Date of Award

1992-12-01

Degree Name

Doctor of Nursing Science

Dissertation Committee

N/A

Keywords

ethnography, nurse-patient relationship, nurse practitioners, nursing, patients, sociolinguistic

Abstract

Ethnographic methods were used to examine the sociolinguistic dimensions of female nurse practitioner interactions with female patients. The purpose was to provide a contextual account of the discursive practices used by the nurse practitioners during routine office visits with female patients. Direction for this research was provided by my concern about power inherent in professional-client dyadic relationships. Data collection methods included formal and informal interviews, participant observation and audio taping nurse-patient encounters. Nine nurse practitioners and 26 patients participated in the study in both private and public ambulatory care settings. Data analysis yielded two concurrent story lines which I labeled "language as process" and "patterns of language". These two story lines eventually converged on the question of power in nurse practitioner encounters with patients. The language process that characterized the encounters consisted of five action oriented linguistic steps or phases that served to establish the ambiance, as well as control the pace, and direction of the office visit. The steps or phases were identified as: openings, transitions to business, the business at hand, transitions to closure, and closures. The four major linguistic patterns that seemed to characterize the talk of the nurse practitioners as they interacted with female patients were as follows: Supporting, informing, controlling and professional jargon. Instances of sociolinguistic power were identified in the processes that controlled the pace and direction of the office visits and potentially truncated data gathering. Controlling language, including warning and command statements, and the use of professional jargon were also examples of power embedded in the language of nurse practitioners identified in the verbatim transcripts. Some implications for this study relate to educating nurse practitioners about the transparent power of language, and the potential for untoward outcomes for patients when that power is not recognized.

Document Type

Dissertation: Open Access

Department

Nursing

Included in

Nursing Commons

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