Shannon Vandenberg 1

Shannon Vandenberg
ENGL 321 Courtright-Nash
Discourse Community
September 18, 2013
The Language of Nursing
John Smith is a 15 year old boy dreaming to become an engineer. He has become ill and
seeks medical attention with his mother who is an elementary school teacher. He gets called into
an exam room by a nurse where she asks him if she can take his vital signs, weight, and height.
What are vital signs? Then the nurse asks questions pertaining to the reason of care, pain,
symptoms, and personal questions regarding educational level, environment, you name it she
asked it. Now lets say this nurse asks, Any dyspnea? Well, John and his mother look at each
other in confusion and back to the nurse for clarification. When the nurse uses medical
terminology she is speaking in her discourse community.
A discourse community is group of people who share a common interest and a specific
language to communicate with. Members of a discourse community actively share goals and
communicate with other members to pursue those goals. Typically they focus on the use and
analysis of written communication (Borg, 2003). This can be within medical terminology, care
plans, journals, and associations. Nurses are special in a way that we have direct communication
with our clients. As nurses we need to understand the transformation of language from our
discourse community to our patient.
In my example I used with John and his mother, the nurse was clearly not achieving the
transformation. I discussed that both John and his mother were not a part of the medical field.
The Scope and Standards of Practice states, The registered nurse conveys information to
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healthcare consumers, families, the interprofessional team, and other communication formats
that promote accuracy (ANA, 2010 p. 1). This means nurses have to play chameleon and be
able to change our communication depending on the people we are speaking with to provide
accuracy. The nurse in my example should have explained what vital signs were so that the
patient (John) knew what procedures he was about to encounter. Using terminology such as
dyspnea (change to medical term you decide to use in the introduction) with John was also a bad
transaction. The nurse should have either used the word then explained what it meant or simply
used vocabulary that would make sense to the patient.
The Scope and Standards of Nursing Practice defines nursing as, Nursing is the
protection, promotion, and optimization of health and abilities, prevention of illness and injury,
alleviation of suffering through the diagnosis and treatment of human response, and advocacy in
the care of individual, families, and communities, and population (ANA, 2010 p. 54). I used the
American Nurses Association (ANA) as my professional website. The ANA website makes it
very approachable for people that would like to join the nursing discourse community. It is easy
to navigate and they use user-friendly vocabulary, while also targeting those who already
understand the shared language. While navigating, I noticed that the information wasnt lengthy.
It was short, sweet, and to the point. The website provides a significant amount of information
regarding nursing such as health and safety, practice, and ethics. The nursing professional
websites are used offer brief information about themselves and the nursing profession.
I used the Scope and Standards of Practice book as a reference. As nurses we have a
standard of professional nursing practices and performances to maintain. There are sixteen
standards in which some include assessment, diagnosis, planning, implementation, evaluation,
education, quality, collaboration, and communication. The book analyzes each standard in depth
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using vocabulary and terminology to construct guidelines. It isnt very user friendly to those
outside of the nursing community. For example, the quality of practice states, The registered
nurse identifies problems that occur in a day-to-day work routine in order to correct process
inefficiencies (ANA, 2010 p. 52). It targets those in the community seeking further goals and
interests in the profession of nursing.
Communication within the nursing profession is vital to good practice. Nurses seek
continuous improvements of communication. They communicate with patients, their families,
other nurses, physicians, dieticians, radiologists, pharmacists, and others involved in patient care.
The Foundations of Nursing Practice defines the nursing role as a communicator by, The use of
effective interpersonal and therapeutic communication skills to establish and maintain helping
relationships with patients of all ages in a wide variety of healthcare settings (Taylor, C. R.,
Lillis, C., LeMone, P., & Lynn, P., 2011 p. 12). Nurses are the official communicators with the
patients. Their relationship intertwines communication, care, and time (Chan, E., Jones, A., &
Wong, K. 2013). The nurse has to provide enough time to interact with their patient especially
during procedures. Their communication during tasks is on a more meaningful level pertaining
to the informing and educating on the procedure resulting in encouraging self-care. They also
have to use opportunistic types of communication such as non-verbal. (Chan, E., Jones, A., &
Wong, K. (2013)
Reading the journals such as the Journal of Advanced Nursing and journals through the
ANA I saw a pattern where standards and purposes were being provided with the use of the
nursing discourse community language. They were lengthier entries usually to prove standards
within the medical field. For example the journal, Mindful Communication: A Novel Approach
to Improving Delegation and Increasing Patient Safety by Anthony and Vidal where they
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address the issue concerning how nurses are relying on unlicensed assistive personnels as a
member of the healthcare team. That means the nurses are accountable for the outcome of the
care the unlicensed assistive personnel provides because the nurse delegates those tasks. They
need to depend on effective communication because delegation, safety, and quality of care are at
risk (Anthony, M., Vidal, K., (2010 May, 31). It is important to the nurse to effectively
communicate to any member of the health facility, not just the unlicensed assistive personnel.
While reading the journal it is apparent that they are targeting an audience familiar with the
medical field especially using phrases like delivery care system which someone out of the
discourse community wouldnt quite understand.
The individual that I interviewed for this assignment was Kathleen Bogucki, a registered
nurse for twenty-five years and currently working in the emergency room at St. Marys hospital.
Kathleen is a respectable nurse that provides an insight from the past to the present of health
care. I start the interview out by asking her how nursing defines itself. She states, First and
foremost nursing is a vocation not a job or career. I feel anyone entering this profession must be
doing so for the calling not for the money. From my perspective, Nursing is an art and a
science. Its an art because as a professional nurse I treat my patients with compassion, empathy,
and sensitivity on an individual basis. With these 3 characteristics I am treating the patients
mind and spirit. Nursing is a science starting with the basis of anatomy/physiology,
pathophysiology, and biochemistry. The science is where the nurse collaborates with physicians
to meet the medical needs of the patient. Here Kathleen touches on communication within
nursing but she really defines the true meaning behind the profession.
Then Kathleen and I get into more depth about communication where she proceeds to
explain, In todays health care settings written communication is pretty much gone. Everything
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I do is done electronically getting doctors orders, charting patient assessments, looking at lab
values and radiology reports. The 1
st
25 years of my nursing career was paper charts where a
nurse had to be an excellent interpreter of the doctor handwriting to decipher the doctors orders.
Lab and radiology were hand typed and sent back when done. I have a feel on how in the
medical field they have changed their ways from paper to electronic. From Kathleens tone of
voice I could tell she felt sour towards the transition to electronic. However she added that,
Errors have decreased since we dont have to read handwritten anymore. Since some people
have chicken scratch. This provides a technological advance to the health field where we are
continuously improving.
One of the most important statements Kathleen added was, A major part of
communication is subjective and objective data in documentation. Subjective data is what the
patient states or indicates. Objective data is what the nurse actually observed. For example
subjective data would be the patient states, I have pain in my arm. An example for objective
data would be vital signs, height, weight, or actually palpating the arm for tenderness or
swelling. Nurses have to understand these two terms to write their documentation. The objective
and subjective date help create a nursing diagnosis. This goes into the documentation and care
plan to improve their health and status.
In conclusion, between the journals, books, professional websites, and the interview I
have found that the communication within the nursing profession is purposeful and professional.
Usually the journals are lengthier providing standard practices and using only the medical field
vocabulary. The professional websites use user-friendly vocabulary inviting other communities
to learn about the nursing profession while offering nurses their satisfaction of interest within
their community. The verbal communication consists of medical terminology where the
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community must be able to perform translations to whoever they are speaking with. The focus of
communication towards our patients is more expressive and therapeutic. Whereas talking with
our colleagues we use medical abbreviated terminology. The communication is ongoing and
advancing. It is my responsibility as a nurse to keep up with the change and apply all the
communication to my daily routine as a nurse.


















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Works Cited
ANA. (2010). Scope and Standards of Practice (2nd ed., pp. 1-54). Silver Spring, MD:
Nursingbooks.org.
Anthony, M., Vidal, K., (2010 May, 31). "Mindful Communication: A Novel Approach to
Improving Delegation and Increasing Patient Safety" OJIN: The Online Journal of Issues
in Nursing Vol. 15, No. 2, Manuscript 2.
Bogucki, K. (Personal communication, September 10, 2013)
Borg, E. (2003, October). Discourse Community. In ELT Journals. Retrieved October 11, 2013,
from http://eltj.oxfordjournals.org/content/57/4/398.full.pdf+html
Chan, E., Jones, A., & Wong, K. (2013). The relationships between communication, care and
time are intertwined: a narrative inquiry exploring the impact of time on registered
nurses' work. Journal Of Advanced Nursing, 69(9), 2020-2029. doi:10.1111/jan.12064
Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of Nursing: The Art and
Science of Nursing Care (7th ed., p. 12). N.p.: Lippincott Williams and Wilkins.





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Interview (E-mailed portion)
How does nursing define itself?
First and foremost nursing is a vocation not a job or career. I feel anyone entering this
profession must be doing so for the calling not for the money. From my perspective, Nursing
is an art and a science. An art because as a professional nurse I treat my patients with
compassion, empathy, and sensitivity on an individual basis. With these 3 characteristics I am
treating the patients mind and spirit. The counselor part of my nursing profession. Nursing is a
science starting with the basis of anatomy/physiology, pathophysiology, and biochemistry.
Depending on the individual medical history the nurse is expected to recall what part of science
pertains to that individual. The science is where the nurse collaborates with physicians to meet
the medical. needs of the patient This describes the scientist part of my nursing profession.
.
The kinds of skills and qualifications the job requires?
The fundamentals such as Vital Signs, recognizing abnormal lab values, along with the items I
stated above. I understand a Bachelors Degree is the degree of choice currently but I feel that
anyone pursuing a nursing profession must work in the health care field with patient contact
prior to being admitted into a program. I feel this gives the individual insight into the art of
nursing.
The expectations and surprises you had in entering the profession?
I have been a RN for 35 years with 4 years of nurse assistant experience while attending
nursing school. A lot has changed especially from the 1
st
10 years in my career from the
perspective that the doctors expected not to ask questions or be a part of the patients overall
plan of care _ Just do what I tell you to do and know Im right Not Good.
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Today however the current generation of doctors collaborate with nursing in the patients best
interest. Maybe because RNs have stepped up in the profession as well.

The biggest surprise is how nursing school doesnt prepare you for organizing multiple patient
assignments each needing individual and unique care. This is achieved through
facility/organization orientation and having a mentor who can be a contact as a nurse matures
and gets more confident in her day-to-day role.

What kinds of communication, especially writing, do you do on the job?
In todays health care settings written communication is pretty much gone. Everything I do is
done electronically getting drs. Orders, charting pt. assessments, looking at lab values and
radiology reports.
The 1
st
25 years of my nursing career was paper charts where a nurse had to be an excellent
interpreter of the doctor handwriting to decipher the doctors orders. Lab and radiology were
hand typed and sent back when done. Errors have decreased since we dont have to read
handwritten anymore. Since some people have chicken scratch. A major part of communication
is subjective and objective data in documentation.

The other important communication is verbal either face-to face or on the phone. Mostly using
phone when needing to contact dr or other health care staff that may be needed for a specific
patient

With whom this communication occurs?
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Electronically I can communicate with anyone in the health care setting for the needs of the
patient.
First would be doctors orders, followed by lab and radiology staff. If a special med is needed I
send a communication to pharmacy otherwise because of the electronic chart the doctors orders
go directly to the pharmacy and I can expect the meds to arrive to my area in a short time.
Electronic communications can also be sent to Central supply for specific equipment needed for
an individual patient as well as Nutrition Services.