Multilingual medical communication: Staff with different language repertoires in an intensive care environment

This thesis examines the complex intersection of multilingualism, institutional hierarchy, and the nursing profession within the Intensive Care Unit (ICU) of a private South African hospital. Global nursing migration and local skill shortages have created a workplace context in which English is the dominant language of a linguistically diverse site. This research explored how registered nurses, whose first languages include Afrikaans, isiXhosa and languages indigenous to the Indian subcontinent, such as Malayalam and Kannada, navigated this multilingual landscape in terms of patient care and workplace communication. The study employed a qualitative, multi-method design using data collected from questionnaires and semi-structured interviews with registered nurses and managerial staff in an ICU. A systematic three-pronged analytical framework was applied. This included Thematic Analysis of interview data, which examined how language serves as a vehicle for enforcing and upholding authority within the hierarchical structures of an intensive health care facility. Narrative Analysis enabled an understanding of the complex relationship between language, embedded ideology and professional identity. To capture the nuances of staff members' personal linguistic experiences, stories about routine and daily practice were analysed using Small Story Analysis (SSA). The discourses of reflection on language in the healthcare environment provide insight into how language dynamics operate in an ICU setting. In addition, the study highlights broader discourses that refer to the role of nursing migration. This phenomenon, driven by unequal resource distribution and global scarcity in nursing skills, amplifies the linguistic and cultural diversity currently found in many healthcare settings within South Africa, as well as beyond this country's borders. The thesis presents an account of the communication challenges nursing staff encounter in bilingual and multilingual settings. It outlines the pivotal role language plays in developing and guiding workplace relationships and how the linguistic variety among staff affects workplace communication and the distribution of institutional authority. The research identifies how different strategies, such as those displayed in translanguaging and speakers drawing on their multilingual repertoires, are used to overcome language barriers and to deliver optimal patient-centred care. While institutional policies generally mandate a monolingual stance, the study highlights how nurses pragmatically manage their diverse cultural backgrounds and linguistic identities to ensure effective workplace performance. Findings emphasize that the linguistic and cultural diversity in this workplace, a direct consequence of skills shortages and global migration trends, needs to be recognised, understood and supported to ensure a healthcare environment that delivers quality care in a medical setting that requires specially focused skills. The study concludes that knowledge of linguistic and cultural diversity is necessary for improved communication and optimal patient-centred care in high-pressure settings. The findings suggest routes to formulating policy and developing practice-based strategies to cultivate a communicative environment that accommodates diversity and is attuned to cultural humility which enables optimal workplace collaboration.

Grantor dc:publisher

Stellenbosch : Stellenbosch University

Year dc:date.issued

2026

Author dc:creator

• George, Erica Bernidine

Advisor dc:contributor.advisor

• Anthonissen, Christine

Language dc:language.iso

en

Repository record dc:identifier.uri

https://scholar.sun.ac.za/handle/10019.1/136010

OAI identifier oai:identifier

oai:scholar.sun.ac.za:10019.1/136010