Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
communication. This was not done to bracket, but instead to bring
myself into the research and exploration of the OR environment. I
believe that it is important for a researcher to recognize,
acknowledge, and embrace one’s bias as a socially constructed
individual.
The typology pertains to common types of communication
patterns and responses within healthcare between physicians and
nurses. The typology is developed from my perspective as a nurse
in acute healthcare with the use of the concepts from the logical
force ideas of CMM. From a social space, the logical forces provide
multiple contexts that give one an idea of what someone maybe
experiencing within their specific conversational situation (Pearce, in
press).
The main points of the typology are as follows. First, using a
prefigurative thought process, as nurses enter conversations,
nurses have a tendency to try to avoid confrontation with
physicians. Second, nurses understand that there is a practical
aspect to being non-confrontational in that they may then maintain
a positive relationship with physicians. Third, nurses exist in a
contextual environment and within the framework of the medical
hierarchy nurses try to maintain a balance between being the
patient advocate, and being non-confrontational with physicians in
an effort to maintain the nurse-physician relationship. And fourth, at
times the implicative force takes over in that the nurse knows if
they speak in a certain way to a physician the nurse can or will
provoke a specific response, be that good or bad (refer to table I).
Table I.
Typology: CMM Forces and Nurse-Physician Interaction
CMM Forces CMM Forces and Nurse & Physician
The prefigurative force is
the sense of obligation
that one has as one
responds within
conversation because one
senses that this is how the
response should happen
Interaction
Nurses avoid confrontation and
therefore the nurses when interacting
with the physicians may usually have
this idea in mind before they proceed
in any conversation. And, that
conversation between these two
parties has rules of engagement or
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