In the example below, the nurse uses a combination of minimal words and direct action to obtain a response from a resident who is putting off her requests for information: After the patient has arrived in the OR, the anesthesiologist asks the surgical resident if the surgical team will want the patient’s arms to be tucked in for the surgery. There are many skills that are known to be of importance to nurses and one of the main ones is that they require to have great communication … In the first instance, the nurse asks twice about the preoperative diagnosis and gets no response; in the second, the surgeons do not respond to five requests about whether they want a Belfour retractor. This is understandable given the difficulty of documenting silences in communication and the traditionally marginal role of silence in qualitative research (Poland & Pederson 1998). Circulating nurse: {quiet voice}‘Surgical pause, please’. Journal of Cognitive Engineering and Decision Making. Nurse says into phone, ‘Can you page [surgeon], please’. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 2004). In our data set, anaesthesiologists tended to talk and interact less overall, so that we had fewer opportunities to capture their communication or to characterize their silences by references to contextualizing speech. Lead How to Use Silence to Communicate--and Negotiate Your ability to be quiet may be the most powerful communication tool you have, and here's an exercise to practice it. The nurse’s doubtful tone and raised eyebrows suggest that she is not entirely convinced. Therapeutic silence is an important part of effective communication. Communication is simply about conveying a message, and sometimes silence … Learn about our remote access options, Fauzia Gardezi MA Research Associate The Learning Institute, The Hospital for Sick Children, Toronto, Canada, Lorelei Lingard PhD Lead Educational Researcher The Learning Institute, The Hospital for Sick Children, and Associate Professor Department of Pediatrics and University of Toronto, Canada, Sherry Espin RN PhD Associate Professor Ryerson University, Daphne Cockwell School of Nursing, Toronto, Canada, Sarah Whyte MA PhD Candidate and Research Associate The Wilson Centre for Research in Education, University of Toronto, Canada, Dr Beverley Orser MD PhD FRCPC Professor of Anesthesia and Physiology Canada Research Chair in Anesthesia, University of Toronto and Department of Anesthesia, Sunnybrook Health Sciences Centre, Canada, G. Ross Baker PhD Professor Department of Health Policy, Management and Evaluation, University of Toronto, Canada. Most importantly, why are some speakers hesitant, tense, reticent and not entirely audible, while others are confident, at ease, gregarious and perfectly audible, if not in fact loud? Butler (1997) critiques what she refers to as Bourdieu’s static notion of authority, however. Journal of Operating Department Practitioners. Communication is the transfer of information between people. Diagnostic radiographers working in the operating theatre: An action research project. Our observations suggest that a reticent tone and form of speech are at times tactical, a strategic mode of speech that nurses adopt. Nurs Stand. 2008). The first relates to the audibility of the nurses’ speech (‘The scrub nurse and student nurse ask four more times…but never loudly’). There’s no further mention of the Belfour. However, unlike other research, we also consider silences on the part of other OR professionals, and suggest that silences on the part of nurses and others can be expressive rather than inexpressive, strategic rather than simply defensive. How will the nurse be perceived by colleagues from his/her own and other professions? There are examples of quiet tone that seem to suggest silence as structured in the sense of Bourdieu’s (1977) concept of ‘habitus’. The staff surgeon keeps asking the scrub nurse for ‘burning forceps’, but often he hasn’t handed them back to her. Structured Communication for Patient Safety in Emergency Medical Services: A Legal Case Report. Well, they’ve taken out her colon so technically she doesn’t have it anymore. Previous research suggests that nurses often feel constrained in their ability to communicate with physicians. Communication for nurses is important in the present situation, and communication is an important part of the nursing practice, which has a special meaning. Researchers in the fields of sociolinguists and feminist anthropology have explored the strategic use of silence. The instances we examine do not all relate to issues of patient safety; many are much more mundane exchanges. Hiding in plain sight: communication theory in implementation science. A nurse brings a new light source into the room but does not ask if it should be set up. The Power of Silence in Effective Communication Generally speaking, eastern cultures value silence more than the use of words, while in western culture, sometimes the opposite is … In our own ethnography, leaders of the different professions spoke to us about occasions when something of concern took place in the OR and ‘nobody said anything’. Surgical resident says he does not know, but will ask, and then leaves the room. Concerns About Verbal Communication in the Operating Room: A Field Study. In reality, though, silence can be a very effective communication tool. 2015 17th International Conference on E-health Networking, Application & Services (HealthCom). Nurse‐doctor interactions during critical care ward rounds, Toward a problematic of silence in action research, Teamwork and communication in surgical teams: implications for patient safety, Reading between the lines: interpreting silences in qualitative research, Rethinking theatre in modern operating rooms, Governance in operating room nursing: nurses’ knowledge of individual surgeons, Communication failures: an insidious contributor to medical mishaps. Exploring the Unspoken Dimensions of Complex and Challenging Surgical Situations.  |  Subscribers can upload their reflective accounts at rcni.com/portfolio. 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