midwife had been listening to our conversations so she had got person-
ally involved. I was shocked at that. I thought she was interfering at first
but actually she was really, really nice; she was going out of her way to
get everyone involved; it was quite ‘wow’; that was amazing. She really
went over and above what she had to do.
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The story reveals that the midwife recognizes a benefit to Tina in meet-
ing more than her immediate medical needs. It is through a close personal
connection and intimacy towards Tina and her mum that she perhaps
provides a deeper level of healing, although Tina is a little uncomfortable
at first when she realizes that the midwife is listening to the conversation
between her and her mum. This opening of an intimate space in which
Tina has allowed the midwife to enter creates a very special kind of healing,
described by Patten (1994) as therapeutic hospitality. Patten (1994) refers to
this as the therapeutic use of self and is based upon Nouwen’s (1976) para-
dox of hospitality, which creates a friendly space where strangers and hosts
can enter freely to share their own stories. This action is received by Tina to
be totally unexpected; she is shocked that a stranger, a person who has only
just walked into her life, should do so much for her. She finds it difficult to
comprehend that anyone would give so much to her, so unconditionally. Yet
the ‘wow’ moment that occurred in this instance brought Tina and her mum
great comfort. It brought closeness and it perhaps brought healing to them
It is the actions of others that go beyond a prescribed service or technical
procedure that create a memorable hospitality experience (Hemmington 2007;
Lugosi 2008), and it is often the interpersonal skills that staff display, rather
than their technical skills, that a guest remembers and lead to high patient
satisfaction (Patten 1994). The midwife’s actions may convey her naturalness
towards healing; however, the effect upon Tina is a very memorable hospital
Staying in hospital for any period of time can lead some patients to feel a
loss of identity of who they are, particularly if no one shows much interest
in getting to know them. For some patients like Susan this was heightened
because her operation had left her unable to speak, rendering communication
quite difficult.
Susan’s story illustrates the effect it had upon her when staff shared a little
of themselves and gave her a bit of their time:
They were lovely, the nurses. Some were more rushed than others and
more efficient than others but the Filipino nurses I have to say were
fantastic! I commented by writing to one, that I thought he was really
good. Most of the staff, yes their efficiency I thought that was very good.
My … I didn’t tell them about the slack nurses up the top! But what
really made a difference were the nurses that made a personal connec-
tion: ‘what are you reading? I have read that, what do you think of this?’
Even those who were really, really busy if they give you a bit of time,
that was very much appreciated, that they would share a bit of them-
selves. Sometimes I would be writing on my pad and they could see
without asking, and they would take their time to read it and respond
to a question. The ones that made me feel I was cared for were those
people who gave you a bit more time and it is hard as they are so busy
and they can’t all do that. But some people just give that extra, even if
it’s just a smile and how are you today and hey you are looking better,
that sort of thing.
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122 Hospitality & Society
Susan understands that the nurses are busy with many duties to perform; she
is very accepting of that, yet when one of the nurses makes some time to
talk to her, to show a genuine interest in her, she feels really cared about.
This small action, this enquiry about the book she was reading, created a
brief momentary connection, an emotional shared experiential space between
Susan and the nurse. This emotional hospitable act can occur only when those
involved ignore any rational judgements or preconceived ideas they may have
about the other to create a moment of mutual well-being (Lugosi 2008). Such
a moment is described by Lugosi (2008) as a form of hospitality, called ‘meta
hospitality’, when an emotional encounter is created by allowing an open-
ness to be given towards the other. Susan is quite transformed within herself,
she is happier within herself, she recollects that it was those nurses who gave
her some of their time, who got to know her a little, that made a big differ-
ence to her patient lived experience. A patient often has too much time to just
think and worry about their situation, perhaps experiencing alienation due
to the strange environment they find themselves in (Renzenbrink 2011). It
is suggested that time spent in conversation with a patient is an act of caring
that embodies the kindness and ethical treatment that can play a significant
part in the healing of a patient (Peloquin 1994).
When a personal connection is made, it displays a unity of hospitality and
true presence promoting a quality of care (Stanley 2002). This connection may
be demonstrated in a small gesture. The act of acknowledgement given to
Susan from the nurse, just a smile and how are you today, made her feel valued,
feel human and really cared about.
When the participant was treated with respect they felt so much happier
within themselves. Beth has a real problem with bruising on her arms, the
result of giving blood on several occasions. She is very anxious about having
to give blood again.
Ok, so I had bruises all up my arms; thankfully they had inflicted that
upon me when I was asleep! I had bruises everywhere, and I had an IV
over here which is only just functioning and then the blood taker comes
to take more blood off me. I looked at my hands and I said to her, ‘I
have got no more veins, I have collapsing veins, so taking blood off me
is a real problem.’ I said to her can you use a paediatric needle and just
go through this vein. And she listened to me, she did it and it worked!
It was really good that the blood taker actually listened to me and didn’t
ignore what I had to say as that would have stressed me out massively.
She listened; thank goodness someone listened to what I said and it
was a very good experience.
In the retelling of her story Beth appears to be joking about the fact that her
body is full of bruises; yet it is clear that she is worried about having to give
blood. She describes the health care worker as the blood taker, suggesting she
is very worried about the consequences on her body. Yet the anguish for Beth
dissipates when the blood taker listens and respects her wishes. A common
complaint from patients in hospital is that their individuality is often ignored,
leading to feelings of depersonalization. The extent to which this exists will
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Hospitality in hospitals 123
depend upon the attitude of each individual health care professional they are
in contact with (Hepple et al. 1990).
The way that the blood taker listens to Beth shows a genuine interest and
duty of care towards her. She demonstrates presence and empathy in her
actions and a deep understanding of what is best for Beth, with compassion
and humility, not arrogance (Stanley 2002).
True presence may show itself in many ways. One such way is through intui-
tion, the way in which a person shows an inner understanding of the needs of
others. The next story is retold by Grace and highlights a moment in her stay
when she is being healed through the presence of intuition:
One night I couldn’t go to sleep and I had plenty of drugs in me so I
don’t know why? But then one of the nurses said, ‘Oh sometimes you
know if we put an extra blanket over your feet and really tuck you in
then you can fall asleep.’ And I thought, oh that’s nice. ‘Yes please’. And
it worked. Having the extra blanket over my feet must have just tipped
the balance.
Grace’s story hints of agitation at finding herself unable to sleep. She does
not ask for any assistance. She is accepting that at this moment she is simply
unable to sleep. Then something unexpected happens to Grace. A nurse
comes to her. She observes that Grace is awake and a little restless, so she
makes a suggestion of how she can help her. She wraps her up in a blanket
and tucks her in. She demonstrates a kind of intuitive knowing; she under-
stands the needs of Grace; she demonstrates her experience and her willing-
ness to care; she shows hospitableness, and Grace falls asleep. She provides
security and psychological and physiological comfort, which is described as
hospitality (Hepple et al. 1990).
It is perhaps not the action of tucking Grace up in a blanket that aided
Grace in sleeping but the action of someone showing real compassion and
understanding of her situation. It is acknowledged by Stanley (2002) that
presence requires intuition. It cannot be learnt but it may be acquired through
the lived experience of the practitioner. It seems that Grace is recognized
as an individual, as a person by this nurse; she goes beyond the delivery of
purely technical duties to recognize that for Grace to be comfortable and to be
healed she needs something else.
This study also revealed moments when hospitality was absent and the rela-
tionship between the guest and the host was not a hospitable one.
Clare’s story uncovers an occasion when she does not feel healed, when
she feels ignored:
The nurses are the ones who look after you a lot more than anyone
else in the hospital and their social skills are not always good. They
need some education about hospitality. Yes they are stressed. You have
20 patients to attend to but do all of them have a bad day? I mean maybe
one has a bad day. I think it comes down sometimes to education and
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Rosalind Kelly | Erwin Losekoot | Valerie A. Wright-StClair
124 Hospitality & Society
how things can be done a little bit differently, come across a little bit
differently, or said a little bit differently. I mean especially the nurses
who come and jab the line in your hand. Gosh, ha ha, I am really hard
to get a line in, and I say, ‘Oh no I don’t want to do this.’ Some of the
nurses they roll their eyes about it but then there are others who say it’s
ok, it will just be a small prick and it’s gone and I’ll be done. That’s so
much better and you can feel the difference.
This story from Clare talks about the lack of hospitality that is given to her
by the nursing staff. She interprets hospitality as the way in which the nurses
interact with her, their social skills. She is quick to empathize with the nurses
in terms of their workload and the number of patients they care for. Yet she is
unhappy with the way she is communicated with by so many: she asks do all
of them have a bad day? It appears that the nurses are doing the jobs they need
to do, but the way in which they are completing their tasks leave Clare feel-
ing depersonalized and ignored. It is only the symptoms of the illness that the
nurses are addressing and not the person inside the body who has feelings,
thoughts and emotions. It is interesting that genuine hospitality originated
in the treatment of the sick in religious times (King 1995; O’Gorman 2006)
and yet in this instance it has been lost and replaced with the completion of
technical tasks and duties that lack any concern for the welfare or pleasure
of the guest. Described by Telfer (2000) as essential when caring for those
in need, it is suggested that health care practitioners should understand that
they become significant others to the patient due to the special connection
that illness brings (Peloquin 1993).
These interpretations have explored the interpersonal relationships
between the health care professional and the patient; it is these relation-
ships that have a significant impact on the overall patient experience. It has
been suggested by Nouwen (1976) that many patients may leave the hospital
healed of their illness but with hurt feelings due to the impersonal treatment
that they have received. Being in hospital is an unusual event for most people,
which may be emotional and even fearful, which is not always acknowledged
by health care professionals, who are sometimes silent and impersonal when
providing treatment (Peloquin 1993). However, these findings suggest that
when the health care professional gets to know the lived experience of the
other a friendly space is opened, a space that is free from judgement, which is
safe and open. It is then that the patient feels comfortable enough to tell their
stories to someone who will really listen (Nouwen 1976). Listening with real
attention is a skill described by Nouwen (1976) as one of the highest forms
of hospitality. It is through the listening of the stories that are told, of being
interested in the stories, that the host really gets to know and fully understand
the guest. It is only then that healing will begin (Bunkers 2003; Nouwen 1976).
The aim of this study was to uncover the nature of hospitality within a hospi-
tal setting. By using a hermeneutic phenomenological approach, it sought a
better understanding of the lived experience of the hospital patient. Through
the use of such an approach, it aimed to develop a better understanding of
the meaning of the words that were spoken (Gadamer 1993). It is through
interpreting the lived experience of being a hospital patient that this study
HOSP_6.2_Kelly_113-129.indd 124 7/11/16 2:09 PM
Hospitality in hospitals 125
seeks a deeper understanding of the ‘other’ factors that surround the medical
care of a patient in an attempt to discover whether hospitality is a healer. The
findings reveal that hospitality appears to have significance when it is present
in the lives of a hospital patient, leading to an overall feeling of being cared
about. It suggests that when it is absent, when the delivery of care becomes
purely technical and impersonal, the patient is left feeling dehumanized and
ignored. This compares to some commercial hospitality operations that are
accused of ignoring the importance of customer experience and focusing too
heavily on service delivery in an impersonal way (Lugosi 2008; Hemmington
2007). When attention is given to the patient in a genuine manner the essence
of hospitality found in its earliest forms in monasteries (Lynch et al. 2011;
O’Gorman 2008) creates feelings of comfort and of being cared about.
Hospitality revealed itself in ‘the listening’ by health care professionals to
the stories that the patients narrated, and in the emotional connection between
health care workers and patients. It was sometimes demonstrated in very small
ways, like in the nod of the head or with a look into the eyes, but these actions
demonstrated a manner of acting with a ‘spirit of hospitality and attending to
the other with true presence’ (Bunkers 2003: 307). The effect of their actions
upon the patient was to create a mutual well-being, a hospitable act that disre-
gards any judgement of the other, described as pure hospitality (Lugosi 2008;
Patten 1994). Many of these attentive actions can occur during routine medi-
cal tasks and do not require more time from a health care professional. Indeed,
Youngson (2012) suggests that this is good practice. By making the time to
connect with a patient, by giving them some attention, the patient is more satis-
fied and less likely to keep ringing for assistance. He believes that ‘caring doesn’t
take any time at all, it happens in a magical moment’ (Youngson 2012: 17).
This study set out to discover whether hospital care was still true to its
origins in the religious orders of ‘hospitallers’. Hospital staff taking a few
moments and listening carefully to their patients can ensure that people in
vulnerable situations feel valued and cared for. This phenomenological study
does not provide a list of steps to be followed to ensure good hospital experi-
ences, but that is not phenomenology’s role. What it does do is uncover an
important aspect of the hospital environment that has perhaps been hidden.
If staff (both medical and support) are more aware of the value of genuine
hospitality, then perhaps they can make time to care about, as well as for,
their patients, meeting more than just their medical needs and treating more
than just symptoms.
What is argued in this paper is that it is through the often small yet
heartfelt acts of hospitality that a health care professional will impact so
completely the lived experience of a surgical patient, evoking feelings of being
cared about. This would suggest that hospitality is indeed a healer, and that
a greater awareness of the spirit of hospitality among hospital professionals
would make hospital stay a more hospitable experience.
The small-scale, exploratory nature of this study in Auckland means that
its findings are not generalizable, but the experiences described by the partici-
pants might well be transferrable to other medical facilities.
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126 Hospitality & Society
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Rosalind Kelly has recently completed her Masters in International Hospitality
Management at Auckland University of Technology (AUT). She is a lecturer
in hospitality at Auckland Institute of Studies (AIS) delivering papers in food
and beverage, hospitality management and hospitality principles.
Contact: Auckland Institute of Studies, Asquith Campus, 120 Asquith Ave, Mt
Albert, Auckland 1140, New Zealand.
Erwin Losekoot, Ph.D., FIH, FRGS, is Head of Hospitality and Tourism
Programmes at Auckland Institute of Studies (AIS). His research interests are
in hospitality and facilities management and the impact the service environ-
ment has on staff and customers.
Contact: Auckland Institute of Studies, Asquith Campus, 120 Asquith Ave, Mt
Albert, Auckland 1140, New Zealand.
Valerie Wright-St.Clair, Ph.D., Master of Public Health, Diploma of
Professional Ethics and Diploma in Occupational Therapy, is an associ-
ate professor in the School of Clinical Sciences and co-director of the Active
Ageing Research Group at Auckland University of Technology. She has
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Hospitality in hospitals 129
research interests in ethics of care, social gerontology, and promoting age-
friendly communities.
Contact: Auckland University of Technology, Private Bag 92006, Auckland
1142, Auckland, New Zealand.
Rosalind Kelly, Erwin Losekoot and Valerie A. Wright-StClair have asserted
their right under the Copyright, Designs and Patents Act, 1988, to be identi-
fied as the authors of this work in the format that was submitted to Intellect
HOSP_6.2_Kelly_113-129.indd 129 7/11/16 2:09 PM
Intellect is an independent academic publisher of books and journals, to view our catalogue or order our titles visit or E-mail: Intellect, The Mill, Parnall Road, Fishponds, Bristol, UK, BS16 3JG.
of Photography
ISSN: 2040-3682 | Online ISSN: 2040-3690
2 issue per volume | Volume 7, 2016
Aims and Scope
The purpose of the journal is to provide a forum for debate of issues arising
from the cultural, political, historical and scientific matrix of ideas, practices
and techniques that constitute contemporary photography.
Call for Papers
The editors of Philosophy of Photography seek contributions to this
new interdisciplinary, peer-reviewed journal. We welcome inquiries and
submissions from researchers and practitioners in a broad range of disciplines,
who have an interest in the theoretical understanding of photography.
Daniel Rubinstein
Central Saint Martins
Andrew Fisher
University of London
of original
HOSP_6.2_Kelly_113-129.indd 130 7/11/16 2:09 PM
... Literature on hospitality in the tourism domain included, but was not limited to, seminal works by Brotherton (1999Brotherton ( , 2019, Hemmington (2007), Hemmington and Gibbons (2017), Jones (2004), Lashley (2007aLashley ( , 2007b, Lashley and Morrison (2000), and Lynch et al. (2011). From non-tourism domains, hospitality discourses related to immigration, migration, asylum seeking (Claviez, 2013;Kearney and Semonovitch, 2011;Molz and Gibson, 2007b), historical, religious and philosophical standpoints (Kirillova et al., 2014;Munasinghe et al., 2017;O'Gorman, 2005O'Gorman, , 2010Rotman, 2011;Lynch, 2017), teaching and education (Hemmington and Gibbons, 2017;Marmon, 2008;Ruitenberg, 2009Ruitenberg, , 2014, healthcare and nursing research (Kelly et al., 2016;Peters, 2012;Wu and Robson, 2013), and information technology (Aristarkhova, 1999;Bell, 2007aBell, , 2007bMolz and Gibson, 2007b) were also reviewed. ...
... Mythology discusses hospitality as a way of honouring gods, while religious perspectives consider it a fundamental aspect of spiritual life, in which etiquette and the ethical treatment of strangers is paramount (Bodhi, 2005;Rotman, 2011). Discourses on information and telecommunication technologies (Aristarkhova, 1999;Molz and Gibson, 2007b), teaching and education (Hemmington and Gibbons, 2017;Marmon, 2008;Ruitenberg, 2014Ruitenberg, , 2009, and nursing and healthcare (Kelly et al., 2016;Peters, 2012;Wu and Robson, 2013) incorporate concepts of hospitality to analyse human interactions, for example, between websites (hosts) and users, teachers and students, and nurses/doctors and patients. ...
The concept of hospitality and hospitableness in tourism has been predominantly defined from a service encounter perspective, as a dyadic, service provider-receiver relationship in a commercial hospitality setting. However, a critical review of hospitality discourses from a range of disciplinary areas leads to a broader conceptual understanding of hospitality in tourism contexts. This critical review proposes a context-bound and place related understanding of hospitality in tourism, by highlighting the limitations of the commercial service encounter perspective, by offering a conceptual model that seeks a more culturally diversified understanding of hospitality in tourism from an Asian and indigenous perspective. The implications of this approach lie in the positioning of hospitality in a tourism environment to identify the social and cultural nexus between tourism and hospitality, en route to finding ways to enhance hospitable tourism experiences.
... The concept of hospitality is becoming more and more important for organisations outside of the hospitality sector. Organisations such as hospitals, museums, shops, funeral homes and airports acknowledge the importance of hospitality (Kelly et al., 2016;Grit, 2013;Pizam, 2020;Filimonau and Brown, 2018;Losekoot, 2015). Graduates and executives from hospitality are recruited and employed by non-hospitality sector organisations. ...
... The concept of hospitality is becoming more and more important for organisations outside of the hospitality sector. Organisations such as hospitals, museums, shops, funeral homes and airports acknowledge the importance of hospitality (Kelly et al., 2016;Grit, 2013;Pizam, 2020;Filimonau and Brown, 2018;Losekoot, 2015). Graduates and executives from hospitality are recruited and employed by non-hospitality sector organisations. ...
... The concept of hospitality is becoming more and more important for organisations outside of the hospitality sector. Organisations such as hospitals, museums, shops, funeral homes and airports acknowledge the importance of hospitality (Kelly et al., 2016;Grit, 2013;Pizam, 2020;Filimonau and Brown, 2018;Losekoot, 2015). Graduates and executives from hospitality are recruited and employed by non-hospitality sector organisations. ...
Full-text available
Responding to Richter’s call (1983, 317) “to know far more about the tourism policy making process”, this paper seeks to introduce the assumptions, concepts and research methodologies of the Narrative Policy Framework (Jones & McBeth, 2010; Jones et al., 2014, McBeth et al., 2014; Shanahan et al., 2018) and apply them in tourism research in order to investigate the black box of tourism planning and policy processes (Hall, 2008, 15).
Understanding patient experience is crucial as it influences patient satisfaction, perceived quality of healthcare services, loyalty to physicians and providers, as well as patient health and well-being. However, the multidimensional, long-lasting, affective, and dynamic nature of patient experience demands using new metrics and emerging methodology for measurement. This research note aims to review the potential approaches to measuring patient experience in healthcare, provide a typology of patient experience metrics, and call for further research on evaluating patient experience and analyzing its effects on health outcomes.
Organizational processes and experiences in hospitality can be thought of as instruments for creating value in organizations and achieving a competitive edge. Another important element for creating value among the stakeholders of an organization is trust. This article seeks to understand the relationship between hospitality and trust among stakeholders, and focuses in particular on customers and veterinarians. The method employs a questionnaire based on three scales: experience of hospitality; hospitableness; and trust. The questionnaire was applied to 185 people responsible for pets, and who are the users of services in veterinary clinics and hospitals in Brazil. The analysis technique involved structural equation modeling. The results showed that the hospitality experience and hospitableness are positively associated with trust being generated in the veterinarian. In conclusion, hospitality factors can have a positive influence on the service offered to stakeholders, and organizations should invest in human relations in order to provide a better quality of service.
Conference Paper
Full-text available
Abstract— Over the decades, the Global System for Mobile (GSM) communications technology has become one of the fastest growing and most challenging telecommunications technologies. The Call Setup Failure Rate (CSFR) and Hand�Over Failure Rate (HOFR) were the most important Key Performance Indicators (KPIs) used in ascertaining the efficiency of GSM network in terms of the quality of services rendered. For customers, it is expected that maximum satisfaction is derived from any service rendered, which was not the case over the years. The increase of HOFR and poor network availabilities due to increased CSFR became a great concern to all parties (providers, users, and researchers). Hence, this paper assessed the Quality of Service (QoS) of MTN GSM network in four geographical areas (Kaduna south, Kaduna North, Zaria, and Kafanchan) using two Key Performance Indicators (KPIs) of HOFR and CSFR. The data used in the assessment was collated from MTN Network Management Center (NMC) with the aid of the FACTS tool. These KPI results were evaluated against those specified by the Nigerian Communications Commission (NCC) in order to make some important recommendations from the findings (contributions) to improve the QoS of MTN network.
Professional relationships in the health and welfare sector involve many challenging client encounters. This study aims to describe what kind of client interaction social service workers in disability services find challenging and how they rationalise and manage these challenges. The study investigates disability service workers’ perceptions of challenging client interactions using data from 22 interviews with disability service workers in two hospital districts. Interviewees highlighted lack of mutual trust and lack of shared understanding as two issues arising in challenging communicative behaviours that disability service workers find burdensome and miserable. The interviewees’ accounts referred to four aspects of these challenges: 1) individual, 2) third-party, 3) structural and 4) experiential. In addition, six different management strategies were identified: 1) adjusting interaction, 2) listening, 3) negotiating, 4) problem solving, 5) withdrawing and 6) encounter interruption.
Full-text available
The research project is an investigation into the philosophy of the phenomenon of hospitality in order to identify the extent to which these are founded in ancient and classical history. The research focuses on Classical Antiquity and specifically investigates the history and philosophy of the phenomenon of hospitality within Greco-Roman texts and contemporaneous religious writings. In so doing it demonstrates how authoritative and disciplined research can make a significant contribution to the emergent research area of hospitality studies. The resulting thesis details a variety of outcomes and conclusions related to the phenomenon of hospitality, and also provides a basis for further enquiry. The research outcomes support the view that modern hospitality management literature has largely ignored this area of investigation. The principal methodological conclusion is that robust textual analysis can be undertaken within hermeneutical phenomenology and enhanced using a derived hermeneutical helix. The principal investigative outcome is that the hospitality phenomenon in its broadest sense has been recorded since the beginning of human history and it embraces a wide range of activities beyond the commercial provision of food, drink and accommodation. In particular, the essence of the hospitality phenomenon, within Classical Antiquity, is characterised by a reciprocally beneficial two-way process that takes place within three distinct and separate contexts: domestic, civil and commercial, which can also be summarised and represented by dynamic visual models.
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This article aims to offer a consideration of hospitality in organizations, occupations and thresholds to illustrate the sociocultural dimensions of hospitality spaces. Our aim is to open up thinking around spaces of hospitality offered by organizational members, particularly those employees who work with the vulnerable ‘other’, across thresholds into homes and organizational spaces. Community social workers illustrate the practice of hospitality as they offer advocacy and inclusion for those individuals excluded from the wider community. The move towards professionalism has been argued as one way of establishing value, authority and confidence in the role of the community social worker and the decisions these individuals make in their work. However, critics have indicated that professionalism emphasizes practices of ideological control, norms and exclusion, in effect undermining key social work values, ethos and practice. Our results illustrate that community social workers developed asymmetric relationships of trust within their community and negotiated with other organizational members in order to create spaces for their work and inclusion.
Hospitableness is the name of the trait possessed by hospitable people. It is clearly something to do with hospitality, so 1 shall begin with that. We can define hospitality, in its basic meaning, as follows: it is the giving of food, drink and sometimes accommodation to people who are not regular members of a household. Typically givers, or hosts, provide these things in their own homes, and the point is that they are sharing their own sustenance with their guests. This notion may be stretched in various directions: for example, a firm is said to provide hospitality if it gives food and drink to visitors. But the central idea of the concept remains that of sharing one's own home and provision with others.
For a couple of decades now, both higher education providers and industrial organizations in English speaking countries have used ‘hospitality’ to describe a cluster of service sector activities associated with the provision of food, drink and accommodation. Reflecting changes in the industrial descriptor used by practitioners, both academic and industry journals have adopted the notion that hospitality was a term which better described activities which had previously been known as hotel and catering . The academic community have increasingly used ‘hospitality’ in degree course titles, and in several countries, educators describe their professional association using this term. Without wishing to explore the emergence of hospitality and its appeal to both practitioners and academics, it does open up potential avenues for exploration and research about hospitality which hotel and catering discourages. That said, the current research agenda and curriculum could still be described as hotel and catering under a new name. It is the contention of this chapter that the topic of hospitality is worthy of serious study and could potentially better inform both industrial practice and academic endeavour.
Cover Blurb: Researching Lived Experience introduces an approach to qualitative research methodology in education and related fields that is distinct from traditional approaches derived from the behavioral or natural sciences—an approach rooted in the “everyday lived experience” of human beings in educational situations. Rather than relying on abstract generalizations and theories, van Manen offers an alternative that taps the unique nature of each human situation. The book offers detailed methodological explications and practical examples of hermeneutic-phenomenological inquiry. It shows how to orient oneself to human experience in education and how to construct a textual question which evokes a fundamental sense of wonder, and it provides a broad and systematic set of approaches for gaining experiential material that forms the basis for textual reflections. Van Manen also discusses the part played by language in educational research, and the importance of pursuing human science research critically as a semiotic writing practice. He focuses on the methodological function of anecdotal narrative in human science research, and offers methods for structuring the research text in relation to the particular kinds of questions being studied. Finally, van Manen argues that the choice of research method is itself a pedagogic commitment and that it shows how one stands in life as an educator.
Personal illness narratives are used here to highlight deficiencies in hospital care and to challenge hospitals to become more hospitable and less like factories for treating illnesses. An alienating hospital environment where staff focus on technical tasks and functions can drive patients and family members into a state of deep isolation and disconnectedness just when they need compassion and understanding. It is also suggested that hospital staff may actually benefit from learning to relate to patients at an emotional level and that compassion fatigue and burn out are more likely to develop when staff maintain their distance. Acute health care still has much to learn from models of hospice and palliative care that recognize the personhood of both patients and staff.