Exploring power relations embedded in medication communication processes on general medical wards
Abstract
Purpose
The purpose of this paper is to examine power relations embedded in verbal and non-verbal medication communication processes that involve nurses, doctors, pharmacists and patients in two general medical wards of an acute care hospital.
Design/methodology/approach
This paper reports on the findings of an ethnographic study investigating medication communication processes in hospital spatial environments. It was theoretically informed by the work of Norman Fairclough. Data collection methods comprising video-recordings and video reflexive focus groups were employed. Fairclough's critical discourse analytic framework guided data analysis.
Findings
Four different forms of power relations between clinician-patient, nurse-doctor, clinician-organisation and multidisciplinary interactions were uncovered. Nurses asserted their professional autonomy when communicating with doctors about medications by offering specific advice on medical prescribing and challenging medication decisions. Video reflexivity enabled nurses to critically examine their contribution to medication decision-making processes. Clinicians of different disciplines openly contested the organisational structure of patient allocation during medical discussions about management options. Clinicians of different disciplines also engaged in medication communication interchangeably to accomplish patient discharge.
Originality/value
An investigation of existing power relations embedded in medication communication processes within specific clinical contexts can lead to a better understanding of medication safety practices. Video reflexive focus groups are helpful in encouraging clinicians to reflect on their practice and consider ways in which it could be improved in how power relations are played out.
Keywords
Acknowledgements
The authors would like to acknowledge the Australian Research Council for funding this study with a Discovery Grant (grant number DP0879002). The authors’ thanks also go to the staff members and patients who generously gave up their time to participate in this study. The authors are grateful to the anonymous reviewers for their constructive comments on our original manuscript.
Citation
Liu, W., Manias, E. and Gerdtz, M. (2014), "Exploring power relations embedded in medication communication processes on general medical wards", Qualitative Research Journal, Vol. 14 No. 2, pp. 161-178. https://doi.org/10.1108/QRJ-06-2013-0041
Publisher
:Emerald Group Publishing Limited
Copyright © 2014, Emerald Group Publishing Limited