By Olivia Sanford
1/30/19

In the nursing community there are specific ways that its members communicate so as to properly achieve the groups collective goals.

 “Rejoice in your work; never lose sight of the nursing leader you are now and the nursing leader you will become.”
— Sue Fitzsimons, PhD, RN, senior vice president of patient services and CNO at Yale-New Haven (Conn.) Hospital during the Yale School of Nursing 2013 commencement address

10 of the most inspiring quotes about nursing. (2015, March 11). Retrieved January 28, 2019, from https://www.beckershospitalreview.com/hospital-management-administration/10-of-the-most-inspiring-quotes-about-nursing.html

 Nurses are an important part of the medical community, as they are the caretakers, the supporters, and the advisors of the patients coming into each hospital around the world. They are needed for communication between doctors and the patients, for administering medicine, and for caring for the patient in general. Nurses, being such a big and important part of the medical community, have their own discourse community.

Six Characteristics of a Discourse Community

As recorded in the essay “” John Swales said that to be classified as a discourse community the group must have six identifying qualities. First, the group must have “a broadly agreed set of common goals” that guide their work. These common goals are just the reason for why the group is getting together in the first place and what they specifically want to do. Second, the group must have “mechanisms of intercommunication used among its members”. This means how the members of the group communicate, whether it be through face to face speech or through technology. Third, the group must “use its participatory mechanisms primarily to provide information and feedback to its members”. This is just where a group shares, discusses, and critiques new information to the field. Fourth, the group must “utilize one or more genres in the communicative furtherance of it aims”. The genres are just the texts that relay information to the discourse community. Fifth, the group “must have a specific lexis”, such as abbreviations and acronyms. Finally sixth, the group must have “a threshold level of members with a suitable degree of relevant content and discoursal experience”. This means that the members need to understand the discourse community that they are in and have experience with the field of work.

Nursing Goals and Communication

The definition of the discourse community is the other nurses that you can relate to, communicate with, and work with towards a common goal. These common goals include things like providing quality patient care, educating patients and families, promoting a safe work environment, and evolving professionally and continuing education. Overall though, the main goal of a nurse is to be the patients caretaker during their stay at the hospital.
With this common goal in mind, the nursing community has several ways to communicate so that they may accomplish these goals efficiently. Nurses pass information back and forth through many different kinds of texts. Some of the texts are things like bedside written reports, verbal reports that are presented to a group, and tape- recorded reports.  They use these kinds of reports to share and discuss results from patient testing or the general condition of the patient or the procedures needed to be used to improve a patient’s health. Nurses also use things like consultations, orders, practitioner notes, x-ray interpretations, lab test results, diagnostic test results and patient assessments to pass on what the patients are to fellow nurses.
Although these are techniques are used often, verbal communication is the main source of communication between nurses. This is because when you are talking face to face you have a better chance of being understood and the information can be confirmed right away.

Participatory Mechanisms

Participatory mechanisms are places for the members of a discourse community to publish, share, and talk about information from their specific field of work. Some participatory mechanisms could be databases, journals, conferences, etc… In the nursing discourse community one of the most popular databases would be CINAHL. This is database covers texts that are related to nursing and health services. Some other popular databases would include Scopus, Cochrane library, and EMBASE (Excerpta Medica Database). Scopus is the world’s largest abstract database. The Cochrane Library covers medical evidence from many medical organizations on which to base clinical treatment decisions. Finally EMBASE is a database for biomedicine.

Some of the major journals for nursing include American Journal of Nursing (AJN), American Nurse Today, Journal of Nursing Care Quality (JNCQ), and The Online Journal of Issues in Nursing (OJIN). The AJN is the oldest nursing journal in the world and is peer reviewed and evidence based, which shows that it is reliable. The American Nurse Today is the official journal of the ANA (American Nursing Association) and is there to talk about the goals of the ANA and helps nurses to advance in the profession by presenting many reliable sources of information found all over the world. The JNCQ is a peer reviewed journal that provides medical information to the nursing community and is a place where nurses can discuss the issues within the field. Finally the OJIN is a peer reviewed  publication that talks about current topics, research, and education within the field of nursing.
The nursing discourse also has conferences where fellow members can discuss and present their ideas and where people can come and get new information so that everyone may keep up to date when it comes to practicing medicine. Some of these conferences would include the International Conference on Nursing and Healthcare, ANA Quality and Innovation Conference, and Global Nursing Education Conference.

Mechanisms of Communication

When it comes to the “mechanisms of intercommunication” or genres of the nursing discourse community, there are two main types that are used often and are sometimes combined. These would be charting and technology. Nurses have been handwriting charts for hundreds of years as these charts hold important medical and personal information about each patient so that the medical team helping the patient can make informed decisions. Nowadays a lot of this information is still charted, but in a more digitized way.

Now medical facilities are using electronic charting. This is a faster and more efficient way of charting and is easier to access, as well as being more organized. Nurses also use pagers and cell phones as a means of communication between themselves. Its a quick and efficient way of saying that one of the nurses is needed in a certain place and a certain time and keeps everyone informed and up to date. Some smaller, but just as important technological advancements in nursing would include “GPS tagging and tracking on medical equipment, enhanced diagnostic devices, smarter alarm systems, and lifting devices that allow nurses to lift patients without injuring themselves”.

The interweaving of technology to the medical practice is great, but also has some downfalls such as the fact that nurses have to add the attribute of being “tech savvy” to the resume. It can be difficult to learn how to electronically chart at first. Another issue is security when it comes to each patients information because somebody has to create each charting database. It’s more of a risk than a constant issue though and no system is perfect.

Controversial Topics in the Community

Each discourse community has flaws and things that will need to be fixed, but that is why each group has participatory mechanisms to help deal with that. The nursing discourse community has many major topics of conversation at the moment. The most popular controversial topic right now would have to be the debate on whether nurses should have more schooling or not. Some believe that the only thing that is really needed is a 2 year associate’s degree but others argue that to improve the quality of patient care nurses should have at least a 4 year bachelor degree.

Some other controversial topics currently would include issues with compensation, workplace violence, short staffing, long working hours, and workplace hazards. In the issue with compensation, apparently nurses aren’t getting paid the same in different regions of the United States and that has caused some workers to become upset. There’s also supposedly a wage gap between the sexes. In the issue with workplace violence, nurses want it to be a felony charge each time they are attacked by patients or coworkers. The issue with short staffing is that nurses want to lower the amount of patients they are assigned at a time so they can pay proper attention to each patient and improve patient care. Nurses also have long working hours and the issues not just long shifts, sometime nurses work back-to-back shifts or have their shifts extended. This leads to high fatigue levels and patient dissatisfaction. Finally with the workplace hazards, nurses are exposed to bloodborne pathogens on a daily basis, they have a higher possibility of getting injured, and are exposed to cold and flu germs. Some nurses would like medical facilities to provide antiviral face masks so they may protect themselves from all of the germs they are surrounded by constantly.

Terminology

Within the nursing discourse community there is a specific lexis that has been developed over the years. This consists of important terms, acronyms, and key words to the field. These terms are usually things that only people from this discourse community will understand and are usually only used in conversation between fellow nurses, as well as other medical professionals. Some important terms to know in this discourse community are things like blood pressure, blood sugar, vitals, codes, body temperature, etc… There are many different acronyms used on a daily basis in a medical facility. Some of theses acronyms include CPR (Cardiopulmonary Resuscitation), IV (Intravenous), ICU (Intensive Care Unit), RN ( Registered Nurse), HIPAA (Health Insurance Portability and Accountability), SHARQ (Situation, History, Assessment, Recommendations, and Questions), etc…

Research Questions

When searching through all of these databases and journals, as well as looking for the major topics in the nursing community, I came up with a few research questions of my own about such topics. My first question I would like to research would be the wage gap between male and female nurses. I would like to look into where and when it started, how much of a gap there is, and why and how it has persisted throughout the years. Then I could make a suggestion on how it can be fixed why it should be fixed this way.
Another question I would like look further into is why nurse shifts are allowed to be pushed back-to-back and how they can extend shifts. I would look into how long shifts for nurses usually were in the past and how they have changed or stayed the same over the years. I would then propose a solution to lightening the load these nurses take on each time they walk through the medical facility’s doors and shorten the hours that aren’t in their usual shift.

One more question that I might like to research in the near future is why short-staffing of nurses is such a common issue in medical facilities and how the decision regarding the amount of patients a nurse can take on at a time is made. I would like to figure out where this short-staffing issue is most common and why nothing has been done about it in the past and even currently. I would then propose a solution to lower the number of patients assigned to nurses at a time so that it would improve the quality of care patients are getting and it would make each nurses jobs easier.

Conclusion

This medical group has common goals amongst its members, mechanisms of intercommunication, participatory mechanisms, genres that are used to help them reach their goals, terms specific to this group, and members that are educated and experienced in the field. According to Swales’s six characteristics rule this group is definitely able to be labeled as a discourse community.

References

Debski-Seigel, R. (2010, May 17). Karen Ann Quinlan Hospice. Retrieved January 28, 2019, from https://www.karenannquinlanhospice.org/press-future-nursing-education/

Elrick, L. (2017, September 26). Technology in Nursing: How Electronics Are Changing the Field. Retrieved from https://www.rasmussen.edu/degrees/nursing/blog/technology-in-nursing/

Gardner, D. (2017). Nurses Perception of Mobile Communication in an Acute Care Setting. James P. Adams Library Digital Commons. doi:10.28971/532017gd79

Gooch, K. (2015, August 13). 5 of the biggest issues nurses face today. Retrieved January 28, 2019, from https://www.beckershospitalreview.com/human-capital-and-risk/5-of-the-biggest-issues-nurses-face-today.html

Johnson, C. (2015, March). Communicate with me: Information exchanges between nurses. Retrieved January 28, 2019, from https://www.canadian-nurse.com/en/articles/issues/2015/march-2015/communicate-with-me-information-exchanges-between-nurses

Swales, J. (2016). Reflections on the concept of discourse community. ASp,(69), 7-19. doi:10.4000/asp.4774

Timmons, B. (2018, December 31). Nursing Goals & Objectives. Retrieved from https://careertrend.com/nursing-goals-objectives-30541.html
ER Nursing: A Discourse Community. (2014, December 16). Retrieved from https://nursingdiscoursecommunityanalysis.wordpress.com/what-makes-this-community-a-discourse-community/