In 2010, I embarked on a doctoral research project to explore the benefits of nurses using advanced physical assessment skills with patients in general hospital wards. While patient assessment has always been important to nursing practice, little was known about how nurses' advanced assessment skills improved patient outcomes, in part due to the complex nature of patient outcomes and health care practice in general. Many factors are involved in any patient's hospital experience. Thus, it is difficult to control for any one health practitioner's actions. Traditional approaches to linking practice with health outcomes did not seem a good fit, so I focused on exploring outcomes as ‘consequence’.
My study used a novel approach combining a Gadamerian hermeneutic interpretation of stories with Deweyian pragmatism. Pragmatism – specifically the notion of consequence – was used to investigate the benefit of the nurse's assessment actions for patients. Stories from practice were analysed to identify the consequences as reflected in and through nurses' actions and perceived outcomes for patients. This case study describes the process of interpretative data analysis undertaken. It guides the reader through the process of hermeneutic data analysis and reinforces the close relationship between the research question, the chosen methodologies and data analysis.