Why Can't We Have More Patients That Are Ventilated? at Least They Don't Talk! - Macabre

“Why can't we have more patients that are ventilated? At least they don't talk!" - Macabre language at ICU's as a tool to frame a nurses identity

Affiliation: University of Kassel

Eva-Maria Willis

Hoffmann-von-Fallerslebenstraße 6

34117 Kassel

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Macabre language is often used backstage by nurses on ICU wards. Even though this type of language is seen by educators who train nurses as humour and therefore a coping strategy (Hirsch 1983), ethnographic field research gives us the opportunity to see it used as a complex tool to establish, corroborate or negotiate the identity of oneself and other's as a nurse on an ICU.

The observations in the field were made in an ICU ward of a German hospital where the author of this paper worked as a nurse herself to conduct the field research which show how this type of language can be used to define normality and abnormality of a nurses identity on an ICU ward. It can be used to establish a superior identity towards others, either by staging situations as mundane and normal (Goffman 1982) for an example when a new nurse starts her position at the ICU ward and more experienced nurses use the language to distinguish themselves from her by marking the lack of experience by the lack of confidence to use this language with.

Even though language exercised in a macabre way is framed by nurses as a resource that can be used in an emergency situation to keep oneself and others calm, being able to use this code and operate in an emergency situation can also assist as a tool to corroborate a nurse's identity as an experienced nurse that therefore is more likely to be able to influence other situations in their benefit.

We have to keep in mind that even though macabre language is used backstage, not all colleagues are staged as trustworthy and macabre language can be used as a tool with which a nurse might mark others as trustworthy to share more backstage information with.

Macabre language can also be used as a tool that defines situations as more dramatic not only within the group as it would occur at the handover to the next shift, but also to affiliate or distinguish oneself in interaction with other professions such as doctors. With it, a nurses identity and influence might be negotiated by using this type of language to stage herself as strong or weak, depending on what framing would be more beneficial.

References:

Goffman, Erving: Das Indivuduum im öffentlichen Austausch, 1982

Hirsch, Rolf Dieter: Arbeitsbelastungen und deren Bewältigung, München 1983