'Walking the walk': The emotional and methodological demands of ethnographic participant observation in nursing practice

Ethnography is increasingly recognised as a methodologically powerful approach in nursing research, yet the personal and emotional demands it places on the nurse-researcher remain significantly underreported. This keynote draws on a focused constructivist ethnographic study of lie telling carried out on wards for people with dementia in the National Health Service in England. It explores the emotional costs to conduct participant observation in an ethically complex clinical setting, and what the nursing research community must do differently to support researchers who take this work on. The parent study involved 45 shifts (approximately 338 hours) of overt complete participant observation across two inpatient wards for people with moderate to severe dementia, between 2018 and 2021, with the researcher functioning simultaneously as a Band 5 staff nurse and an ethnographic researcher. Approximately 250 instances of lie telling were documented alongside daily reflective field notes. This presentation draws analytically on that fieldwork to address three interconnected challenges: the sustained tension between nursing and researcher identities; the unexpected emotional weight of witnessing morally ambiguous care as a reflexive practitioner; and the demands of managing insider positioning within a familiar clinical culture. The central argument is that reflexivity in ethnographic nursing research is not merely a quality-assurance mechanism; it is an emotionally demanding, often destabilising process that requires active support structures. The field journal functions simultaneously as methodological tool, data source, and emotional processing space. When these functions are not explicitly acknowledged and supported, both researcher wellbeing and data quality are compromised. These findings are synthesised into the DREN Framework (Dual Role Ethnographic Navigation), a practice-oriented tool that organises the demands of dual-role fieldwork into four interacting domains: identity negotiation, ethical witnessing, emotional labour, and methodological rigour, sustained by a continuous reflexive cycle. This keynote offers nurse researchers and research supervisors a frank account of the personal cost of ethnographic inquiry, and a practical framework for navigating it with integrity.
Keywords: Ethnography; Participant Observation; Reflexivity; Dementia; Nurses; Emotional Labour; Insider Research; Qualitative Research; Role Conflict; Focused Ethnography

Dr. Jane Murray is an Assistant Professor at Northumbria University, Newcastle. Her main interests are older persons mental health, particularly dementia and its’ associated issues, multimorbidity and frailty. She teaches these topics in the UK, China, and Singapore. Dr Murray also has extensive experience teaching these topics into Borneo and Malaysia. She is currently Programme Lead for a Pre-registration nursing programme at the Shanghai University of Traditional Chinese Medicine and the Programme Director for a Bachelor of Science, Nursing, at Kaplan Singapore. She also has a keen interest in Nursing Ethics, which she leads on in the Kaplan programme.