Buus Niels
University of Southern Denmark, Randers School of Nursing, Randers, Denmark.
Issues Ment Health Nurs. 2006 Dec;27(10):1079-96. doi: 10.1080/01612840600943721.
Mental health nurses routinely hand over clinical knowledge at intershift reports. In the present study, field descriptions from prolonged fieldwork and transcripts of audio recordings of handovers were analysed discursively drawing on ethnomethodology and conversation analysis. The analysis identified linguistic and social conventions for handing over clinical knowledge; in particular, differences were identified between non-interactional and interactional handovers. The interactional handovers were relatively more substantial but did also bring forth obvious signs of uncertainty regarding exact clinical situations. Handing over caused a silencing of the least powerful nurses' voices, generated uncertainty, and promoted knowledge about the patients' clinical situation that was not necessarily precise or up-to-date.
精神科护士在交接班报告中会常规性地交接临床知识。在本研究中,运用民族志方法和会话分析,对长期实地考察的田野描述以及交接班录音的文字记录进行了话语分析。分析确定了交接临床知识的语言和社会惯例;特别是,在非互动式和互动式交接之间发现了差异。互动式交接相对更丰富,但也确实出现了关于确切临床情况的明显不确定性迹象。交接导致最无权势的护士的声音被压制,产生了不确定性,并传播了关于患者临床情况的知识,而这些知识不一定准确或最新。