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“Transition in and between Discourse Communities: One Nurse’s Struggle”

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by Terri Cole | Xchanges 9.2

Abstract: In this IRB-approved study I contribute to studies of enculturation within writing studies by investigating the transition one new nurse makes from an academic to a workplace discourse community. Drawing on the Cycle of Transition framework constructed by composition scholars Anson and Forsberg (1990), I examine three possible stages the focus nurse goes through in her transition: expectation, disorientation, and transition and resolution. I discuss the ways in which the focus nurse struggles to adapt to the shifting rhetorical and social situations within her new workplace community. Focusing mainly on one particular literacy practice, the SBARP-Verbal Communication for Transfer of Care (Change of Shift Report), I illustrate the challenges she faces in negotiating her identity in the process of transition, as well as exemplify the way nursing literacy practices facilitate one’s initiation into the workplace community. I propose that many new nurses encounter similar challenges and continually undergo the cycle of transition process and suggest implications for writing researchers, teachers, and nursing practitioners.

One Nurse’s Struggle

Lena Jones (a pseudonym I will use throughout) is an intelligent and outgoing twenty-five-year old woman who graduated with a nursing and psychology degree from Stone Edge University in the spring of 2011. Prior to becoming a nurse she was a waitress for nine years at a local restaurant in order to support herself through school. Lena has always considered herself to be a friendly person who can readily handle stressful social situations.

However, her confidence in between graduating college and searching for a nursing position quickly turned into apprehension. She became nervous that she did not have enough knowledge to be an adequate nurse and that more experienced nurses would think she was “stupid.” Lena originally wanted to find a nursing position on the Psychiatric unit because of her major in psychology and recent clinical experience on that unit, but she was able to obtain a position on the Oncology unit at Sherwood Hospital (a pseudonymic name for the hospital at which she worked) and although she was at first hesitant, she accepted. Her training began at the beginning of November 2011 and lasted until January 2012. Over the first few months at her new job, Lena physically started to show stress—she rarely smiled, constantly appeared tired, and when she talked about work it was always putting herself down, usually making comments such as “I don’t know enough,” “I don’t understand,” or “I don’t think people like me.” Lena actually seemed unprepared and even requested an extra week of training because she did not feel she had acquired enough knowledge specific to the hospital unit.

This article focuses on Lena’s struggle with the shifting rhetorical situations in the nursing community and investigates the ways in which nursing literacy practices facilitated her initiation into this workplace community. I focus heavily on her experience with one particular nursing literacy practice, the SBARP-Verbal Communication for Transfer of Care, and investigate the challenges Lena faced in adapting to this genre and its unspoken written and verbal guidelines. Using Anson and Forsberg’s (1990) theory on the “cycle of transition” as my framework, I examine Lena’s process of acculturation, proposing that like Anson and Forsberg’s interns, Lena goes through three stages: expectation, disorientation, and transition and resolution. My research with Lena leads me to suggest that these two communities often have conflicting roles; what is necessary or appropriate in one community is not in another. Furthermore, my research draws attention to genres in nursing, and the role genre learning has in the workplace.

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