Reported Speech in Conversational Storytelling During Nursing Shift Handover Meetings

Abstract

Shift handovers in nursing units involve formal transmission of information and informal conversation about non-routine events. Informal conversation often involves telling stories. Direct reported speech (DRS) was studied in handover storytelling in two nursing care units. The study goal is to contribute to a better understanding of conversation in handover and use of DRS in storytelling in institutional contexts. Content analysis revealed that the most frequent sources quoted were oneself and patients, followed by physicians and colleagues. Further, DRS utterances are preceded by reports of situations, actions, and other reported speech, often constituting the climax of a story. Conversation analysis revealed how DRS participates in multimodal reenactments, complaints about patients, and justifying deviations from medical protocols. Results inform understanding of the uses of DRS in institutional storytelling, show how they index relevant membership categories and related knowledge and expectations, and serve as resources for making sense of non-routine events.High-reliability organizations like hospitals maintain task continuity around the clock (Roberts & Bea, 2001;Weick & Roberts, 1993). Thus, work is often organized in shifts. Shift changes occur several times per day and are punctuated Correspondence concerning this article should be addressed to Adrian Bangerter, Institute of Work and Organizational Psychology, University of Neuchâtel, Rue Emile-Argand 11, 2009 Neuchâtel, Switzerland. E-mail: adrian.bangerter@unine.ch , , 1 Published in Discourse Processes 48, issue 3, 183-214, 2011 which should be used for any reference to this work by shift handover meetings (hereafter, handovers) during which relevant task information is transferred from an outgoing shift to an incoming one. In nursing care units, handovers serve to transfer relevant patient information. Handovers are complex events (Grosjean, 2004): They are formal communicative routines conducted according to specific roles while also allowing informal conversations. Informal conversation during handover serves to make sense of ambiguous, non-routine events, thereby helping nurses construct and update a shared understanding of the current state of the care unit. However, little is known about how informal conversation facilitates the emergence of shared understanding. Much information transferred during handovers is in narrative form (e.g., stories about noteworthy incidents, circumstances justifying a medical order, or conflicts with patients). Stories are vivid, collectively elaborated, grounded in experience, and constitute important means of creating shared understanding in professional groups (Orr, 1996). Thus, they may be a means by which nurses create shared understanding. Despite the theoretical and practical importance of understanding stories in handover conversations, there has been little research on this topic.Here we study the interactional functioning of reported speech (RS) in handover storytelling. RS is using "talk to report ...

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