During daily hospital ward rounds, medical teams, led by doctors, assess the progress of an individual patient's health. It is widely reported in the research literature that nurses play a relatively passive role during these rounds, because although they may have valuable information about the patient's condition and progress, and indeed their role includes advocacy on behalf of their patients, nurses nevertheless can experience difficulties in participating during case constructions. Here we report an instance from a (gastro-surgical) ward round in a Finnish hospital, in which nurses played a key role in reversing a consultant's initial decision to discharge a patient. They did so not by directly challenging the consultant's opinion, but by employing indirect means to introduce their discrepant perspective: they provide descriptions and ask questions that draw attention to information that results in the doctor coming to a different assessment than theirs of the patient's condition, and a different decision about what should be done (the patient was not discharged from hospital). The encounter reported here is taken from a corpus of ward round discussions in a Finnish hospital. The method of our study is Conversation Analysis.
Työelämän monikielistyessä yhä useammalla työpaikalla kohdataan haasteita, jotka liittyvät työntekijöiden rajalliseen kielitaitoon. Erityisesti korkeakoulutusta vaativat tehtävät edellyttävät abstraktien ja monitahoisten ilmiöiden kielentämistä, minkä lisäksi tilanteissa on pystyttävä ottamaan huomioon osallistujien institutionaaliset roolit ja niihin liittyvät odotukset. Tämä artikkeli tarkastelee keskustelunanalyysin keinoin, millaisia ongelmia kakkoskielisten työntekijöiden osallistumiseen liittyy kokousvuorovaikutuksessa. Aineistona käytetään erään kulttuurialan säätiön kokouksia (yhteensä 20 tuntia videomateriaalia), ja niissä tarkastellaan vuorovaikutuksen etenemisen ongelmakohtia, jotka liittyvät suomea toisena kielenä käyttävien työntekijöiden responsiivisiin vuoroihin. Tutkittavia vuoroja voidaan pitää erilinjaisina, sillä ne eivät vastaa edeltävien vuorojen niille asettamiin odotuksiin. Erilinjaisia vuoroja on kolmenlaisia: vuoroja, jotka osoittavat, ettei puhuja ole tunnistanut itseensä kohdistuvia odotuksia, vuoroja, joiden edustama toiminto on epäselvä, sekä vuoroja, joiden edustama toiminto on odotuksiin nähden riittämätön. Analyysi osoittaa, millaisia ongelmia erilinjaiset vuorot aiheuttavat keskustelun etenemiselle: niistä seuraa esimerkiksi taukoja, uudelleenmuotoiluja tai korjausaloitteita. Muut osallistujat tulkitsevat toisinaan ongelman johtuvan kielitaidosta ja esimerkiksi vaihtavat kieltä. Kakkoskielisten puhujien erilinjaisissa vuoroissa limittyvätkin ymmärtämisen ja tuottamisen ongelmat, ja tilanteita saattaa vaikeuttaa myös institutionaalisiin rooleihin liittyvien taustaoletusten tunnistaminen. Artikkelissa osoitetaan, miten kakkoskielisissä kokouksissa tasapainoillaan työrooleja kannattelevan hienotunteisuuden ja ongelmien selvittelyä edistävän eksplisiittisyyden välillä. Mahdollisuus käyttää kieltä antaa joka tapauksessa kakkoskieliselle työntekijälle mahdollisuuden kehittää kielitaitoaan, mistä on pitkällä tähtäimellä hyötyä koko työyhteisölle. Disaligned turns of second-language speakers in workplace meeting interaction An increasing number of workplaces face challenges related to the limited language skills of their employees. This article takes a conversation analytical view of the problems that educated second-language (L2) speakers encounter in workplace meeting interactions. The data employed consists of 20 hours of video recordings taken at a Finnish cultural organisation. The article concentrates on problems in the progressivity of interaction related to responsive turns produced by L2 speakers of Finnish. The problematic turns are seen as disaligned, as they do not meet the expectations projected by previous turns. Three kinds of turn are discussed: 1) turns that show that the speaker has not identified the expectations set by preceding turns, 2) turns that are unclear with regard to the activity they represent, and 3) turns that meet the expectations of previous turns inadequately. The analysis shows that disaligned turns are followed by several problems with regard to the progressivity of interaction: e.g. pauses, reformulations, or repair initiations. Occasionally, other participants interpret the problems as displays of a lack of language skills, and they react by switching language. The article illustrates practices used to deal tactfully yet effectively with problems in the progress of interaction. The article asserts that, despite these problems, the opportunity to use and practice a second language is valuable both to L2 speakers and their work community.
Nurses need to adapt to various interactional situations and design their talk for different recipients. One essential communicative task for nurses is to transmit information on test and measurement results both to the patient and to the physician. This article examines how nurses design their talk on numerical values according to the recipient and the activity.The nurse can deliver the patient information either plainly through numbers or by formulating some type of qualitative description of the value. The data consist of 7.5 hours of video-recorded interaction in a Finnish hospital. Using conversation analysis, we demonstrate how the institutional roles and the ongoing activity sequence affect how nurses formulate their talk. When nurses discuss results with their patients, they typically use qualitative descriptions, whereas when they talk with doctors, the typical turn involves numeric information. It will be demonstrated that nurses construct their professional identity involving both care and medical expertise through their linguistic-interactional choices. 3 BIONOTE Salla Kurhila is university lecturer at the Department of Finnish, Finno-Ugrian and Scandinavian Studies at the University of Helsinki. Her publications include studies on different phenomena in second language conversations, language learning in interaction, and correction and intersubjectivity in conversation. Inkeri Lehtimaja is a post-doctoral researcher at the Department of Finnish, Finno-Ugrian and Scandinavian Studies at the University of Helsinki and university lecturer in Finnish languageat Aalto University, Helsinki. Her research interests cover second language teaching and learning, professional language, and classroom interaction.4 Dealing with numbersnurses informing doctors and patients about test results
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