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Yolanda Lejuste Professor Wolcott ENC1102 23 September 2013 Genre Analysis Amy Devitt, the author of Standardizing Written English: Diffusion in the Case of Scotland 1520-1659, has written articles on the genre theory in College English and CCC and theoretical studies of writing genres, defines a genre as something designed within one specialist community for functions to be filled by nonmembers of that community (Devitt, 543). I take genre as something used by a member of a discourse community to be comprehended by nonmembers, but still keep exclusive information within that community private. Based on the way that a genre is organized, it helps one to interpret that data and give feedback to the recipient of that community. My discourse community is in the medical field; therefore as in, any community, there are countless amounts of genres used: medical charts, medication records, insurance forms, patient forms, just to name a few. These documents are organized in a way that the patient is able to understand what he or she is putting on paper and is used for doctors to analyze and make official records. The simplest, but one of the most important records dealing with patient care is pain management. Pain assessments are needed to evaluate the levels of functioning, comfort, and to identify any more underlying issues dealing with the patient’s condition. There are more than enough ways of assessing pain in the medical field and we choose the most easiest and standard routes. For pediatrics, we use the Wong-Baker scale. As seen in appendix A, it has different types of faces indicating an expression for the patient’s pain. There are some scales that come in

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black and white and others come in color to be visually attractive. In the American culture, color changes are significant to how a person feels. The color of the faces on this particular scale goes from a bright yellow color to amber to red, indicating a change in mood. A number line from one to ten is at the bottom in correspondence with the faces to give the doctor a number value to place on the patient’s pain. That scale also has colors; it goes from a bright blue to red. In psychology, they teach us that our brains respond in various ways to certain colors. Just like a yellow traffic light means to slow down and anything with the color red is assigned to danger: a fire alarm, traffic light, or labels on a medication jar, but how do our minds make these connections and why do we listen to them? If your eye catches a red light when you’re REM sleeping, you automatically wake up. The fact that this color is associated with danger, it is only right to make the highest level of pain red, to indicate to the doctors that pain management is needed immediately. The face meaning that no pain is present is a smiling face and we associate a smile with a sense of comfort and the number zero. In the second face, the eyebrows are descended slightly and the smile becomes smaller meaning a minuscule amount of pain is felt; that face is associated with the number two. The face related with the number four, has no smile. When the scale gets to the pain level of six, the eyebrows and eyes get low and a frown is present on the face, meaning that the pain is getting worse. Number eight, the facial structures are even lower and the smile looks like a wide upside down letter U. This face indicates it hurts a whole lot, as displayed on the scale. The last level ten, the face has tears and the frown is as low as it can get and the eyebrows are touching the eyes. While the faces are changing, the number line color changes from a blue and fades into red. The numbers go by two because the scale is an estimate for the healthcare provider to intervene with either medication or comfort measures. Also, take

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into account that the Wong-Baker scale is exclusively used for children and based on their cognitive development they will be more able to respond to faces rather than numbers. It is clear that the medical community structures certain things in a way that the patients will be able to understand. Adults, on the other hand, use a different type of scale to voice their pain to their doctors. In Appendix B, you see that they use a simple pain scale, going from zero to ten, with different shades of yellow, red and green. You may think it silly that adults need to use this number line scale to express their pain, but when someone is in distress, they are at a loss for words. Words used to describe levels of pain vary from, none to agonizing. It too uses increments of two to tell their pain, but the adult patient has the option of saying three or seven, to be properly medicated. Numbers from zero to three is green, meaning that the pain is mild. Once it gets to four, it turns yellow and when it reaches six the color fades into amber. From seven to ten, the highest level, the color is orange to red. As I’ve mentioned before red is the number one color for danger. At the bottom of the sheet there is a line that says, “Task, date, start and end”. Task indicates that the doctor wants to know what the patient was doing when they felt pain, date, meaning the assessment day. The time it started and ended is needed to know the duration of the pain. This can be most likely used for surgical patients or women going into labor, so that they may adjust their positioning, but not compromise the surgical area or the fetus. Appendix C is much more complicated and detail oriented. It is the FLACC pain scale. This form is used precisely by the healthcare provider for children ages two through seven and is used interchangeably for adults. It lists the areas assessed for pain and the patient’s facial features when in that pain. It assesses the face, legs, activity, cry and consolability. This is not the same as the first two pain scales, for they are not measured on a scale from zero to ten. For

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each area, it’s zero to two. Based on the level the patient describes their pain, it can equal ten. There is also a date and time section, so we know that the assessment is done every four hours for the day. Doing this every four hours can seem redundant and it may annoy the patient, but it necessary for proper patient care. A doctor’s assessment is always more detail oriented. They want to get to the core of the situation, to avoid missing any key signs. Even the smallest amount of pain or the tiniest grimace can signify a condition. Again, doctors know that many cultures illustrate pain differently. For example, Asian patients do not express pain and rarely ask for pain medication, so by performing a thorough pain assessment, it can get us one step closer to the intervention stage of treatment. These ways of assessing pain are uncomplicated and makes a difference in saving a life. They are put in layman’s terms so that the patient will easily understand them. If a doctor gave a patient a medical chart and asked them to interpret it, it would be rather difficult because it is put in a way so only medical personnel would be able to grasp the information. This discourse community invites their patients in, but in all communities, there are restrictions. Clear lines are made to separate members from nonmembers, but with the usage of genres, other ways are made possible to develop a connection between these two groups of people. Genres are not based on content anymore as they are with the organization and structure of a document. In the medical field, because we deal with patients lives, we have to organize our work in a way that is comprehendible to both the patient and any other personnel involved in patient care.

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Appendix

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Works Cited "A Review of the Evaluation of Pain Using a Variety of Pain Scales". Table. Dannemiller: Education Center. Dannemiller, 2013. Web. 19 Sept. 2013. Devitt, Amy J., Anis Bawarshi, and Mary Jo Reiff. "Materiality and Genre in the Study of Discourse Communities." 65.5 (2003): 541-557. Web. 19 Sept. 2013 Jacques, Erica. "FLACC Scale -- Pain Assessment Tool". Table. About.com. N.p., 3 Sept. 2009. Web. 19 Sept. 2013 Wong, DL, Hockenberry-Eaton M, Wilson D, Winkelstein ML, Ahmann E, DiVito-Thomas “PA: Whaley and Wong's Nursing Care of Infants and Children.” ed. 6, St. Louis, 1999, Mosby, p. 1153. Web. 19 Sept. 2013