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In:Identity Struggles: Evidence from workplaces around the world
Edited by Dorien Van De Mieroop and Stephanie Schnurr
[Discourse Approaches to Politics, Society and Culture 69] 2017
► pp. 263–280

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Chapter 14
Identity work in nurse-client interactions in selected community hospitals in Kenya

Published online: 26 April 2017
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https://doi.org/10.1075/dapsac.69.14ojw
Abstract
This chapter illustrates how nurses and clients in selected community hospitals in Kisumu County of Kenya negotiate their identities within their conflicting social and professional roles. I investigated nurses’ and clients’ perceptions and contestations of their roles, obligations and rights through non-participant observation and audio-recording of naturally occurring interactions. It emerged that the nurses’ exercise of professional practice was often challenged by clients’ explicit claims to rights and expectations based on socio-cultural background and polite behaviour. The nurses often experienced a conflict of identity due to the rigid institutional procedures required of them vis-à-vis the proactive clients’ service charter that emphasized client rights. So on the one hand, the clients expect to be treated with respect in conformity with the cultural norms and considerations of personal status while on the other hand, the nurses strive to maintain a professional distance. Hence, this chapter demonstrates the nurses’ struggles to strike a balance between the prescribed impersonal procedures of service while trying to avoid impinging upon the clients’ positive face.
Article outline
  • Introduction
  • Background of nursing care in Kenya
  • Analytical framework, methodology and data
  • Data analysis and discussion of findings
  • Conclusions
  • References
References (25)
References
Brown, Penelope, and Levinson, Stephen. 1987. Politeness: Some Universals in Language Use. London: C.U.P.Google Scholar logo with link to Google Scholar
Coppock, Liz. 2005. Politeness Strategies in Conversation Closings. London: Lawrence Erlbaum.Google Scholar logo with link to Google Scholar
Culley, Lorraine. 2006. Transcending transculturalism? Race, ethnicity and health-care. Journal of Advanced Nursing, 23(3): 564–570. Google Scholar logo with link to Google Scholar
Giddings, Lynne. 2005. Health disparities, social injustice and the Culture of nursing. Nursing Research, 54(5): 304–312. Google Scholar logo with link to Google Scholar
Hincliff, Sue, and Schober, Jane. 2003. Nursing Practice and Healthcare. London: Oxford University Press.Google Scholar logo with link to Google Scholar
Hyland, Deirdre. 2002. ‘An Exploration of the Relationship between Patient Autonomy and Patient Advocacy. Implications for Nursing Practice. Nursing Ethics: 472–482. Google Scholar logo with link to Google Scholar
Jeffs, Lorna. 2001. Teaching cultural safety, the culturally safe way. Nursing Praxis in New Zealand, 17(30): 41–50.Google Scholar logo with link to Google Scholar
Jungerson, Kawa. 2002. Cultural safety-an occupational safety perspective. New Zealand Journal of Occupational Therapy 49(1): 4–9.Google Scholar logo with link to Google Scholar
Kaseje, Dan, and Omondi, Odhiambo. 2001. Health, Poverty and Dignified Living. Development 44(1): 51–57. Google Scholar logo with link to Google Scholar
Kenga, David. 2006. Kenyan Health Sector Reform Agenda Targets Nurses. The Kenya Nurse 15(2): 12–14.Google Scholar logo with link to Google Scholar
Kim, Young, Lettenmaier, Cheryl, Odallo Dan, Thuo, Margaret and Khasiani, Shanyisa. 1996. Client Provider Information, Education and Communication in Kenya. Baltimore: John Hopkins Center for Communication Programs: 1–53Google Scholar logo with link to Google Scholar
Kenya Population Council. 1995. Quality of Care in Family Planning Service Delivery in Kenya and Clients’ Perspective. Nairobi: The Population Council.Google Scholar logo with link to Google Scholar
Kenya Institute of Public Policy Research and Analysis. 2004. An Evaluation of the Health Sector and Client Satisfaction in Kenya. Nairobi: Claripress.Google Scholar logo with link to Google Scholar
Leininger, Madeleine. (Ed.). 1991. Culture, Care, Diversity and Universality: A Theory of Nursing. New York: National League for Nursing.Google Scholar logo with link to Google Scholar
Makabila, Simon. 2006. Kenya Losing Specially Trained Nurses. The Kenya Nurse 10(2): 6.Google Scholar logo with link to Google Scholar
Ministry of Health. 2006. Patients’ Service Charter. Government Press, Nairobi World Health Organizaiton (2005) Patients’ Rights. Available at [URL]
. 2004. The Second National Health Sector Strategy Plan. Nairobi: Government Press.Google Scholar logo with link to Google Scholar
Montagu, David. 2003. Assessment Systems for Healthcare. London; Health Systems Resource Centre.Google Scholar logo with link to Google Scholar
Nursing Council of Kenya. 2001. National Curriculum for the Community Health Nursing Programme, Nairobi: NCK.Google Scholar logo with link to Google Scholar
Ojwang’, Benson. 2010. A Pragmatic Analysis of Politeness Strategies in Nurse – Client Interactions in Selected Public Health Facilities in Nyanza Province, Kenya – Unpublished PhD. Thesis, Maseno University.Google Scholar logo with link to Google Scholar
Ojwang’, Benson, Matu, Peter, and Ogutu, Emily. 2010. Face Attack and Patients’ Response Strategies in a Kenyan Hospital. Journal of Sociolinguistics 44(1): 65–80.Google Scholar logo with link to Google Scholar
Ovretveit, John. 1995. How Patient Power and Client Participation affects Relations between Professions. In Interprofessional Working for Health and Social Care, John Ovretveit, Tony Thompson, Peter Mathias (eds.), 35–38. London: McMillan.Google Scholar logo with link to Google Scholar
Singer, Bernard. 2008, April 14. Kenyan Nurses in Brain Drain. The East African, Available at [URL]
The Daily Telegraph. 2010, April 6. “Hospital job title ‘sister’ dropped for being sexist. Available online at [URL]
World Health Organization. 2007. Views of Older Persons on Elder Abuse. Geneva: World Health Organization.Google Scholar logo with link to Google Scholar
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