Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter Mouton February 26, 2020

Nursing handovers as unbounded and scalar events

  • Tom Bartlett EMAIL logo , Virpi Ylänne , Tereza Spilioti and Michelle Aldridge-Waddon

Abstract

In this paper we analyse data from nursing handover meetings in terms of the interplay of different voices that operate at different interactional and institutional scales. We suggest, firstly, that the handover is not a single bounded event, as suggested in previous literature, but rather a gradual moving in and out of focus of a particular discourse activity; and, secondly, that while different phases within the handover as an extended event are characterised by voices operating at a specific scale, there are continuous movements between scales in each phase. This leads us to suggest two categories of rescaling as an activity: translational rescalings, as the handover shifts between phases and from one scale to another, and digressive scales, in which the scale of interaction that typifies a specific phase is temporarily interrupted by another. We illustrate how both these categories serve important revoicing functions and, on the basis of this analysis, extend the use of scales theory in interactional linguistics through the addition of dynamic systems theory and a-curve distributions, in which 20% of token types predominate, while the remainder, or tail, perform essential complementary activities that over time can open up space for gradual shifts in the characteristics and overall function of the activity itself.

Acknowledgements

This paper is a rescaling of a presentation made at the Symposium on Scales co-hosted by the Centre for Language and Communication Research in Cardiff and the Babylon Center in Tilburg on November 15, 2017. Our thanks for all the feedback received at that event.

Appendix: Transcription Key

(?)

talk too obscure to transcribe/ Inaudible/ Can’t decipher word

hhh

audible out-breath

.hhh

in-breath

<

overlapping talk begins

>

 overlapping talk ends

(.)

silence, less than half a second

(number)

silence in seconds

:::

lengthening of a sound

becau-

cut off, interruption of a sound

she

mphasis

(words in single brackets)

best guess at uttered words when unclear

((words in double brackets))

contextual information

£word£

laughing whilst saying

[FNLN]

first name and last name (of patient) – if M or F proceeds, it means male and female

References

Bartlett, T. 2012. Hybrid voices and collaborative change: Contextualising positive discourse analysis. London and New York: Routledge.10.4324/9780203109373Search in Google Scholar

Blommaert, J. 2005. Discourse: A critical introduction. Cambridge: Cambridge University Press.10.1017/CBO9780511610295Search in Google Scholar

Blommaert, J. 2007. Sociolinguistic scales. Intercultural Pragmatics 4(1). 1–19.10.1515/IP.2007.001Search in Google Scholar

Blommaert, J., E. Westinen & S. Leppänen. 2015. Further notes on sociolinguistic scales. Intercultural Pragmatics 12(1). 119–127.10.1515/ip-2015-0005Search in Google Scholar

Candlin, S. & C. N. Candlin. 2007. Nursing through time and space: Some challenges to the construct of community of practice. In R. Iedema (ed.), The discourse of hospital communication: Tracing complexities in contemporary health care organizations, 244–267. Basingstoke: Palgrave.10.1057/9780230595477_12Search in Google Scholar

Cicourel, A. V. 1972. Basic and normative rules in the negotiation of status and role. In D. Sudnow (ed.), Studies in Social Interaction, 229–258. New York: Free Press.Search in Google Scholar

Cicourel, A. V. 1986. The reproduction of objective knowledge: Common sense reasoning in medical decision making. In G. Böhme & N. Stehr (eds.), The knowledge society: The growing impact of scientific knowledge on social relations, 87–125. Dordecht: D. Reidel.10.1007/978-94-009-4724-5_7Search in Google Scholar

Guadaloupe, F. 2008. Chanting down the New Jerusalem: Calypso, Christianity and capitalism in the Caribbean. Oakland: University of California Press.Search in Google Scholar

Iedema, R. (ed.). 2007. The discourse of hospital communication: Tracing complexities in contemporary health care organizations. Basingstoke: Palgrave.10.1057/9780230595477Search in Google Scholar

Iedema, R. 2007. Communicating hospital work. In R. Iedema (ed.), The discourse of hospital communication: Tracing complexities in contemporary health care organizations, 1–17. Basingstoke: Palgrave.10.1057/9780230595477Search in Google Scholar

Kell, C. 2013. Ariadne’s thread: Literacy, scale and meaning making across space and time. Working Papers in Urban Language and Literacies 118. Available online: https://www.kcl.ac.uk/sspp/departments/education/research/ldc/publications/workingpapers/the-papers/WP118.pdf (accessed 15 July 2014).Search in Google Scholar

Kretzschmar, W. A. 2015. Language and complex systems. Cambridge: Cambridge University Press.10.1017/CBO9781316179017Search in Google Scholar

Lloyd, H. 2016. Pity, mass media and social scales. In J. N. Singh, A. Kantara & D. Cserző (eds.), Downscaling Culture: Revisiting intercultural communication, 225–279. Newcastle: Cambridge Scholars.Search in Google Scholar

Lloyd, H., T. Bartlett, V. Ylänne, T. Spilioti & M. Aldridge-Waddon. in preparation. Opening up space for compassion in nurses’ handover meetings.Search in Google Scholar

Manias, E., F. Geddes, B. Watson, D. Jones & P. Della. 2015. Communication failures during clinical handovers lead to a poor patient outcome: Lessons from a case report. SAGE Open Medical Case Reports doi: 10.1177/2050313X5584859.Search in Google Scholar

Mayor, E. & A. Bangerter. 2015. Managing perturbations during handover meetings: A joint activity framework. Nursing Open 2(3). 130–140.10.1002/nop2.29Search in Google Scholar

Mehra, A. & C. Henein. 2014. Improving hospital weekend handover: A user-centered, standardised approach. BMJ Quality Improvement Reports Available online: http://qir.bmj.com/content/2/2/u202861.w1655.full (accessed 7 November 2018).10.1136/bmjquality.u202861.w1655Search in Google Scholar

Royal College of Psychiatrists. 2015. Faculty Report FR/GAP/02. Compassion in care: Ten things you can do to make a difference. Available online: http://www.rcpsych.ac.uk/publications/collegereports.aspx (accessed 7 November 2018).Search in Google Scholar

Sarangi, S. 2010. Reconfiguring self/identity/status/role: The case of professional role performance in healthcare encounters. Journal of Applied Linguistics and Professional Practice 7(1). 75–95.10.1558/japl.v7i1.75Search in Google Scholar

Searson, F. 2000. Introducing bedside handovers: Changing practice on a coronary care unit. Educational Action Research 8(2). 291–305.10.1080/09650790000200125Search in Google Scholar

Singh, J. N., D. Cserző & A. Kantara (eds.). 2016. Downscaling Culture: Revisiting intercultural communication. Newcastle upon Tyne: Cambridge Scholars.Search in Google Scholar

Swyngedouw, E. 1997. Neither global nor local: Glocalization and the politics of scale. In K. R. Cox (ed.), Spaces of Globalization: Reasserting the power of the local, 137–166. New York: Guildford.Search in Google Scholar

Thakore, S. & W. Morrison. 2001. A survey of the perceived quality of patient handover by ambulance staff in the resuscitation room. Emergency Medical Journal 18(4). 293–296.10.1136/emj.18.4.293Search in Google Scholar

Tokode, M., L. Barthelmes & B. O’Riordan. 2008. Near-misses and missed opportunities: Poor patient handover in general surgery. The Bulletin of the Royal College of Surgeons of England 90(3). 96–98.10.1308/147363508X273533Search in Google Scholar

Uitermark, J. 2002. Re-scaling, ‘scale fragmentation’ and the regulation of antagonistic relationships. Progress in Human Geography 26(6). 743–765.10.1191/0309132502ph401oaSearch in Google Scholar

Wallerstein, I. 1998. The time of space and the space of time: The future of social science. Science Direct 17(1). 71–82.10.1016/S0962-6298(96)00097-2Search in Google Scholar

Ylänne, V., M. Aldridge-Waddon, T. Spilioti & T. Bartlett. in preparation. A critical case study of multiple roles and goals in shift-change nursing handovers: ‘We do a lot really, don’t we?’.Search in Google Scholar

Published Online: 2020-02-26
Published in Print: 2021-09-27

© 2020 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 23.4.2024 from https://www.degruyter.com/document/doi/10.1515/applirev-2019-0135/html
Scroll to top button