Epistemic 'Struggles': When Nurses’ Expert Identity is Challenged by 'Knowledgeable' Clients

Abstract

This paper aims to explore some of the processes through which nurses construct and negotiate their professional identities in telephone consultations with mothers of newborns diagnosed with a mild hereditary disorder. The condition in question, G6PD deficiency (commonly known as favism), is common in Hong Kong where this study was conducted occurring in 4% of all male and 0.6% of female newborns. If certain preventative measures are taken, the individuals with the condition can lead a healthy life. The aim of the telephone counselling interactions is to ensure that the mother has sufficient information about her baby’s condition and the preventative measures. Drawing on a corpus of 50 telephone counselling interactions, this paper analyses one of the identity struggles that the nurses regularly have to deal with in these encounters when interacting with ‘knowledgeable ’mothers, that is those mothers who have the condition themselves or who have family members with the condition. In these instances, the nurses need to negotiate the institutionally assigned identities and roles of ‘nurse’ as ‘information deliverer’ and ‘educator’, and ‘mother’ as ‘information recipient’ which are closely tied to the institutional agenda and purpose of these encounters. We identify and describe the discursive processes through which these identity struggles are enacted and negotiated on the micro-level of the interaction. We show how through negotiating (professional and lay) knowledge and expertise with potentially arising face-issues (both, for the nurses and the mothers), the participants ensure that the aim of these encounters, that is ensuring the well-being of a child after the hospital release, is met.