A fear of childbirth is a reason for a Cesarean section on request without a medical indication. The law for patients' rights in Norway does not give women the opportunity to choose a Cesarean section, only the potential to participate in the decision-making process. This requires cooperation between health professionals and patients. The present study explores the experience of women who had a vaginal birth after requesting a Cesarean section due to a fear of birth. A biographical, narrative, interpretative method was used. Through five women's stories, it is evident that the practice of decision-making constitutes a challenge for both the women and the health professionals. The importance of a woman's right to be taken seriously, even if she does not want to understand the reason behind her fear of birth, is emphasized. An open mind from midwives and physicians is required, although this seems difficult to achieve.

BackgroundThe personal is a vital part of professional nursing practice. From a psycho-social perspective, nurses produce and reproduce conceptions of the Self through experience. A literature search on nurses’ self-understanding in a psycho-social perspective yields no results. Hence, the aim of this study was to investigate personal and professional experiences that may have formed the self-understanding of a nurse, and how this self-understanding may have influenced her professional practice.MethodsUsing a single case approach, I conducted a Biographical Narrative Interview with a 50-year-old experienced Norwegian nurse. I asked the nurse to tell me the story of her life and how her work has affected her and possibly changed the way she saw herself. The overall aim of the interpretation was to understand the historically situated subjectivity in terms of the nurse’s personal, social and professional constraints and chosen options.ResultsThe nurse’s narrative of her life story made it possible to trace a common theme throughout her experiences, the experience of being “only a nurse”. The nurse experienced a low status, as well as a downgrade in the competence needed to deliver quality care in professional relationships. She felt it difficult to identify with the experience of being on the bottom of the social ladder and to identify with the female, mothering ideal connected to nursing. She desired a better position, and wanted to identify with strong women. In contrast to reality, her self-understanding influenced her relationship with her patients, her professional pride and her further professional development.ConclusionsThis study shows that the professional practice of a nurse was informed by her self-understanding. This study suggests that the individual nurse must be given the opportunity to explore her professional vulnerability based on the assumption that it is both personally and socially constituted. This study indicates that the exploration of a nurse’s self-understanding is one way to contribute to professional development.

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Thinking from experience in psychosocial practice: reclaiming and teaching 'use of self'. AbstractA course based on psychosocial theory and students' experiences in practice has been taught in the UK, Norway and Quebec. It departs from the classical social work concept 'use of self' and aims to help novices in health and social work to understand how the social world is internalised and re-produced and the value of thinking from experience. International developments such as, competency-based education, New Public Management and evidence-based practice reduce opportunities for experiential learning. This trend has been exacerbated by a focus on anti-oppressive practice without a corresponding understanding of how oppressive relations are internalized and enacted by defended and conflicted subjects. Attempts to rectify a relational deficit through traditions of reflective practice and critical reflection are important developments, but could be further strengthened by psychosocial and psychodynamic perspectives. The course combines critical, contextual and relational thinking for students in caring professions.

This paper draws on data collected from my recent exploration of how teachers become competent in the area of relationships. In an interview, a student teacher, Kristin, voiced the challenges she faced: 'I think it is easy enough to get the knowledge the student needs. The problem is, in a way, when people are involved'. This paper presents an encounter between Kristin and a student after Kristin had started to work as a teacher. It shows the difficulty of being professional when 'people are involved', that is, when emotions are at work. A Study of Emotional WorkFor many years, I have been interested in the special demands made on professionals who work in close personal contact with other people and for whom empathy and the ability to build relationships are crucial (Ramvi, 1996;Ramvi and Roland, 1998;Ramvi, 2007). Teaching is one such 'relationship profession' (Moos et al , 2004). Teachers realise that emotional bonding, emotional understanding and building relationships are essential to good teaching (