Westenberg Sydney Westenberg Professor Emilia Grant English 1101-008 November 5th, 201

!edi"ally S#ea$ing% an Ethnogra#hy on the !edi"al &is"o'rse (omm'nity

)f one *as to *al$ into a hos#ital on any given day, they *o'ld find a large array of health "are *or$ers 'sing *hat those not a"tively a #art of the #ra"ti"e may "onsider a strange lang'age to rea"h a "ommon goal+ ,he health "are *or$ers inside of that hos#ital are #art of *hat is "alled a dis"o'rse "omm'nity+ Strand -'otes that ./ames Porter defined the dis"o'rse "omm'nity as% 0 lo"al and tem#orary "onstraining system, defined by a body of te1ts 2or more generally, #ra"ti"es3 that are 'nified by a "ommon fo"'s+4 5y this definition, the medi"al "omm'nity *o'ld fall 'nder the "ategory of a dis"o'rse "omm'nity+ Strand "ontin'es on to des"ribe the si1 standards a "omm'nity m'st meet in order to be "onsidered a dis"o'rse "omm'nity as defined by /ames P+ S*ales+ ,hese si1 -'alifying standards are6 2*o'ld ma$e more sense to me if the *ord that *as added here3there is a broadly agreed '#on set of goals *ithin the "omm'nity, that there are methods of inter"omm'ni"ation #resent in the "omm'nity, that there are #arti"i#atory methods that #rovide information and feedba"$ to the 2*ithin73 the "omm'nity members, that there are varied genres 2methods of "omm'ni"aton73 that are 'sed in "omm'ni"ation set to*ards the "om#letion of the "ommon goals of the "omm'nity, that there is an e1"l'sive le1is or lang'age #resent in the "omm'nity, and that there are members of the

Westenberg "omm'nity that 2*ho3 are "onsidered e1#erts and there is a minim'm threshold for $no*ledge re-'ired to 8oin the "omm'nity+ ,he 9i##o"rati" :ath, 'sed to s*ear in ne* members in the medi"al "omm'nity, sho*s some of the "hara"teristi"s re-'ired by S*ales to be "onsidered a dis"o'rse "omm'nity 2Senten"e needs "larifi"ation3+ Strand e1#lains ho* a medi"al "omm'nity fits all the re-'irements of a dis"o'rse "omm'nity in that its "ommon goal is to im#rove the *ellbeing of man and to im#rove treatments of health "onditions, the "omm'nity "omm'ni"ates thro'gh a n'mber of genres 2medi'ms73, the medi"al "omm'nity has a n'mber of 8o'rnals and boo$s #'blished in order to e1"hange $no*ledge6 the "omm'nity has a "ommon interest, $no*ledge of the h'man body and s#e"iali;ed terminology in !edi"al dis"o'rse is al*ays "hanging and re-'ired to $no* by members, and *itho't #rior training one "annot enter the medi"al dis"o'rse "omm'nity+2,his needs to be bro$en '# for "larity3 &es#ite the vast "overage of the medi"al "omm'nity as a dis"o'rse "omm'nity, there is little resear"h s'rro'nding the #ositive im#a"t that a 'niversal medi"al le1is #rovides *ithin the medi"al dis"o'rse "omm'nity+ ,his ethnogra#hy *ill sho* 2&is"'ss7 )t so'nds smoother3 ho* the s#e"ifi" dis"o'rse

Westenberg and le1is that is 'sed thro'gho't the dis"o'rse "omm'nity aids in the a""om#lishment of "ommon goals and en"o'rages fast and effi"ient "omm'ni"ation *ithin a *ide range of #eo#le+ ,he resear"h in this #a#er *as obtained thro'gh a #ersonal intervie*, vario's a"ademi" arti"les and te1tboo$s, and firsthand observation+ Part 2:ne3of the re-'irements for a dis"o'rse "omm'nity is "omm'ni"ation *ithin the "omm'nity+ (omm'ni"ation is a vital #art of the medi"al dis"o'rse "omm'nity for 2be"a'se3 it allo*s the movement of information and dis"'ssion *ithin 2bet*een3 members of the gro'#+ Patients are "onstantly being transferred from different 'nits *ithin a hos#ital, and "omm'ni"ation on a #atient<s "ondition and medi"al needs is essential in #roviding "are for the #atient+ :ften times in a hos#ital, transferring a #atient "an be an emergen"y sit'ation in *hi"h every se"ond "an "o'nt+ )f the #atient is in "riti"al "ondition, the do"tors and n'rses re"eiving the #atient need to $no* *hat they are dealing *ith as soon as #ossible in order to treat the #atient in a timely manner+ ,he 'se of a s#e"ifi" le1is *ithin the medi"al "omm'nity is the sol'tion to that #otential #roblem+ )n the medi"al dis"o'rse "omm'nity, a "ombination of medi"al terminology that "onsists of =atin based #refi1es and s'ffi1es as *ell as abbreviations are 'sed in .sim#lifying long, "om#li"ated terms for disease, diagnosti" #ro"ed'res, and thera#ies that re-'ire e1tensive do"'mentation4 2(olbert 113+ Simmers sho*s ho* several abbreviations "an be "ombined to give orders or dire"tions *ith the e1am#les%

Westenberg 5? "@ 5?P, AAl -h, BS -id NP: 8 #m, ,o =ab for (5(, 5CN, and A5S 2Simmers 1203+ ,hese abbreviations translate into% bedrest *ith bathroom #rivileges, for"e fl'ids every ho'r, vital signs fo'r times a day+ ,he se"ond e1am#le is inter#reted as follo*s% nothing by mo'th after eight o<"lo"$ in the evening, to the laboratory for a "om#lete blood "o'nt, blood 'rea nitrogen, and fasting blood s'gar+ Csing the abbreviations, a larger amo'nt of information *as transferred 'sing a -'i"$er method that re-'ired less *riting+ Some of the more "ommon abbreviations are as follo*s% (9A D (hroni" 9eart Aail're, ()(C D (ardia" )ntensive (are Cnit, ()P& D (hroni" )nflammatory &emyelinating Polyne'ro#athy, (: D (om#laints :f, (B0 D (erebrovas"'lar 0""ident 2or a stro$e3, &N? D &o Not ?es's"itate, E5= D Estimated 5lood =oss, EEG D Ele"troen"e#halogram, EG& D Eso#hagogastrod'odenos"o#y, 9)P00 D 9ealth )ns'ran"e Portability and 0""o'ntability 0"t, 9B=, D 9igh-Belo"ity =ead ,hera#y 2g'nshot *o'nd3, )&0 D )ron &efi"ien"y 0nemia, !0?S0- !ethi"illin and 0minogly"oside-?esistant Sta#hylo"o""'s 0're's, !) D !yo"ardial )nfar"tion 2heart atta"$3, !?S0 D !ethi"illin-?esistant Sta#hylo"o""'s 0're's, NP: D Nothing by mo'th, NE& D Not Eet &iagnosed, PE??=0 D P'#ils E-'al ?o'nd and ?ea"tive to =ight and 0""ommodation, ?5( D ?ed 5lood (ells, ?)(E D ?est )"e (om#ression Elevation, ?:! D ?ange :f !otion, ?F: D ?'le :'t, SS?) D Sele"tive Serotonin ?e'#ta$e )nhibitor, ,5 D ,'ber"'losis, and ,)0 D ,ransient )s"hemi" 0tta"$+ ,he abbreviations that are listed are a handf'l of terms that along *ith "o'ntless

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Westenberg other abbreviations, #refi1es, s'ffi1es, and *ord roots that "ome together to "reate medi"al terminology+ 0s stated by Simmers, .Entire di"tionaries have been *ritten to in"l'de the terminology 'sed in health "are+ )t *o'ld be im#ossible to memori;e the meaning of every *ord+ 5y learning "ommon #refi1es, s'ffi1es, and *ord roots, ho*ever, a health "are *or$er "an brea$ a *ord into #arts and fig're o't the meaning of the *ord 21 G34+ ,his s#e"ifi" le1is, *hi"h many #ra"tioners 2s#elled *rong3 "onsider to be 'n-'antifiable, is *hat se#arates the "omm'nity from o'tsiders+ :ne "annot be a #art of the "omm'nity *itho't a "onsiderable amo'nt of st'dying, learning, and training that e1#oses oneself to the dis"o'rse 'sed *ithin the "omm'nity and its members+ ,he medi"al "omm'nity is, by S*ales "riteria and definition, a dis"o'rse "omm'nity+ 9o*ever, the medi"al "omm'nity "an also be loo$ed at 'sing /ohns< "on"e#ts of a "omm'nity of #ra"ti"e 2define this3+ (onfli"ts *ithin the "omm'nity "ome from vario's so'r"es, one of the most "ommon being different inter#retations and methods of doing #ro"ed'res+ ,hese "onfli"ts "o'ld be vie*ed as relating to the *ide diversity and "onventions #resent in a large "omm'nity s'"h as a hos#ital+ 5eing a member of this "omm'nity does involve sa"rifi"ing a fe* l'1iries 2s#elling3 s'"h as s'ffi"ient slee#, an o#en s"hed'le, freedom to tal$ abo't *or$, and o""asionally a healthy so"ial life o'tside of the hos#ital+ ,he a'thority #resent in the hos#ital "an be divided in t*o *ays, the assigned a'thority and the earned a'thority+ ,he assigned a'thority is the

Westenberg members of the hos#ital that are hired to be s'#ervisors and held at a higher level+ ,he earned a'thority is the a'thority that is given to members of the "omm'nity *ho have been in #ra"ti"e for the longest amo'nt of time and *ho $no* the most abo't their #ra"ti"e+ )t is very diffi"'lt to m'shfa$e 2hahaha, s#elling73 in this "omm'nity, for ne*"omers m'st have a basi" level of $no*ledge abo't the "omm'nity and their le1is in order to be a #art of the "omm'nity+ ,he genres or m'ltilitera"ies 2s#elling3 'sed by members *ithin the #ra"ti"e are most "ommonly #atient re"ords, along *ith emails, notes, fa"e to fa"e "onversation, and memos over the "om#'ter system set '# for #atient re"ords and "ondition+ When "onsidering both S*ales and /ohns< definitons a "on"l'sion "o'ld be made that the medi"al "omm'nity *ithin a hos#ital is both a dis"o'rse "omm'nity and a "omm'nity of #ra"ti"e+ ,he hos#ital as a *hole is a "omm'nity of #ra"ti"e *ith all of the staff shares the "ommon interest of the #reservation of life and health *hereas the s#e"ifi" 'nits *ithin the hos#ital *o'ld be "onsidered dis"o'rse "omm'nities that are "on"entrated on a s#e"ifi" goal that is "entral to their s#e"ifi" 'nit+

Westenberg Wor$s (ited

(olbert, 5r'"e /, /eff 0n$ney, and Jaren ,+ =ee+ Anatomy, Physiology, & Disease. An Interactive Journey for Health Professionals. C##er Saddle ?iver, Ne* /ersey% Pearson Ed'"ation, 200G+ Print+

Simmers, =o'ise, Jaren Simmers-Nart$er, and Sharon Simmers-Jobela$+ Diversified Health Occupations. Ith ed+ (lifton Par$, NE% &elmar (engage =earning, 200G+ Print+

Strand, ?a"hel, and 0manda ,haler+ The Analysis of !ommunity+ P&A+

edical Discourse

Westenberg !a$e s're yo' define the /ohn<s g'ys theory, and e1#lain *hat a genre is+ E1#lain everything+