Discourse analysis of nurse-patient communication in a hospital setting: implications for staff development.

This ethnographic study examined the symmetry (active listening)/asymmetry (dominance) of nurse-patient communication. A convenience sample of 20 gendered nurse-patient pairs from two community hospitals participated. Eleven discourse modes emerged from taped conversations between nurses and patients. In many nurse-patient interactions, nurses demonstrated symmetry; however, symmetry and asymmetry changed throughout the conversation. Nurses often missed cues that patients needed someone to listen to their concerns. Staff development implications include teaching strategies that increase symmetrical nurse-patient communication.