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Alyssa Meuleners

202D Final Project


Company Profile: New Hope Children’s Hospital in Philadelphia has had magnet status for five
years and counting. It has more than 200 pediatric experts on staff with a wide array of specialties
including oncology, cardiology, and gastroenterology. It has family-centered care at the heart of its
culture. At every opportunity, New Hope endeavors to provide the most advanced, safest and
compassionate care for our patients and those with them on the journey toward getting well. New
frontiers in care delivery are explored daily.

Medical Staff: Psychiatrist, Pediatric Nurse, Nurse Practitioner, Nurse Management, Medical Social

Moves for Company Profile: I took “magnet status for five years and counting” from my
interviewee when she described her hospital to show its credibility. I tweaked my moves to show
“family-centered care” is important. I also made that move because genre 1 and genre 2 are pushing
for a patient + family outlet.
Textual Genre #1: Endorsement [business memo form]
Rhetorical Situation Behind Textual Genre #1:
● Context/Background Info: Parents have verbalized interest in a cancer support group.
They want an outlet for a close support system with other families to find ways to handle
chronic illness. Barbara Underwood, the psychiatrist asks Mr. Davis who is the head of the
Patient Services Committee for his approval to endorse the support group.
● Exigence: Provide an outlet to families/ draw more people to the hospital
● Writer: Psychiatrist
● Primary/Intended Audience: Head of the Patient Services Committee
● Secondary/Peripheral Audience: Other committee members
● Author’s Purpose/Goal: An endorsement for support group

To: Ed Davis
From: Dr. Underwood
Subject: Inquiry for Support Group
Date: 12/13/18

Dear Mr. Davis,

I understand you are the head of the Patient Services Committee. I am writing to request an
endorsement for a cancer support group for patients and parents.

There are several reasons why I believe a support group would be a great addition to the hospital.
Firstly, parents have verbalized their interest in participating in a support group. Since family
centered care is our focus, this is huge. It would provide an outlet for them to have supportive
relationships with other patients and parents to discuss their stories. I believe if we continue to
maintain the importance of family care in our hospital that it will create lasting effects.

In addition, several colleagues have expressed their desire to help guide discussions that provide
coping strategies and ways to handle chronic illness. I also am willing to oversee the logistical side of
it. My thought was to hold the support group once a week on Thursday morning from 10-11 a.m.
However, I am flexible to discuss other times if it conflicts with another event.
I hope you will approve this request to provide patients and their parents an outlet to cope with
chronic illness. My colleague Brenda Clemmer is a nurse manager who created a flier (attached down
below) if the support group gets approved. I eagerly anticipate a response by Friday, December 7th.
Thank you for your time.


Barbara Underwood
Service: Psychiatrist

Metacognitive “Moves” I made for Textual Genre #1

The purpose of the endorsement is so the hospital will fund the support group. I wrote it from a
psychiatrist to give the request more credibility since they work with patient’s emotional and mental
well-being. I wrote “I am writing” to make it clear and straightforward to avoid confusion. Another
move was writing “parents have verbalized their interest” first for explaining my reasons. This
shows their desires should be a priority to the hospital. In addition, I said “the importance of family
care” to emphasize that this is a big deal. In the closing paragraph, I originally said, “Thank you for
considering this request.” However, “I hope you will approve this request” shows that the
psychiatrist believes strongly in the support group.
Textual Genre #2: Flier (using canva)

Rhetorical Situation Behind Textual Genre #2:

● Context/Background Info: Flier offering support group which provides a visual and some
details about when the meeting date.
● Exigence: It is to spread awareness to patients and families on the resource.
● Writer: Brenda Clemmer who is the Nurse Manager
● Primary/Intended Audience: Patients and families
● Secondary/Peripheral Audience: Nurse staff
● Author’s Purpose/Goal: To provide an outlet for families to take advantage of.
Metacognitive “Moves” I made for Textual Genre #2
I designed a flier because I wanted to create a visual for children and parents to see the positive
message of the support group. The message speaks community and wants everyone to feel welcome
to join. Originally, I had a picture of a little white boy and his mom. However, I decided it would be
better to not show faces or one specific race because I wanted all people to feel welcome. One of
the reasons I chose this picture is because they are holding hands. By standing in a circle, it
emphasizes they are on the same team and in this together. I also know hospitals are very diverse.
On page 70 in “Communication Challenges” it states, “Your efforts to recognize and bridge cultural
differences will open up business opportunities throughout the world and maximize the
contributions of all the employees in a diverse workforce.” Healthcare providers will communicate a
lot with people from different cultures throughout their career. In “Communication Challenges” on
page 71 states, “Cultural competency includes an appreciation for cultural differences that affect
communication and the ability to adjust one’s communication style to ensure that efforts to send
and receive messages across cultural boundaries are successful.” I purposely did not choose one
child because I did not want to emphasize isolation or loneliness even if that is reality. It says, “You
are not alone” because they are surrounded by people who can relate and have similar challenges. I
wrote “Helping each other” because they were not called to walk alone in life with chronic illness.
Though the group is for parents as well, I chose a picture that is child-friendly because it is aimed
for pediatric patients. The bright colors are associated with happy messages versus black and white
which could produce a sorrow message to children. For the meeting time, I originally had Thursday
morning but changed it to Saturdays if a parent wants to come who has work. Furthermore, I
emphasized the word “FREE” because people will more likely take advantage of the resource.
Textual Genre #3: “Call To Action” Email
Rhetorical Situation Behind Textual Genre #3:
● Context/Background Info: Nurse is concerned about her patient’s condition. The parents
are opposing medications for their child as they are in denial he is in pain. Nurse practitioner
emails the social worker who is in charge of the Ethics Committee to address the situation.
● Exigence: To inform the Ethics Committee of the patient’s status + the parent’s
● Writer: Pediatric Nurse
● Primary/Intended Audience: Medical Social Worker
● Secondary/Peripheral Audience: Ethics Committee/ other nurses
● Author’s Purpose/Goal: To have the committee review the situation + provide solutions
on how to handle this conflict

Subject: Ethical Dilemma

Dear Miss Swope,

I am aware that you are in charge of the Ethics Committee. I am writing to inform you of a situation
that I recently encountered. There is currently a patient in the pediatric unit that I am caring for who
is severely ill. The patient was admitted to my unit on the third floor on pediatric med surg on
November 18th. He has been experiencing shortness of breath, chest pain, severe wheezing, and a
fever over 101. The parents of the patient have denied he is in pain and refuse the nurses to give
medication. This is unethical as the patient is progressively getting more ill.

It is a sticky situation because as the caregiver I want the patient to be comfortable. When it is in
direct opposition to what the parent wants, how do I handle that? I would like your committee to
review this situation as soon as possible. I plan to address this with my fellow colleagues as well.
Thank you for your time and comments.


Liz Adam
Metacognitive “Moves” I made for Textual Genre #3
The genre is a call to action email because it cuts to the chase instead of stringing the news along. I
changed the subject line from “Patient’s Health Status” to “Ethical Dilemma” because the first did
not exude as much urgency and the latter communicates a call to action which is the genre. I
specifically said, “child that I am caring for” because it is a credible source. Another move I made
was not mentioning the patient’s name because it is confidential. Adhering to HIPAA (Health
Insurance Portability and Accountability Act of 1996) laws is a huge part of the health care
provider’s job which protects individual’s health information. The medical social worker adheres to
HIPAA as well so there is no need to explain. It did not work to say, “I cannot disclose further
information” since both employees deal with these situations there is a mutual understanding. For
the unit, I chose Pediatric med surg because they treat patients with any medical or surgical problem.
There is no law regarding this situation that led to my moves. It is subjective where the nurse feels
obligated because she is the patient’s advocate. Another move I made was asking the question,
“How do I handle that?” because the nurse wants to find out what to do in future instances.
In addition, instead of reaching out to the Patient Services Committee, I emailed the medical social
worker since I felt they were a better resource. They “provide valuable social services to patients
who are in the midst of challenging medical issues.” In my free write I wrote, “Nurses deal with a lot
of emotional stress in their job. I wanted to show the emotional involvement that takes place in the
hospital. I made a move showing she is the patient’s advocate and voice in this situation by saying,
“This is unethical as the patient is getting progressively more ill.” I wanted to show the nurse is
distressed and affected by her patient’s status. “As soon as possible” stresses the urgency of the
Textual Genre #4: Individualized Patient Care Plan

Rhetorical Situation Behind Textual Genre #4:

● Context/Background Info: Nurse’s write a few individualized care plans per shift. Nurse
Tracy Atkins writes a care plan for her patient with a burn. She assumes whoever is reading
it understands medical terms/insider language.
● Exigence: To promote quality care for the patient.
● Writer: Pediatric Nurse
● Primary/Intended Audience: Other nurses, Med students, Nursing students (in the
● Secondary/Peripheral Audience: Therapist
● Author’s Purpose/Goal: The short-term goal is to monitor the patient’s health status and
the long-term goal is to have the patient healthy to discharge.

10:00 P.M.
Alex Smith 8 year-old male
Burn on right and lower extremities

Pt resting comfortably in bed. Mother at the bedside. VSS. Afebrile. No signs or symptoms of
discomfort. PIV infusing w/o difficulty. Burn dressings clean, dry, and intact. Pt complains of
5/10 pain. Tylenol and Motrin administered x1. NPO at midnight for dressing change w/sedation
in am. RLE elevated. Will continue to monitor.

Tracy Atkins, RN
Service: Pediatrics
Metacognitive “Moves” I made for Textual Genre #4
From my interview, I learned that 10 p.m. and 6 a.m. are the designated times to write care plans
during the night shift which is why I created one at 10:00 p.m. My interviewee also shared the
insider language in the profession so I included abbreviations they use in care plans: “Pt” (patient),
“VSS” (vital signs stable), “afebrile” (no fever), “NPO” (nothing by mouth), PIV (peripheral IV),
and “RLE” (right lower extremity). The format is concise with no excess words. The choppy and
incomplete sentences is a technique used in care plans so it is straightforward and easy to read for
doctors, med students, and other nurses.
Textual Genre #5: Condolence Message

Rhetorical Situation Behind Textual Genre #5:

● Context/Background Info: A patient died in the pediatric unit. The physician writes a
handwritten note with a personalized touch on behalf of the hospital.
● Exigence: To show their sympathy and support to the family.
● Writer: Physician Assistant
● Primary/Intended Audience: Parent/family
● Secondary/Peripheral Audience: Staff
● Author’s Purpose/Goal: Show care for family’s loss

On behalf of the Children’s Hospital,

I express my deepest condolences to you and your family at the loss of your precious child. Your
child was cared with compassion and love. I hope you may draw some comfort knowing that others
care and share in your loss. From caring for Julia, I know what a special girl she was. Please reach
out to Dr. Jones who is the head of the grievance committee. The whole hospital’s thoughts are with
you during this time.


Emma Lane
Service: Physician Assistant

Metacognitive “Moves” I made for Textual Genre #5

From “Writing Positive Messages” in the “offering condolences section” on page 240, it discussed
messages are better “Short, simple, and sincere” so that is why the length is short and thoughtful.
“On behalf of the Children’s Hospital” is to show that the whole staff is acknowledging their loss.
From the same section it discusses, “The primary purpose of condolence messages is to let the
audience know that you and the organization you represent care about the person’s loss” (“Writing
Positive Messages” 239). Another move I made was “From caring for Julia, I know what a kind and
lovely girl she was” because the same chapter claimed, “Such a statement accomplishes two goals:
explaining why you in particular are writing and letting the recipient know that his loved one was
appreciated” (“Writing Positive Messages” 239). Furthermore, “This adds meaning and depth to
your expression of sympathy” (Writing Positive Messages 240). For my closing sentence I had,
“Heaven gained an angel” but I thought those statements should be avoided since they stem from
religious ideas. I wanted to be sensitive because “you risk offending with unwelcome or
inappropriate sentiments” (“Writing Positive Messages” 240). Then, it was “Again, I extend deep
and heartfelt sympathy to you and your family.” This sounded superficial so I decided to close with
“thoughts are with you during this time.”
Textual Genre #6: Raise Request

Rhetorical Situation Behind Textual Genre #6:

● Context/Background Info: Allison Hawthorne is an exceptional nurse who has achieved
much and emails the human resources requesting one.
● Exigence:
● Writer: Pediatric Nurse
● Primary/Intended Audience: Human Resources (Diane Smith)
● Secondary/Peripheral Audience:
● Author’s Purpose/Goal: To obtain a raise

Date: February 20th, 2018
Subject: Raise Request

Dear Mrs. Smith,

I am writing to request a raise. I have greatly enjoyed working at New Hope Children’s Hospital. My
service to this company has been exemplary over the last two years. I have learned a lot from my
time within the Pediatric department, and I feel I have contributed in valuable ways.

Over the past year alone, I have trained three interns. I have not missed a day of work except my
vacation time which was given to me. In addition, I served on the Patient Improvement committee
to better serve our patients. During our regular meetings, my team and I created a CAUTI (Catheter
Associated Urinary Tract Infection) bundle. It has decreased the amount of urinary tract infections
caused by a catheter resulting in greater patient comfort, satisfaction, and safety. Furthermore, it is
saving the Hospital money and resources.

Given my recent accomplishments and that my salary is below industry averages, I would like to
request a raise. I would think an appropriate raise would be 3%. I would like to discuss this with you.
I look forward to continuing my role within the hospital.

Allison Hawthorne
Service: Pediatrics

Metacognitive “Moves” I made for Textual Genre #5

I wanted to articulate strong points and achievements to give Allison credibility to show she
deserves the raise. I was specific and assertive when I said, “I would think an appropriate raise
would be 3%”. In How to Read Like A Writer, chapter 40 is “Request & Inquiry. In that section
on page 247, it states, “Begin with a clear, concise, and courteous statement of your request. Be
as specific as possible.” Though I was confident, I made sure I kept a pleasant tone and ended
nicely: “I look forward to continuing my role within the hospital.”
Z. De Piero
202D Business Writing, F’18
Student: Alyssa Meuleners

Rubric for 202D Final Project

Rubric for Rhetorical Situations

Did Not Meet Met Exceeded

Expectations Expectations Expectations

Company Profile

Have you you provided relevant background information

to help bring your organization to life? What’s the name
of this organization/company? What’s their field,
industry, or “line of work”? Where are they
located? Who is their clientele?


What prompted the writer’s need to communicate? What’s

the urgency behind the need to enact this particular
genre? Why this, why now?


Who is the writer? What’s their name, what

organization/company are they affiliated with, and what’s
their role/position?

Audience (Primary and Peripheral)

Who is the intended/primary audience for this

genre? What’s their name, what organization/company
are they affiliated with, and what’s their position/role?

Additionally, what other peripheral/secondary audiences

might play a role in how we can understand this
genre? Might other people be interested in the message
that’s being communicated? Could the writer have
additional people in mind beyond the specific person(s)
that they’ve contacted?


What’s the writer’s goal? Is it realistic? Have they

identified a concrete, actionable outcome that they’re
hoping to achieve?

Context / Background Info

What additional information is necessary to make the

most sense of this rhetorical situation? Do the writer and
their audience have a “history” of sorts? Is there an
upcoming deadline? Has a company’s policy or personnel
recently gone through changes? Is there a current “hot
topic” that’s circulating throughout the news cycle that
makes this communication more urgent?

Notes and Score (X/7.5)

Rubric for Textual Genres

Did Not Meet Met Exceeded

Expectations Expectations Expectations

Genre Identification

Did you (accurately) name/identify each unique genre

that you enacted?

Alignment with the Rhetorical Situation

Does the genre that you created/enacted accurately

reflect the rhetorical situation (for each genre) that you
laid out?

Genre-Specific Conventions

To what extent did each textual genre include its most

important conventions? Remember: when we think of
“conventions,” we think of the unique characteristics,
features, patterns, or ingredients of a particular
genre. (e.g. a sspecific subject or an e-signature line for
an email)

Rhetorical Strategies
Has the writer used various rhetorical strategies to
persuade their reader/audience in the most effective
way possible? From jargon (technical terminology), to
particular details (e.g. the specific amount of $ due for
a claim; timelines for a call to action), to
communication with internal vs. external audiences,
have you (the student) brought each genre “to life” in
realistic ways with your language-based decisions?


Is the writer’s communication organized/structured in

a clear and logical manner? Does the organizational
strategy best suppor the writer’s goals of each particular

Mechanics + Punctuation

Have you demonstrated a control of mechanics and

punctuation? Are you using complete sentences (unless
intentionally avoiding them for stylistic reasons)?

Notes and Score (X/15)

Rubric for “Metacognitive Moves” Reflection

Did Not Meet Met Exceeded

Expectations Expectations Expectations

Focus on “Moves”

What writerly decisions did you make in this project? Did

you identify numerous, conseequential “moves” that you
made for this project? Did you articulate what you did
and why you did it? (Or didn’t do it?) do that

Examples of “Moves”

Is your analysis of your moves connected to your

language? Have you quoted yourself to provide concrete
Learning and Insights

The whole point of engaging in a metcaognitive reflection

(like this) is to better understand what you’re learning and
to communicate that with others. What insights are you
gaining about written communication? About language?
About rhetorical situations? About genre? Ahout
organizational structures?


Think back to your interview. How/when/where/why

did you draw from insights that came out of your
interview? Indicate how your interview informed this 202d

Connection to Assigned Readings

Per the syllabus, did you make specific connections to

our assigned course readings? What ideas, concepts, or
strategies informed your project? I’d like to see you
paraphrase and “quote” at least 5 different times from at
least 3 different readings/chapters.!

Notes and Score (X/15)