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Communication and Medicine

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Whiteboards: Mediating professional tensions in clinical practice

Robin Riley / Rowena Forsyth / Elizabeth Manias / Rick Iedema
Published Online: 2007-12-04 | DOI: https://doi.org/10.1515/CAM.2007.020

Abstract

In this paper we argue that whiteboards in clinical settings play a hybrid role: communicating inter- and intraprofessional directives, mediating professional tensions, and mitigating potentially face-threatening acts. The data upon which this paper is based emanate from two independently conducted ethnographic studies: the first explored a range of nurse–nurse and nurse–doctor communication practices in operating rooms, while the second explored work routines and communication methods in oncology wards. Data collection included fieldwork using observations, interviews assisted by photographic methods, and in the first study, a personal diary. A deconstructive analysis was independently undertaken. As a communication method, the use of whiteboards in clinical settings provided a focal point for the coordination of clinical work activities and for the dissemination of information to large groups of people. Whiteboards were a conduit for potentially face-threatening information in that they facilitated the policing and disciplining of staff, while distancing communicators from one another. We conclude that whiteboards are ‘pseudo-synchronous’ in nature, enabling ‘communication at a distance’. In doing so, whiteboards may facilitate and economize clinical communication but they also perpetuate the invisibility of nurses' contribution to ensuring safe care, and they mask the symbolic violence that is committed within and between health professionals.

Keywords: whiteboards; communication; deconstruction; health professionals; operating rooms; oncology

About the article

Robin Riley

Robin Riley, R.N., B.A., M. N. Studies, Ph.D., is a Nurse Unit Manager of operating rooms at Box Hill Hospital in Melbourne and a senior fellow at the University of Melbourne, Australia. Her research interests include interpersonal and organizational communication, interprofessional relationships, and patient safety. She has published in several journals, including Social Science & Medicine and Quality & Safety in Health Care.

Rowena Forsyth

Rowena Forsyth, B.A. (Hons), Ph.D., is a medical sociologist with experience in hospital-based ethnographic research. Rowena's doctoral thesis was on organizational dynamics within which practices of laboratory test ordering are embedded and the impact of new computerized information technology on relationships between doctors and laboratory scientists at a metropolitan teaching hospital. She is now Researcher on a National Health and Medical Research Council funded project at St. George Hospital in South-Sydney, Australia.

Elizabeth Manias

Elizabeth Manias, B. Pharm., M. Pharm., R.N., M. N. Studies, Ph.D., is a registered nurse and a pharmacist. She is employed as an Associate Professor at the School of Nursing at the University of Melbourne, Australia. Her research endeavors include medication safety, interpersonal and organizational communication, and consumer participation. Specifically, her work considers different individuals' perspectives and the complexities of the dynamic environment in which communication takes place.

Rick Iedema

Rick Iedema, B.A., M.A., Ph.D., is Professor of Organizational Communication, Associate Dean (Research), Faculty of Humanities and Social Sciences at the University of Technology, Sydney, Australia. His research targets the organization of clinical work in hospitals, and he has published in journals such as Social Science & Medicine, Organization Studies, and Communication & Medicine.


*Address for correspondence: School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 1, 723 Swanston St Carlton 3053, Australia.


Published Online: 2007-12-04

Published in Print: 2007-10-26


Citation Information: Communication & Medicine, Volume 4, Issue 2, Pages 165–175, ISSN (Online) 1613-3625, ISSN (Print) 1612-1783, DOI: https://doi.org/10.1515/CAM.2007.020.

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