Interactional accomplishments between nurses and doctors in a medical context

The use of language is significant in co-constructing reality. This highlights the way that speakers relate to each other through talk with the available discursive positionings in a specific context. An institutional context with particular asymmetrical relations introduces how the construction of reality is an area accessible to explore the use of language in maintaining and creating power relations. This research study explores institutional talk through conversation analysis. The focus is on asymmetrical working relations in medical settings. This considers the implications on individuals with a differentiating status with how power is managed in conversations. Nurses and doctors represent asymmetrical relations and their conversations illustrate differences in the way that language creates reality in a medical context, in this case a public teaching hospital in South Africa. Nurses and doctors were recorded during ward rounds, which spanned 22 hours of audio recordings. Approximately 40 ward rounds were followed where both a doctor and nurse were present. Ward rounds provided an opportunity to capture nurse-doctor conversations. The recordings were supplemented by ethnographic data that focused on the management of power. This focus is both at an individual interactional level and at a broader institutional level. Thus, showing how language coincides with the predominant subject positions available in a medical institution. The findings show how doctors do power overtly through various ways of speaking which show leadership in interactions. The findings also show how a doctor's subjectivity relates to qualities that continually build superiority in interactions. Nurses, on the other hand, manage power indirectly, by negotiating agency while enacting a passive actor role in conversations. Both doctors and nurses manage power and assertiveness, but continually show the sensitivity embedded in orienting themselves to one another. This aids in showing speaker support and is especially important for nurses, who are in a lower status, for managing their position in relation to doctors.

Grantor dc:publisher.institution

Department of Psychology

Year dc:date.issued

2010

Author dc:creator

• De Nobrega, Nicia

Advisor dc:contributor.advisor

• Foster, Don

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/10398

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/10398