ARTICLES

 

From Place to Space: A Heideggerian Analysis

 

 

Elizabeth Smythe^I; Deborah Spence^II; Jonathon Gray^III

^IProfessor, School of Clinical Sciences, Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand. E-mail address: liz.smythe@aut.ac.nz
^IISenior Lecturer, Postgraduate Nursing Programme, Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand. E-mail address: deb.spence@aut.ac.nz
^IIIFormer Director of Ko Awatea, South Auckland, New Zealand and, currently, Chief Executive Officer, South West Academic Health Science Network, Exeter, Devon, UK. E-mail address: jonathonrobingray@outlook.com

 

 

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ABSTRACT

In this paper, we pay attention to the impact on staff of what was a new place, Ko Awatea, within a large New Zealand hospital. The place became a space from within which a particular mood arose. This paper seeks to capture that mood and its impact. Using a Heideggerian hermeneutic approach, the study reported on drew on data from interviews with 20 staff. Philosophical notions about the nature and mood of place/space are explored. As staff claimed this space, the mood that emerged was of liveliness, buzz and comfort. It became a space where people wanted to be, where they met others, where conversations unfolded, where thinking happened in new ways. Staff places tend to be sacrificed or poorly resourced in resource-tight environments. We argue that creating a space that feels home-like, where staff come, linger and engage in community is a priority for generating the mood and thinking of an organization. Such spaces do not happen by chance; it takes forethought and intentionality. The gift of such space is the thinking that is sparked and grown.

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Rome. St Peter's Basilica. Long queues of tourists. Finally, I get in, already weary, elbowing my away around, peering through heads, jostled. It's huge, it's amazing; but quite quickly I make my escape, away from the crowds.

Next morning, I hear the voice of a friend whispering, "If you want to take good photos get up with the sun and follow where it takes you." Curiously, it leads me back to the Basilica. At this early hour there are no queues, only priests and nuns going about their daily routines. I re-enter the place of yesterday to find it so changed. It has become a sacred space, a place of stillness, of beauty; holding my awe. This time I am captivated; I linger, intrigued how this place, now free for its purpose, is so transformed.

Being is always an experience of being-there, in that moment, on that day, with one's own mood already infused into the emerging sense of unfolding. Being-there is an embodied experience; weary from the wait or energized by the dawn of a new day. Being-there is a peopled experience; the aloneness amidst the mass of strangers, the companionship of the whispered voice of a friend on the other side of the world, the at-homeness in sharing a sense of sacred worship. Being-there is everything that calls our attention, along with all that is passed by unnoticed. We are always being-there, always in an emerging situation, always remembering while at the same time we plan ahead; thinking, pondering, feeling, being. Heidegger (1927/1995) named this Dasein. There is no English word equivalently all-encompassing. Thus, in this paper, we will continue to talk of Dasein, the being-there, being-open to that which draws one's attention and impacts one's mood (Freeman, 2014; Sheehan, 2001). Dasein is about so much that can never be pinned down, defined, or boxed. We take our understandings mainly from Heidegger's later writings, philosophers who offer interpretative opinions (Inwood, 2000; Sheehan, 2001), scholars who have taken his ideas and translated them into links with their own disciplines (Freeman, 2014; Gendlin, 1978), and those who pay particular attention to Heidegger's notions of place/space (Bachelard, 1958/1994; Bollnow, 1961; Casey, 1998; Malpas, 2006). We understand that it is the Being-there that always interprets what something means through one's own life-constructed lens (Gadamer, 1960/1982). Gadamer, who went beyond the ideas of his teacher, Heidegger, stated:

To acquire an awareness of a situation is, however, always a task of particular difficulty. The very idea of a situation means that we are not standing outside it and hence are unable to have any objective knowledge of it. We are always within the situation, and to throw light on it is a task that is never entirely completed. (1960/1982, pp. 268-269)

In other words, we are always within the place we seek to examine (even when we do so from outside of the physical space). We always bring into it our own pre-understandings of any situation. In a later paper on the significance of art, Gadamer (2006) cautioned against:

... seeing a building only in terms of its purpose. It emerges as an artwork only when, in the middle of its use, something wonderful shines forth, as with everything that is beautiful. This experience causes us to pause in the midst of our purposeful doing, for example in a room of a church, or in a stairwell, when suddenly we stand there and remain as if entranced. . its purpose steps into the background, so that what is distinctive in the building completely fills us. It is then like "music that has fallen silent" (Goethe). (p. 80)

Our quest within this paper is to listen to the moments when the music of busy noise was silenced into a stillness of knowing.

Of particular note in this paper is that "The world is not something external but is constitutive for the being of Dasein" (Svenaeus, 2000, p. 126). That is, place/space is not something outside of self; rather, it impinges on one's very sense of self in any given moment. This paper draws attention to a particular place; yet the analysis is not about the place itself. Rather, we see the place as gathering people. It is their being-there-together, or alone, having their "experience" that matters. Their experience is what it is because they are "there"; yet being-there, Dasein, is about more than place. Our quest is to reveal Dasein by exploring "the ways in which the world makes sense and matters to it" (Freeman, 2014, p. 449). People within the governance of health institutions oversee the availability of places to meet the functional needs of providing health care. Staff within such organizations fit themselves around the spaces provided, using them to get things done.

Middlemore Hospital, New Zealand, the site of this research, was built during World War II with requisite wards and departments. A staff cafeteria was connected to the rest of the hospital by a very long, wide corridor. The observant person might have noticed that much of the work of this community happened along the corridor walk where chance encounters led to fruitful conversations. Yes, there was a lecture theatre, some classrooms, and a library where one went for specific events. Yes, the cafeteria was always buzzing, but with quick, short conversations as staff rushed back to their patients. Yes, there was a spirit about this community, a sense of commitment and care. But how was the spirit nurtured? Was there ever enough time for idea-sparking conversations? How could people's experience of being-there be enhanced to the advantage of the community served?

In 2011, the leadership team at Counties Manukau Health, who umbrellaed this hospital as their central hub, took the bold step of putting aside a portion of their already tight budget to build a Learning, Development and Innovation Centre to serve local, national and international gatherings. With a limit of 10 million dollars (higher expenditure required Government approval) they created a place with many classrooms to make it a centre of education, with working spaces, a large pod of computers, and a quiet, comfortable, attractive seating area. In the central hub is an open café. It was entirely unlike any previous place in this busy hospital. It felt more like walking into a space where people would come to linger; who ever had time to linger in a hospital? It had a very definite "wow" factor.

The place was named by Maori (the indigenous people), who provided guardianship, as "Ko Awatea", meaning "new dawn". Jonathon Gray, the then Director of Ko Awatea, expressed the significance of the name in this way: "From within the darkness one knows the light is coming. We live in that space, full of hope and optimism, seizing the moment of 'right now'". At his suggestion, we conducted a hermeneutic research study asking, "Ko Awatea: How does it make a difference?" This paper reports on how the place itself has impacted the organization and the people within, becoming a thinking space.

 

Background

The words place and space are familiar. In our everyday conversations we take their meaning for granted: "Do you know the place I am talking about? Is there enough space for the gathering? Will the place work? Did you find thinking-space?" Withers (2009), having explored the emerging meanings given to place and space, concluded that authors were using these terms in different ways. Inwood (2000) reviewed Heidegger's writing and brings us back to Dasein.

DASEIN [sic] is spatial in a way that no other extended thing is. It clears a space around it to give itself "leeway" or elbowroom. Other things occupy or "take-up" (einnehmen) space, but Dasein - in the literal sense - takes [nimmt] space in [ein]. (Heidegger, 1927/1995, p. 419)

Heidegger used the word "place" to mean position of things (on the table by the door), where something belongs (its place is in the top drawer), the site of a decisive event (the place where the accident happened). Then there is region, which denotes the manner in which we orientate ourselves to things through activities. The region of operating theatres is different from the region of the wards, which is different from the region of the carpark. We behave differently in each setting.

Heidegger (1954/1993) reminded us that places are built. When we build, the purpose is to create a place where in we may dwell; however, there is no guarantee that dwelling will occur. The old German word bauen means to build, which, for Heidegger, means to dwell, "to stay in a place" (p. 348). It further means "to cherish and protect, to preserve and care for, specifically to till the soil, to cultivate the vine" (p. 348). Thus, to build a place, such as the building of Ko Awatea, is to seek to create a dwelling place, a place where people will come and "stay", but not to sit idly. It is to encourage and equip them to get on with the purposeful activity that gathers together this community of health workers. Whoever builds, and however they build, they can neither make dwelling happen nor ripen the grapes of the vine. Yet, wanting to nurture the gathering of staff in a particular way can engender the region of hospitality. It can determine the difference between staff passing by, hurrying through, as opposed to pausing, spending time, gathering, dwelling, talking, and thinking. A building is always so much more than walls, floor, roof, and doors.

Norgard and Bengtsen (2016) considered the notions of place and space in relation to a university. They suggest that the difference between place and space is akin to the difference between one's biological body (which can be observed, measured, and assessed) and one's experience of one's lived body (how it feels to be me right now). Similarly, the plans of the architect differ entirely from the lived "placeful" (Norgard & Bengtsen, p. 6) space where I meet my friends for coffee. It is the living selves of the people who inhabit a building who transform it into a dwelling place.

How then has Ko Awatea, a new building within a health community, become "placeful"?

 

Methods

Design

This study was informed by Heideggerian hermeneutics and aimed to get as close to the lived experience of being-there as can be expressed in words following the experience itself. Researchers bring their own lens to the process of interpretation and writing (Smythe, Ironside, Sims, Swenson, & Spence, 2008; Van Manen, 1990). The invitation to conduct this research came from Professor Jonathon Gray, then Director of Ko Awatea, who became a key informant in the study. Smythe and Spence enacted the research and wrote a full report of the study. Smythe did her nurse training at this hospital in the 1970s and worked there in the 1980s. Spence shared a similar journey, but in a different hospital. Both brought experience of Heideggerian hermeneutics to this research. The draft of this paper was submitted to Gray for ongoing hermeneutic conversation, drawing forth a fresh clarity of insight.

Our aim was to work with the data dialogically, drawing on philosophical notions for the purpose of provoking thinking. To that end, we have included quotations from philosophical writers to enable readers to engage in their own interpretative process. It is expected that readers will feel drawn to reconsider their own contexts and experience. Thus, there are no definitive answers, but only a call to wonder afresh (van Manen, 2014). Heidegger (1959/1966) emphasized repeatedly that, as an insight reveals itself, at the same time it withdraws into the mystery. Our writing thus seeks to both show what "is" and ponder the mystery of possibilities that are merely glimpsed.

 

Participants

Ethical approval for this study was granted by the Ethics Committee of the Auckland University of Technology (AUT) and the Counties Manukau Ethics Committee. The researchers spent parts of several days sitting in the café at Ko Awatea showcasing an invitation for people to participate in the study. Some came because they knew us. Others came because "the Director" had told them what we were doing. A few were purposively invited in order to ensure that we had a representative range of voices. Twenty people were interviewed: 10 Ko Awatea staff (supporting improvement, education, and innovation) and 10 from Counties-Manukau District Health Board (DHB) (front line health care workers). All the participants regularly frequented the place/space of Ko Awatea.

 

Data Collection

In keeping with our hermeneutic approach, we regarded an interview as a conversation in which our role was to encourage participants to talk about their experiences of Ko Awatea. Most of the interviews took place on-site in a small private room; two were conducted in the researcher's office. Once participants had signed a consent form, we started by asking them to talk about who they were. There was no set list of questions, with the flow of the interviews instead guided by a sustained dialogical focus on each participant's experience of "how Ko Awatea makes a difference". In the process, participants were encouraged to give specific examples, to tell their own stories rather than offer generalized opinions. Nevertheless, when a place/space is part of one's everydayness, it is hard to do other than talk about the generalized feeling it evokes.

Each interview was approximately one hour in duration. The audio-recordings of the respective interviews were transcribed and then crafted into stories (Crowther, Ironside, Spence, & Smythe, 2017). These stories were returned to participants to allow them to make changes or delete material they did not wish to be included. At the end of 20 interviews, over a five-month period, we recognized that we had a sufficiency of data (Smythe, 2011).

 

Data Analysis

The method of working with the data was informed by van Manen (1990), with the research question kept to the fore in seeking to reveal how participants lived the experience of Ko Awatea rather than conceptualized it as "place". As transcripts were returned, we began the process of crafting stories from the data obtained (Crowther et al., 2017). This process involved extracting the evocative account from the text, the aim in this regard not being to change meaning but rather to ensure that the reader is not distracted by the lazy grammar of speech, irrelevant details, or anything that obstructs the essential meaning. Then began the task of writing initial interpretations of the stories extracted (Smythe et al., 2008), writing and re-writing to seek to capture the salient structure of the nature of "How Ko Awatea makes a difference" and then to communicate this in an engaging and accessible manner (Spence, 2016). In the next phase of the research, we drew on Heidegger and other related philosophers to extend and deepen our thinking as we focused on specific aspects, such as the meaning of place/space.

 

Anonymity

The full unpublished research report was such that it would have been impossible, in the context, to ensure individual anonymity. In agreement with the participants, it was therefore decided to be transparent in respect of their identities. We returned the sections of their own data to each person interviewed, together with the initial interpretation that followed, to enable changes and/or removal of details, both of which were requested in individual cases. We recognize that the nature of the data ultimately presented affords very limited risk should participants be identified. They are co-creators of this study and have a right to be acknowledged.

 

Trustworthiness

Koch (1996) suggested that it is the responsibility of the writer to "show the way in which a study attempts to address the issue of rigor [and that] it is for the reader to decide if the study is believable" (p. 178). Firstly, our intent is to present this research in a way that enables the reader to understand its genesis and values. Secondly, we set ourselves standards of "being truthful", "being ethical" and "being respectful". Thirdly, we endeavour to "show" readers rather than to "tell" them, when the telling would detract from the richness of meaning. This means that the datum comes first, and then the reader is invited to think-along with the interpretation. Fourthly, we seek to reveal the meaning of "place/space" in a manner that is dynamic, held open, and problematic. The possibilities of meaning are what matter most, and what accordingly drive decisions about the writing.

 

Findings

The experiential logic of the findings of the study is presented as follows: Firstly, the underpinning thinking behind a new development of space matters. Secondly, a new place quickly becomes one's own space in a manner that draws (or otherwise). Thirdly, place, in becoming space, engenders mood.

Underpinning Thinking Matters

Jonathon Gray was charged with leading the development of Ko Awatea:

Yes, we would build a teaching 'place' but we aimed to create so much more than that. We wanted to also build a sense of excitement. Let's create an 'Apple Store' where IT people interact with you to connect your IT resources. Let's create a 'Koru longue' [Air New Zealand Business Class lounge] where we stimulate a thousand conversations a day. Let's build a war room. I wanted a place where you moved from talking about something to action.

Jonathon was never building a mere "place". He was always, in his mind, creating something more. It had spaces within to facilitate and galvanize the activities sparked by this fledgling innovation. He had other places in his mind wherein he knew people enjoyed "being" and "innovating". His vision was to stimulate lively interaction amongst the people who came. One cannot build "excitement", but one can provide a place where excitement is likely to be evoked. There were some core concepts that had not previously been accommodated within the DHB's buildings. This was a new venture, doing new things. Jonathon continues:

Let's bring people into one space. Hospitals and health systems are really good at partitioning people. I want them to get a sense that they are all in it together. This is our health system in one room. Students are seeing seniors. I think there's something great about seeing the people you want to be. Front line staff get some energy back from seeing the young enthusiastic students. I hope they leave with a sense we're all in it together and we're all part of this journey, and gradually we'll help them explore it.

Envisaging this building was about seeing how people would come, feel welcome, and interact together in new ways. It was about mixing students and seniors, drawing professions together, capturing the health system in one area. Jonathan talks of energy being transferred from one to the other, people being inspired simply by watching others of a different generation. He wants people to leave this space feeling different somehow because of the experience of being there. Three years later he says:

I sit there often and watch. I think people are now much more comfortable being in the same room. It's been a slow process but I still see the nursing students sat in one part and the physio students and the midwives in another part. So I think we're on a journey; they're all in the same room and ... that feels comfortable now. Each day I see something that makes me smile. An interaction, a caring interaction between staff and families. And everyone comes now, senior doctors are here almost every day. It's a good place to come and do emails and catch up, not in their office shut away on their own. It struck me we even name our system in divisions, the division of medicine, the division of surgery.

Jonathon's dream was that this new building would break down barriers, have people talking to people as opposed to nurses talking to nurses and doctors to doctors. He is mindful that free-flowing conversations of this nature are slow to emerge, but no longer is there ownership of "corners". This place belongs to everyone. It draws people in different ways; students to chatter together after a lecture, staff to have meetings, a busy doctor catches up with emails. Jonathon reflects that, for far too long, the hospital has been compartmentalized into divisions. The word speaks of "dividing" separating one group from another. Everything about Ko Awatea seeks to overturn "divisions".

Jonathon is now a user of the place/space he helped create. He describes how that plays out:

I go and sit right in the middle and have a coffee and enjoy seeing people and talking to them. I want to be part of it because I get energy from it. I prefer to be there than in my office. I really don't enjoy being in my office anymore. It is very rarely now that I have meetings in my office.

There is something about being in the midst of the Ko Awatea café environment that energizes Jonathon. It is a chance to engage in unplanned, spontaneous conversations. He enjoys people; this is a place where one is free to indulge in the enjoyment of sharing. At the same time, this is where the work of Ko Awatea/Counties happens, even though it may not look like work. As leader, Jonathon, sees opportunities to give, encourage, and guide; adding something of value to the people he meets as they pass through. It requires a richness of energy and a sense of spaciousness in his day. Why would he expose himself to such interruptions when he is weary, trying to get things done, needs to concentrate? Because being amidst the energy of others energizes him. He senses that he can absorb some of that vibrancy just by being there.

The layout of Ko Awatea is a café type arrangement of small tables with four chairs and, to one side, armchairs gathered in clusters. We asked Jonathon how he decides where to sit:

I'd sit in the comfortable chairs about 20% of the time. I'm probably more often slightly more formal, sitting at a table being able to scribble on something. I am also a bit of a sloucher. If I get into a chair then I feel as though I'm very, very non-professional. I think I probably control myself a little bit more and sit at the tables. But at the end of the day, catching up with a friend or a close colleague, then I'll probably sit in one of those chairs a bit more.

Jonathon makes conscious choices about the nature of his professional behaviour. A chair at a table, albeit in a café, still signifies a professional approach. Slouching in a comfortable armchair does not. Yet there comes a time towards the end of the day when he feels the need to relax or when he is having a conversation that can more appropriately accommodate slouching. Note, this is from the man who would have insisted that there be armchairs for staff to make use of as they choose. It is Jonathon who sets his own standards.

Place Becomes One's Own Space

It is one thing for the person behind the concept to offer his impressions of how the space works. It is another for the people using it to tell their own stories, showing how they came to experience and "own" the space.

Alex talks of both the spirit of the place and the physical layout:

This kind of feels like the base. This is where we sharpen our swords. This is where I am able to bring some of the stuff I'm discovering out there in the community, back to here. It's where there's resource, both physical and people resource. It's kind of a base.

Ko Awatea is a "coming back to" sort of space - back to the community where ideas are shared, problems are thrashed out and strategies are refined. "Swords are sharpened" ready for the next foray into the challenges of the practice sphere.

Marie talks about how the place works for her:

... Ever since it's been open I've come here several times a week. Sometimes for meetings, sometimes for a coffee, and other times for training. I'm here on a daily basis really. It's lovely having an informal place to come and meet people if you're needing to discuss things that are not of a confidential nature. It's just a nice, relaxed way of doing things. We're not a formal organization. It's reasonably egalitarian and what I like is seeing the likes of Geraint [CEO] having coffee here, and Jonathon Gray and others. So they're just part of it and you can go up and talk to them if you want to.

Marie delights in being able to have many of her work meetings sitting around a table drinking coffee together. She draws attention to the egalitarian nature of how the space is used. There is no sense of hierarchy. The CEO simply takes a place amongst others. In doing so he makes himself accessible but, because he is there so often, this is no "big deal". He can be approached or not. Everybody here is "getting on" with whatever their day entails.

Many participants remarked on how Ko Awatea has brought people together. Marie explains:

Somehow it has brought people together. You might be setting up a meeting with somebody but you see others, like this morning when I saw Liz, and then three other people that I hadn't seen for ages. You're just standing in line waiting for your coffee and you're catching up with people. The other day, I'd booked two meetings back to back in Ko Awatea. The first one was over and done within half an hour and I was waiting to meet up with the second person whom I hadn't met before. And while I was sitting there, an ex-colleague approached and I haven't seen her for months.

Marie came to participate in this study because we had "bumped into her" at the café. Catching up with people happens in this place. Yes, there are planned meetings but, in the space between, in the queue to get coffee, in the unspoken invitation that comes when one sits alone, conversations are opened. Marie recalls a chance meeting with a former colleague. Relationships of all kinds are nurtured in such an environment.

Mataroria reflects on how he has learned to incorporate the people-factor within his time schedule:

I have to think about when I want to make the walk because you always bump into people! Even just coming from the team meeting to here, there was one, two, three, four people along the way. Although you've got the emails and phone calls and whatever, it's that chance to be able to quickly be face to face in that moment. Those passing-by conversations, why I quite like them is because you can have your ear to the ground a wee bit, about what else might be happening. A quick conversation can lead to a spark that might lead to something from there.

Conversations in passing by are a gift. In a short space of time issues can be sorted, ideas can be shared and, along with that, there is the chance of hearing a useful snippet of information, to discern the mood, to have an ear to the ground. Nevertheless, each one takes time. To walk from one meeting to another is no longer a given length of time. People interruptions stall, delay and distract. Yet it is beneficial. One learns to accommodate the unfolding nature of a day.

Lynne refers to some of her meetings as fortunate but unexpected "collisions":

If there was no Ko Awatea building I think fortunate collisions are much less likely to happen, people would probably stay in their own areas or even at their desks. Communication might revert to email conversations and that doesn't suit me personally. So I'd be walking the corridors trying to collide! But having Ko Awatea definitely makes it 100% easier.

The building has created a way of people colliding with each other, unplanned yet fortuitous. Such meetings save having to write an email or seek a person out. Meeting people becomes easy. In that context, it is conceivable that conversations would tend to have an informality that creates openness and space to think.

One arrives in Ko Awatea to a sense of mood:

There's no other place like Ko Awatea in Counties - it's a 'hub' that is buzzing with people from different backgrounds and culture coming together.

It's a meeting place for everyone, to connect, interact, engage in conversations, learn and relax. It's not limited to the people who work at Counties. It's great to see students, doctors, nurses, visitors, and even patients enjoying this space. (Claire)

Claire loves the variety of people who gather at Ko Awatea. This is not just a place for staff. Patients and their visitors also make use of the facilities. Claire loves the sense that it is open for anyone to enjoy. She loves the "buzz" that comes from the mix of all sorts of people.

Place Experienced as Mood

Mataroria, now familiar with this place, now having owned it in terms of a space he enjoys frequenting, goes on to talk of the mood he attunes to when he walks into Ko Awatea:

There's a mood that I feel from Ko Awatea, but I also know that there's a lot of mood that other people would feel from outside too. It's a very bustling feel, when you walk in. I think there's a really good vibe with the students, they're learning. There are workshops that they have too, so there's always people pouring out of the main lecture theatre. Good and bad because then the coffee line's really long! So there's always a very bustling happening feel to things because there's always something going on. It was Te Reo Maori [Maori language] the week before and so there were performances. During Pasifika week often times the building is quite decorated. There's speeches, there's work activities, there's concerts. There's always something happening. People come and think 'Oh gosh this is a pretty happening place'.

It gives you a sense of energy walking into the place. When you walk in it's 'Oh what's happening this time around?' What's going on today? Who's visiting? They have those flashing names up on the boards. So it is enlivening and then, at the same time, it's 'Who am I going to bump into?' as well!

For Mataroria, Ko Awatea is a happening sort of place. Every day he walks in he comes with anticipation that something unexpected and exciting is happening. Sometimes it is a week of events. At other times it is a visiting speaker. Some days there is the bustle of crowds of people, slowing the coffee queue, but bringing energy. The mood of the place gives him energy; it enlivens him. When there is a gathering of enthusiastic people engaging with each other, even as one passes through, there is a sense of contagion.

Lynne picks up the same sort of mood:

It's noisy, it's lively, it's a gift of a place really. I think it melds together the opportunity for quietness and studiousness with the separate rooms and meeting and socializing, be that just catching up on gossip or having very loose meetings, unstructured meetings or conversations. And I think as a place it works really, really well. People like coming here and when we have external visitors, they're all very jealous.

Lynne describes the place of Ko Awatea as a gift. It offers both the buzz of the meeting place and the quietness of the separate room where the noise can be shut out. She uses the words "meld" and "loose". There is a sense of everything coming together but in an organic sort of way. It works because people are free to make it work their way. The staff are reminded how well it works when they see afresh the jealousness of those who visit from other places.

 

Discussion

Ko Awatea began its genesis with a physical space, designed from the start to be much more. Jonathon knew that it needed to be a place that would entice people, serve their needs, and work for them on a practical level. It needed to be flexible, offering different possibilities of space. At the hub is the café, drawing all sorts of people. Around the perimeter are the various rooms available for meetings and/or teaching. Computers with free Wi-Fi are available for anyone. Armchairs welcome the tired body. A mood of buzz and energy has grown. So much is accomplished within this place. There are planned meetings, collisions that spark ideas, opportunities for fellowship, sanctuary, thinking and rest. It is everybody's office/space. It is a showcase of the DHB engaged in everyday work. It is where one finds people, feels the pulse, and draws inspiration. It is the glue that holds everything together; the air that allows people to breathe. It is so much, in so many different ways.

Malpas (2006) worked with Heidegger's notions of space. He talked of the basic structure of Dasein being underpinned by our understanding and our attunement, both of which feed our sense of possibilities. He said: "Understanding is always accompanied by a mode of affectedness ... which is also linked to the notion of 'mood' or 'attunement' (Stimmung)" (p. 99). All the participants in this study talked about the mood of Ko Awatea. Jonathon began with his vision of the mood of excitement and energy he was seeking to nurture. Those who now experience Ko Awatea daily talked of the buzz, the bustle, the enlivening spirit that draws them to the place/space. Already, before they enter the space, they sense that there will be people there whom they will enjoy talking to, with whom they need to have a conversation about "something", or people with whom they chat in the coffee queue who will spark a valuable idea. The space has become base camp, offering a sense of at-home-ness, gathering together people within an atmosphere of comfort, food, and function. As such, Malpas suggested our mood senses the place as one to which we already belong. From such a place the world "worlds", the happenings "happen", and the giving spirit of collegiality gives.

Heidegger (1954/1993) asked the pivotal question: "Do the houses in themselves hold any guarantee that dwelling occurs in them?" (p. 348). If a house or a staff-place is cold, dreary, with uncomfortable furniture, it becomes merely a place where necessary functions are performed. Heidegger suggested that to dwell means "to cherish and protect, to preserve and care for, specifically till the soil, to cultivate the vine. Such building only takes care - it tends the growth that ripens into fruit of its own accord" (p. 349). Dwelling involves a mood of looking after, taking ownership of, taking care of, doing whatever it takes to keep this place how I like it to be. And yet, as Heidegger reminded us, we can never build the mood itself. We can only pay attention to and foster that which encourages "ripening". Yes, Ko Awatea is an attractive place with comfort, coffee and food; but it is more than that. It is a peopled place; a space in which mood is engendered through lively conversation, laughter, bustle, comings and goings. The ripening of relationships is free to happen because people are drawn to what has become their space, where they feel at home, where they are free to be the people they want to be, going about the sheer possibilities of their day.

Casey (1998), drawing from Heidegger, said:

Place opens a region (Gegend) by every time gathering things into belonging together . . Rediscovering the importance of place in this way is like finding a conceptual neighbourhood where one can feel at home: where one can dwell face-to-face in the nearness, even the uncanniness, of sheer possibility. (p. 283)

When the nursing students after their lecture sit alongside the senior medical staff, and with the CEO at an adjacent table, there is a gathering, a oneness, a reminder of the coming together of possibilities. This place, while it still draws people into their own huddles, nevertheless breaks down divisions. Anybody can approach the CEO; he told us he likes that. Similarly, Jonathon, as Director, can engage in conversation with anyone he happens to encounter. The very idea of this research came about through such an introduction in passing by.

Constructing Ko Awatea began with the building itself and its furnishings; a place was created from which a space emerged. The space is all about mood: "In every case Dasein always has some mood. The pallid, evenly balanced lack of mood ... is far from nothing at all. ... A mood makes manifest 'how one is', having a mood brings Being to its 'there'" (Heidegger, 1927/1962, p. 173). The people who know Ko Awatea well have come to know its mood. Yes, some days it is busier than on others; yes, sometimes there is a distinctive flavour to the mood, but it can be counted upon to be a mood that invites, a mood in which one relaxes into dwelling. Heidegger (1927/1962) told us that "A mood assails us. It comes neither from 'outside' nor from 'inside', but arises out of Being-in-the-world ... and makes it possible first of all to direct oneself towards something" (p. 176). Being-in-Ko Awatea has become known as a trusted experience of feeling at home, energized, meeting and talking with all sorts of people. Such a mood cannot be built. It can only be continually nurtured. It is a mood arising from both within and without. From Heidegger's understanding of mood, we argue, like Freeman (2014), that it was not just that the participants felt that Ko Awatea was a positive place to be, or that Ko Awatea is a positive place for me, but rather that Ko Awatea is a positive space. "That is to say, our entire existence within the world is shaped, coloured, experienced, and, in a sense, determined by our moods" (Freeman, 2014, p. 453).

It seems to us that this is a community of people who have taken collective responsibility for protecting the space in order to be together in an energizing way. They venture into the space expectantly; they delight in the possibility of chance meetings; they draw inspiration and energy from being around each other. Such a mood must surely pervade their returning across the protective borders of this space to the frontlines of health care. When they themselves feel cared-for, it is likely that they "top up their own reservoir" of care-to-give-out. When, over a cup of coffee, work feels more like having fun, perhaps the tasks that await them also take on a lightness. When one arrives with a problem, maybe a conversation brings a solution? Feeling good about "being-there" is a mood that is likely to carry over when they head off to the places that are more functional; one holds in mind the dwelling space to which one can return.

Bachelard (1958/1994) said: "all really inhabited space bears the essence of the notion of home" (p. 6). He continues:

[T]he house shelters day dreaming, the house protects the dreamer, the house allows one to dream in peace. Thought and experience are not the only things that sanction human values. The values that belong to day dreaming mark humanity in its depths. (p. 6)

The literature tends not to talk of creating a space for health professionals to day dream; yet this was perhaps the essential aim of Ko Awatea. It needed to be a space where the mix of conversations, quiet thinking spaces, and the energising mood would draw people into what Heidegger called meditative thinking. He described this as the kind of thinking that "is in need of even more delicate care than any other genuine craft" (Heidegger, 1959/1966, p. 47). We suggest that, for staff to dream, to engage in the kind of thinking that cannot be worked through in a methodical manner but must somehow be awaited, one needs to be in a space where one feels at home. Once such a space emerges it needs to be tended and protected; it is a precious yet vulnerable resource amidst a resource hungry organization. Bachelard talked of how the home bathes one "in nourishment" (1958/ 1994, p. 7). When one looks through the window of one's own home to the snow outside, one feels warmer because of the snow outside. It may be that, for health professionals who daily face the icy cold of illness, disability and health challenges, having a "home" to retreat to in the course of a day brings everything alive. The complexity of patient care may somehow look very different when sitting among colleagues drinking coffee. Perhaps this home base provides the sanctuary of space for thinking, envisaging, and energizing that sends one back into the "snow" better equipped for the conditions?

 

Conclusion

This paper presents a philosophical thinking space to showcase one health organization's bold attempt to nuture and protect the thinking-energy, the richness of dialogue and the comfort of at-homeness amidst a busy, resource-stretched hospital environment. When a space within this setting is conducive to lingering, staff are energized in a renewing way. Divisions break down. Chance conversations lead to new initiatives. Senior leaders keep their fingers on the pulse and are accessible to conversations of a kind that spark change. The mood transforms the place into a space, one where people are drawn again and again. Such a space can never be constructed or managed. It is the community of people who feel valued and nurtured that generates the transformative mood.

We remember the fairly recent era when staff rooms were closed down to make way for what were deemed to be more important purposes. This study has shown that making-room for staff to be at-home with each other is perhaps one of the most important investments that an organization can make. The "feel good" mood such provision engenders, the ideas sparked in conversations, the sense of recognizing afresh "who we are", is likely to have far reaching impact on the people themselves and the clients they serve. Perhaps, as with our opening story of St Peter's Basilica, it is when a place is serving the purpose for which it was envisaged that the mood gathers-and-holds? This paper offers a story of vision, commitment and wise knowing towards preserving that which matters - the mood of a thinking place/space.

 

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About the Authors

 

 

Elizabeth (Liz) Smythe is a Professor in the Health Faculty at Auckland University of Technology (AUT). Her practice background is nursing and midwifery. She has spent the past twenty-five years researching and supervising in the hermeneutic phenomenological paradigm. Prof Smythe leads the interprofessional Doctor of Health Science programme and facilitates the paper that encourages students to explore the nature of their practice issues alongside possible research approaches.

 

 

Dr Deborah (Deb) Spence (PhD) has expertise in Gadamerian hermeneutics, and has researched, published and supervised in this area over many years. Dr Spence has a practice background in nursing and midwifery. She teaches in the postgraduate nursing programme at the Auckland University of Technology and works with students in developing their research proposals for the Doctor of Health Science degree.

 

 

Professor Jonathon Gray was the Director of Ko Awatea at the time of the research reported on. He established and led Ko Awatea (Maori for "First Light"), an institute for health system innovation and improvement in South Auckland, New Zealand He has since moved back to the United Kingdom to join the South West Academic Health Science Network (SW AHSN) as Chief Executive Officer on 1 October 2017. Prof Gray is a passionate leader with significant experience as a clinician and an academic, an executive team member, and a director of local, national and international improvement and innovation in the health field.

Prof Gray trained as a clinical geneticist, as a public health practitioner with a Masters in Public Health from Harvard, and as an improvement leader, through a Health Foundation Quality Improvement fellowship based at Boston with the Institute for Healthcare Improvement.

Having grown up in North Yorkshire, among steel works and the chemical industry, as a beneficiary of a compassionate welfare state, he remains passionate about equity and a vision of establishing "great care everywhere", not just in pockets.