Maternity care : the nurse & the family / Margaret Duncan Jensen, Ralph C. Benson, Irene M. Bobak.

  • Jensen, Margaret Duncan, 1921-
Date:
1977
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Maternity care : the nurse & the family / Margaret Duncan Jensen, Ralph C. Benson, Irene M. Bobak. Source: Wellcome Collection.

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    14 Maternity nursing today— emergence, dynamics, challenges their relative importance to the individual involved. Two persons may share the same set of identities but, by arranging them in different orders, vary considerably in how they would react to the same situation. Two nurses, for example, may share identities of nurse and mother. However, by ordering them as nurse, mother versus mother, nurse, one may react in a different way to hap¬ penings such as illness in the family and work atten¬ dance. Cognitive identities are intimately connected with the concept of life-style. This concept is now recognized as an important component in acceptance or rejection of health services. Communication Communication occurs during interactions between persons or between components of a person's self. It is central to all one does in life. The way individuals dress, their behavior and speech patterns, where they were born, their church affiliations, their choice of magazines, in short, every aspect of their lives conveys information about them to others. Every culture sets up an entire repertoire of communication patterns, most of which are acquired by members of that culture as a result of mingling with various social groups and informally learning these patterns. The failure on the part of a stranger to the culture to recognize these and operate within their context can lead to misunderstandings and the inability to carry on meaningful exchanges. The communication process consists of verbal, non¬ verbal, and written messages conveyed by one individual to another and received and inteфreted by the other in light of his own perceptions. Response is made to those parts of the message that one deems important to oneself. This feedback triggers another response on the part of the sender and so the process repeats. Satir (1967) com¬ ments, Communication is a complex business. The re¬ ceiver must assess all the different ways in which the sender is sending messages as well as being aware of his own receiving systems, that is, his own interpretation system. Such a process is too complex and extensive to con¬ sider in detail in this text; however, certain components of the process considered particularly important to the maternity nurse will be briefly discussed. Language. The social or lay language of any culture contains elements that are known and recognized by all who speak it. Each subgroup, however, develops a lan¬ guage of its own. These subgroups may be determined by ethnic origin, age, or profession. The nurse speaks a number of languages. A professional language is learned as part of being initiated into the nursing group. For transactions between colleagues, it provides for a pre¬ cise, meaningful exchange of information. Between nurse and patient it can serve the same puфose if the patient has the requisite background. If the patient has not been schooled in medical terminology, use of the professional language can be effective as a screen to guard the real thoughts of the nurse or as a put-down to remind the patient of his place. It may also mean that the nurse is unable to translate the ideas into the social language familiar to another individual. Working with teenagers in a family planning clinic is illustrative of this. Their in language has differences that need to be recognized, commented on, and used if at all possible. Many slang terms are used for sexual inter¬ course, and some young people do not know and do not use the medical terms for genital organs. Unless the in¬ formation given is couched in their language and feed¬ back for mutual understanding is sought, much of what is said is either unclear or lost. North American culture also supports ethnic groups that use foreign languages in the greater part of their daily living, and their knowledge of English may be limited. After being in North America for a few years, a hybrid language develops that is part original and part English; frequently, the terms relating to medical care become part of the graft. In a prenatal clinic in a predom¬ inantly Mexican-American community, the pamphlets relating to care were written in Castillian Spanish. Un¬ fortunately the people spoke a mixture of Spanish and English (Spanglish as one nurse described it), and the information was therefore still not available to them. Language may also be used defensively. Nurses who maintain a joking relationship with patients regardless of the patient's condition and thereby call forth a similar response on the part of patients may be acting to defend themselves against the hurt and weight of involvement in the pain of others. This is often an unconscious act. According to Luft (1970), The individual, like the group of which he is a part, has limited awareness of the sources of his own behavior and the effects of his behav¬ ior on others. Space. Hall's study (1966) of man's use of space, proxemics, showed that middle-class North Americans utilize the space between communicators in defined ways. There are definite distances used to connote vary¬ ing inteфersonal relationships, and the voice range and tone, the topic discussed, and the body language em¬ ployed are specific for each range. Hall described four distances as follows: intonate, 3 to 18 inches; personal, Wi to 4 feet; social, 4 to 12 feet; and public, beyond 12 feet. Voice tones progress from a murmur to a loud voice; topics discussed range from top secret to informa¬ tion considered in the public domain; and the body Ian-