Development of professional writing skills by French-speaking nurses in an English-medium hospital: a constructivist semiotic perspective

In view of the lack of research pertaining to L2 employees, the present study undertook to explore how French-speaking nurses who joined the staff at an English-medium hospital (here referred to as Thomas Memorial Hospital) in Montreal developed skill in writing nursing notes and care plans. Nursing notes were written by nurses during their shift to provide an update on a patient's condition; care plans served to organize the care to be given to individual patients. The study, which was conducted using qualitative research methods, took place over a period of 22 months. The data retained for analysis involved 11 French-speaking nurses who had taken part in special orientation programs in two consecutive years. All except one were new graduates of French university nursing programs; none had previously done nursing documentation in English. Their language proficiency in English ranged from low to high intermediate. Although, upon their arrival at Thomas Memorial Hospital, they were familiar with both nursing notes and care plans from their work in French hospitals, certain features of the corresponding English genres were rhetorically different; in other words, writing in English could not be reduced to mere translation (i.e. problems with vocabulary/expression). Based on observations of the nurses at work on the units, four types of collaboration, adapted from a taxonomy elaborated by Witte (1991, 1992), were identified: traditional, committee, incidental, covert. Of particular note in this study is the analysis of incidental collaboration which demonstrated how such exchanges, though brief, contributed to the textual product at the linguistic, rhetorical and informational levels. Whereas at the start of the study, nurses viewed the English care plans as a translation of the way they wrote in French, the discussion of the formal care plan task revealed that over time they perceived differences in their writing. These differences were related to increased knowledge of nursing, administrative procedures, and practices particular to a unit. Some nurses, while emphasizing the transactional (Britton et al., 1975) nature of care plans produced at the hospital, retroactively characterized the care plan writing done during their university studies as serving a primarily didactic function. Although in evaluating the three versions of the care plan task, the Clinical Educator was particularly sensitive to the degree to which the latter reflected knowledge of nursing, she considered the tendency by some nurses to simplify the way they wrote problems and objectives, compared to how they had been taught at school, as a deterioration in quality. This divergence was discussed in relation to differing perceptions as to the audience and purpose of care plan writing within the discourse community. This study, in terms of its description of the overt and covert collaborative processes involved in the appropriation of written genres by employees working in a second language, contributes to the relatively scant literature which relates to how new members of a discourse community develop such skills. (Abstract shortened by UMI.)