Discourse Communities in Nursing

Discourse Communities: Nursing

Introduction

 Registered nurses, also known as RNs, are vital to patient care and they play a major role in helping patients manage with illness, preventing disease, and promoting health in their communities. According to Potter and Perry’s Fundamentals of Nursing, “Nurses are a supporter for the patient, the patient’s health, and the patient’s families working to restore health and lessen suffering for their loved one.” As nurses become skilled in their field of practice, their level of responsibility may increase, hence helping them advance into positions with better authority requiring more intricate skills. As nurses become more skilled and gain more responsibility they are becoming a more intricate part of their discourse community. They are learning more about the goals, values, and language of the discourse community in nursing. This helps each nurse to understand more about the nursing discourse community in order to help teach those who are just beginning in the nursing field. After all, you must train the new nurses in order to move others up and replace those who are retiring from the career in order to keep the discourse community going.

 In my opinion, a discourse community can be described as a group of individuals who come together because they share a common goal and purpose. Members in your group must be able to relate with one another through different communication techniques that members implement. Membership within groups are individualized based on the criteria that members put out. A discourse community can be further explained by Ann M. John’s, Discourse Communities and Communities of Practice, she states that “it is an idea of language [and genres] as a basis for sharing and holding in common: shared expectations, shared participation, commonly (or communicably) held ways of expressing.” In other words, people must meet certain criterias to be selected to be part of this group.

 In order to classify different discourse communities, we must analyze the characteristics a of a discourse community. According to John Swales, he explains six defining characteristics in his article, The Concept of Discourse Community. The first characteristic is that “a discourse community has a broadly agreed set of common public goals.” The second characteristic is that “a discourse community has a mechanism of intercommunication among its members (such as newsletters or journals).” The third characteristics is that “it utilizes and hence possess one or more genres in communicative furtherance of it”. The fourth characteristics o is that “it uses its participatory mechanisms primarily o provides information and feedback.” The fifth characteristic is “in addition to owning genres, it has acquired specific lexis.” Finally, the sixth characteristic of a discourse community is “it has a threshold level of members with a suitable degree of relevant content and discoursal expertise.”

 The profession of nursing adheres to Swales’ six defining characteristics of a discourse community. The profession of nursing adheres to Swales’ six defining characteristics of a discourse community. In nursing school, class and lecture objectives are clearly recognized, which relates to the ‘agreed set of common public goals’. Also, nurses strive for the best and cost-effective care of each and every patient in which they see or treat. The goal of the nursing is to improve and promote well-being and cure and manage infections or diseases. The nursing discourse community also finds continuing education and self-wellness valuable for the patients and nurses themselves. This is one of the many participatory mechanisms that the nursing profession has. Finally, to conclude the characteristics of a discourse community directly related to nursing, nursing must incorporate a ratio between a high level of expertise and new graduates. What one might find in the nursing profession is that more experienced nurses “eat their young”, meaning that the new graduate will need to be assertive and take a stand for themselves since he or she has every right to be a part of the nursing discourse community. This is necessary in order for the beginners to develop into the experienced nurses.

Literature Review

 To further understand what this discourse community means to those who are not part of it, I analyzed two literatures to give an insight on the interworks of this group. The first literature comes from Introduction of Public Bank Information Technology Essay – A Nursing Discourse Community. This literature review starts of by explaining that a discourse community are “groups of individuals bound by a common interest who communicate through approved channels and whose discourse is regulated.” He differentiates the two types of discourse communities: primary – original identity (accustomed or grew up in that community) and secondary – non-original (challenging to gain acceptance into that group). Furthermore, the author explains that there are several characteristics that make up a discourse community; shared goals, language, participation, and communication of information. He then directed these characteristics to the Nursing Discourse Community. Nurses share the goal for “enhancing the well-being and cure and manage infections o diseases.” This community value participation and be well versed in the terminology they use in the work field. The author also included a section of the expectations members from this discourse community have on its members and even expectations set by their patients. To further explain the importance of this discourse community, the author included a sample text from this community; he expects that only those who have been exposed or part of this group is able to understand the text.

 This second literature highlights the characteristics of a nursing discourse community and the types of texts and technology used within the group. According to Martin R. Bleich’s paper, An Analysis of the Nursing Workforce, he states that Nurses have three defining characterizes: to have a common goal, to communicate effectively between the members and the different levels or status that each member has. Bleich explains, “Between nurses some common goals do not necessarily need to be written down because good nurses automatically understand these goals.” He highlights that “members come and go all the time and these members must be replaced by other people to continue the discourse community.” Once a member finds a better work opportunity elsewhere, that member can leave whenever they want and the discourse community can still thrive because they are always looking to add new members to their group. Bleich further explains the importance of communication within this group by describing the different ways nurses utilize these resources. He says that “Charts are used to show how the patient’s health has improved or decreased over a certain amount of time… Journals are another one

of these types and are written all the time about the career of nursing by professors who teach nursing courses or by nurses themselves.” To summarize this literature, Bleich understands that a nursing discourse community must have a share goal, a way to communicate with its members and that each member has a status in the group.

Interview

 I interviewed one of my colleagues who is also part of this discourse community. We began with a few simple questions in order to gain a bit of insight within this group. I asked him, what are the shared goals among the members. He responded with, “That’s a bit too broad but in general, we work with other healthcare providers to give care to those who are unable to care for themselves. In nursing, we have goals and we have outcomes. As nurses, our main goals are to care for our patient’s needs. It is more intrinsically motivated than extrinsically. What I mean is that although we get paid a lot, seeing our patients’ eyes glow when we give them a bath, care for them throughout the day, makes this stressful job more. To put simply, nursing is patient centered, we are not motivated for our own wants but for the needs of our patients.” To understand how this group achieves their purpose I asked what mechanisms do members use to communicate with each other. He vaguely responded with “Like other healthcare professionals, we have meetings, use emails, talk on the phone, write letters and papers, conduct speeches, and advocate to the community.” I asked him to clarify how these communication techniques might be utilized and he answered, “During our shifts we use this thing called a Volsera, it’s like a walkie-talkie in the hospital, it allows our staff to communicate to another individual during the shift and makes our job a little bit less hectic. Once we finish giving care to a particular patient, we document or otherwise chart our assessment in a centralized network via the computers that are available in our department.”

 During shifts at the hospital, nurses must work with other healthcare professionals during their shifts. In order to accomplish their goals RNs must use a specialized language to communicate with one another. I asked my colleague what kinds of lexis do members use and he explained that “Nurses run on military time, this allows us to standardize the time of day and to minimize errors when documenting. Instead of saying 7:00 PM we say 1900, both mean the same thing but if a doctor only read 7:00 and forgot if it was AM or PM it would cause a lot of confusion and that’s something we cannot afford when dealing with the lives of patients. When we administer medications, we use the terms PRN, PO, Stat, IV, Subcut, IM, RS, and other medical jargons to speed up communication. There really is no other explanation to why we use these methods rather than just saying, as needed, by mouth, as soon as possible, intravenous, etc. other than cutting down the time we spend writing those words. For instance, if we are to administer 20 drugs in 3 minutes, understanding that an Order is PO rather than IV or IM is faster and more organized than reading out the actual meaning. “

 Nursing is broad and not everyone who enters the field for the first time is an expert. I asked my colleague who are the “old-timers” with expertise? Who are the newcomers with less expertise? How do newcomers learn the appropriate language, genres, knowledge of the group? He wanted to clarify that since nursing is a broad community, “Skills are obtained through out the nurse’s career, there is no particular age that separates the old and the new. In my experience, old timers are usually the nurses who have already been working for more than 5 years and the new comers would be student nurses who are still trying to learn the ins and outs of this career.” He asked me what it’s like to be a new comer and I answered, “Being a new comer can be really stressful, coming into college and finishing my first year learning the fundamentals of this career is really overwhelming. You are expected to learn a lot in such a small amount of time. It’s different with other classes such as history where you learn facts about people from a hundred years ago but in nursing you needed to be able to learn the facts and then apply it to your work immediately. As nursing students, we work beside experienced nurses in our designated hospitals to learn from their experience and to grasp the environment that we would eventually be working in, within the foreseeable future. The nurses are fast to communicate with one another, they are competent in administering medication and giving daily care to patients. The new comers are sometimes ostracized by the older nurses because we either hinder their care and seem incompetent. Other older nurses such as our nursing professors have been teaching students for a long time and gained the experience to teach new comers all the information and knowledge they’ve acquired throughout their careers. They are more willing to share their techniques and aspirations with the new comers than the nurses at the hospital.” I reciprocated and asked my colleague the same thing but in the perspective of an old timer and he responded with, “I agree that some nurses do not want student nurses in hospitals because they take up space in the nurse’s station and we have to find other computers to document our assessments and evaluations. I’ve seen other RNs ostracize other RNs because they did not complete a four-year degree but instead took their associates (these nurses are also known as LPNs). Those nurses feel as if LPNs are incompetent to accomplish the same tasks as those who attained a 4-year degree. Nursing is a battle ground, if you don’t get up from being bombarded by comments like these, you are not ready to be a nurse.”

 Before ending my interview, I asked my colleague if he has any other comments that might be important within this discourse community. He commented and said, “Nursing is a very complicated and complex career, but those who go into this field will experience their fair shares of negativity but they should always remember that Nursing is not for your own satisfaction, you are intrinsically motivated the needs of others and the compassion you want them to experience when you are caring for them.”

Conclusion

 There is a definite discourse community in the profession of nursing in which its members radiate and associate with. This community is a way for members to reach out to each other, to understand the language, their goals, and overall purpose in the nursing field. Nurses utilize many genres to interact amongst each other and others. A few of these genres are using Volsera, computers, charts, and journals. Whether it is to contact pharmacist for prescription, relay vital information, or even contacting doctors for question, these genres allow for different means of interaction, but most importantly communication between other healthcare providers and nurses. Nursing is a very complex discourse community which means if you not a member of this profession, it will be difficult to understand the lexis or goals in which they all follow.

Works Cited

• “Introduction to Advanced Public and Community Health Nursing Practice.” Advanced Public and Community Health Nursing Practice, doi:10.1891/9780826138446.0001.
• Morris, Jenny, et al. “NSW Emergency Department Workforce Research Project and Workforce Analysis Tool.” Australasian Emergency Nursing Journal, vol. 13, no. 4, 2010, p. 137., doi:10.1016/j.aenj.2010.08.266.
• Potter, Patricia Ann, et al. Fundamentals of Nursing. Mosby Elsevier, 2017.
• Swales, John M. “Reflections on the Concept of Discourse Community.” ASp, no. 69, Sept. 2016, pp. 7–19., doi:10.4000/asp.4774.
• Taylor, Pauline, and Narelle Patton. “Practice Communities and Leaders.” Professional Practice Discourse Marginalia, 2016, pp. 213–222., doi:10.1007/978-94-6300-600-2_25.
• Wardle, Elizabeth. Writing about Writing: a College Reader. Bedford Bks St MartinS, 2017.