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
(LUUUUTT) heuristic (Pearce, 2005, p. 48). This concept pertains to
the many known and unknown stories that revolve and evolve
within a communication context from the many varying points of
view (Pearce, 2007). Within the context of this study each
participant had their own particular idea of the medical hierarchy.
They each discussed their own unique story as to how they view the
healthcare hierarchy, and how this affects their own individual
existence. Another point is that the staff and physicians see that
there is a change in attitude between physicians of varying
generations. The participants made yet another point that when
there are dominating negative personalities of physicians, these
traits tend to contribute to the constraints that exist in the
hierarchy. Thus, as stated by the participants, it is the negative
communication stemming from a personality trait which potentially
contributes to the constraints within the hierarchal communication
paradigm.
The following are the literal descriptions from multiple
participants concerning the constraints found in communication.
Within the context of CMM and in using the LUUUUTT heuristic,
these quotes are examples of the stories Told and stories Telling.
These particular stories come from the varying professional
participants as they discuss the notion of the surgeon profile within
the medical hierarchy and how this profile influences the
relationship and team interactions.
“ . . . I can’t point to a specific incident but I can tell you
that from being a nurse in the ‘70s, you know, … the
communication is better with the surgeons… the younger
surgeons I should say. So … the older surgeons… maybe
that’s it. Maybe more of the older surgeons, where they grew
up in the culture that they thought that you were God and
then nobody really challenged them.”
“And that, you know, I don’t really understand where
the surgeon’s coming from when … they don’t play along with
the rules. I don’t understand why they think the law doesn’t
apply to them or unsafe things can’t happen to them. I think
it’s a very juvenile response and very impractical and very
destructive to a team approach. How can you have a team?”
“That’s… we need to also, you know, train physicians to
listen better and also train people to be able to give a
narrative, to be able to have the clinical knowledge to say well
this, this, this and this.”
“Yeah, and it’s old school and new school too, you
know. Certain surgeons are, you know, have a higher God
complex or something, you know … it’s personality is what I
think. I mean, certain people are harder to deal with than
others.”
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