Communication between native Maltese and non-native Maltese nurses : an investigation of clinical nursing handover role-plays

Abstract

Clinical handovers are one of the most common and high-stakes communicative events in nursing practice, resulting in the patient’s safety depending on the accuracy and effectiveness of this communicative event. Despite the awareness of this, most research contributing to English for nursing courses has depended on data grounded on surveys and interviews, without reference to findings in the actual language used during handovers. This study aims to conduct a qualitative needs analysis to inform the design of an English for nursing course situated in the Maltese context. It intends to identify communicative needs and mitigating strategies used by native Maltese and non-native Maltese nurses during handovers. Data were gathered through a combination of semi-structured interviews with eight in-service nurses and an expert nurse practitioner, handover role-plays, and retrospective interviews. Findings show that challenges in communication during handovers are not only shaped by a deficiency in language proficiency, but also by the interactional organisation of the communicative event itself. The study shows how monologic turn design can jeopardize completing successful handovers, while code-switching, intelligibility issues, and vague clinical information also form part of the challenges. Nurses were able to draw on a number of interactional strategies to navigate these issues, such as fostering dialogic interaction, initiating clarification sequences, including questioning, and upgrading vague information to measurable values. These findings could contribute to the design of an English for nursing course situated in Malta. Such a course could involve both native Maltese and non-native Maltese nurses, using the data gathered through the extracts as a foundation of the course material, to help inform professionals the benefits of interactional strategies in safeguarding clinical handovers, and essentially the lives of their patients.