Contrasting discourse styles and barriers to patient participation in bedside nursing handovers

Authors

  • Suzanne Eggins University of Technology Sydney
  • Diana Slade University of Technology Sydney and Hong Kong Polytechnic University

DOI:

https://doi.org/10.1558/cam.28467

Keywords:

agency, discourse analysis, healthcare communication, patient-centred care, patient safety, systemic linguistics

Abstract

This paper applies qualitative discourse analysis to ‘shift-change handovers’, events in which nurses hand over care for their patients to their colleagues. To improve patient safety, satisfaction and inclusion, hospitals increasingly require nursing staff to hand over at the patient’s bedside, rather than in staff-only areas. However, bedside handover is for many a new and challenging communicative practice. To evaluate how effectively nurses achieve bedside handover, we observed, audio-recorded and transcribed nursing shift-change handovers in a short stay medical ward at an Australian public hospital. Drawing on discourse analysis influenced by systemic functional linguistics we identify four handover styles: exclusive vs inclusive and objectifying vs agentive. The styles capture interactional/interpersonal meaning choices associated with whether and how nurses include patients during handover, and informational/ideational meaning choices associated with whether or not nurses select and organise clinical information in ways that recognise patients’ agency. We argue that the co-occurrence of inclusive with agentive and exclusive with objectifying styles demonstrates that how nurses talk about their patients is powerfully influenced by whether and how they also talk to them. In noting the continued dominance of exclusive objectifying styles in handover interactions, we suggest that institutional change needs to be supported by communication training.

Author Biographies

Suzanne Eggins, University of Technology Sydney

Suzanne Eggins, BA (Hons), MA, PhD, is a research fellow with the University of Technology Sydney and is the national linguist on the Effective Communication in Clinical Handover Project. She trained as a systemic functional linguist under Michael Halliday and JR Martin. She is the author of An Introduction to Systemic Functional Linguistics (Continuum 2004) and co-author with Diana Slade of Analysing Casual Conversation (Equinox 2004).

Diana Slade, University of Technology Sydney and Hong Kong Polytechnic University

Diana Slade PhD is Professor of applied Linguistics at the University of Technology Sydney and Hong Kong Polytechnic university. She is the director of the International Research Centre for Communication in Healthcare and is the Chief Investigator on the Effective Communication in Clinical Handover Project. She is co-author with Suzanne Eggins of Analysing Casual Conversation (Equinox, 2004).

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Published

2017-02-08

How to Cite

Eggins, S., & Slade, D. (2017). Contrasting discourse styles and barriers to patient participation in bedside nursing handovers. Communication and Medicine, 13(1), 71–83. https://doi.org/10.1558/cam.28467