An exploration of interactions in intercultural nurse-patient encounters

This research explores interactions between registered nurses (RNs) from culturally and linguistically diverse (CALD) backgrounds and their patients in the Australian healthcare setting. Increasing migration of healthcare workers and patients to Australia has led to increasing language and cultural diversity in the workplace. This has led to concerns regarding the management of clinical communication in a second language, and the communicative competence of healthcare workers from CALD backgrounds which can impact on health outcomes and patient safety (Chiang & Crickmore, 2009; Hamilton & Woodward-Kron, 2010; Shen et al., 2012). Yet, rarely has linguistic analysis of intercultural communication between patients and health providers occurred (Collins, Peters, & Watt, 2011; Ulrey & Amason, 2001). The aim of this project is to explore communication between RNs from CALD backgrounds and their patients in the workplace, using the knowledge to contribute towards greater awareness of communication strategies that support communicative competence. Data is drawn from two phases. Phase one involved interviews of RNs from CALD backgrounds. Five themes emerged through thematic analysis of the data, with the central theme of ‘adjustment’ identified as fundamental to the experiences of the RNs. This theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability. The second phase involved participant observations and audio-recording of interactions between the RNs and their patients. Interactional sociolinguistic (IS) and theme orientated discourse analysis of the second phase identified ‘Focal themes’ (Roberts & Sarangi, 2005) that include the display of empathy, building of rapport, and the provision of empowering patient education. Discourse analysis of this interactional data has made available the strategic, discursive choices that these RNs make. It also provides resources for communication training workshops that support the development of communicative competence of RNs who are new to the Australian healthcare environment, therefore supporting improved health outcomes and patient safety.