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
openly communicate their feelings and ideas about many patient
care scenarios. Then perpetuated within this suppressive
communication environment are the unwanted repetitive patterns
that become communication rituals.
It is the avoidance and intimidation which then continues to
contribute to, and or perpetuate the unwanted and repetitive
patterns of this hierarchal existence. Hence, within this hierarchal
experience the avoidance and intimidation perpetuates the URP
cycle found within the staff-physician relationship.
In particular, as a new non-physician team member enters
the operating room environment and then as this individual speaks
with what may be considered a lesser and unknown voice, the
individual has a tendency to avoid confrontation and what could be
a potential embarrassment. Then through one’s own inner thoughts
about how one should act as a patient advocate and team member,
and gaining focus and self-acceptance that it is one’s duty to speak
to protect the patients, the individual then gains confidence to
speak and initiate this conversation. However, as a new team
member entering into this situation, one may not be well received
and then the individual may begin to feel intimidated and the cycle
continues. It is within this space of intimidation and avoidance that
the unknown stories define the unheard stories, which evolve into
the untellable stories of self defeat and lack of confidence. It is the
stories of self defeat and lack of confidence which individuals
grapple with as new team members within the operating room
environment.
Logical force. 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,
2007). The logical forces as defined in this context are what
healthcare professionals contend with internally and externally in a
conversational space as one enters a dialogue.
Therefore, there is prefigurative force and thought process
that happens before one enters the conversation. Within the context
of healthcare each individual has an idea of how they will enter the
conversation from their unique role definition and function. From
the perspective of the hierarchal boundaries in healthcare there is a
practical force and aspect to what one will say knowing that there
are rules of engagement. There is also the contextual force of our
interactions that transpires as all of the individuals come together
as a social construction of influence within a dialogue in any
particular situation. In addition, in healthcare there are many
professionals that come into a situation at one time and bring with
them varying ideas of what something means from the aspect of
professional backgrounds, education and relationship development.
Thus, at times there can be a mixing of meanings, which convolutes
our interactions. There is also an implicative force that stems from
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