Artefacts as a Starting Point for Studying Clinical Practice

In this discussion paper, we aim to call attention to artefacts, such as for example doors, as fruitful sources for understanding subtle aspects of clinical practice. We draw on a post-phenomenological approach and argue that this perspective can be helpful in identifying changes in clinical practice, which often remain unnoticed in nursing research. We present the post-phenomenological idea that artefacts are not only passive tools or frames for clinical practice but mediate and transform human actions and people's perceptions of themselves. Three examples of analytical applications are elaborated to illuminate the potential of this methodological perspective. The examples originate from a previously conducted realistic evaluation study, which served as the starting point for the discussion in this article. During this previous research process, we became aware of differences in how nurses entered and left the patient rooms in a hospital design with all single-room design compared to a shared-accommodation design. To reflect further on these unexpected observations, we moved away from the critical realism approach and adopted a post-phenomenological approach. We became particularly inspired by the concept of 'hospes', which may mean both host and guest and which served as a theoretical lens, allowing us to explore the differences in how the nurses, patients and relatives acted when they stayed in, entered, or left a room, and when they spoke about their views on, for instance, privacy during hospitalisation. In this article, we further discuss how actors' interactions with doors and rooms constitute different roles and responsibilities for the patients, their relatives and the nurses.