Hidden in the Depths of Silence: Interaction between Patients and Nurses: An Ethnographic Study Conducted at a Muscular Dystrophy Ward

Abstract

In order to elucidate the interaction between nurses and patients through the verbal and non-verbal aspects of nurse–patient exchanges at a muscular dystrophy ward, employing the method of ethnography, 18 nurses at a muscular dystrophy ward, 20 muscular dystrophy patients, and three mothers of the patients were interviewed and observed in the form of participant observation. Three points are drawn from the results of our analysis: 1. Consideration of nurses and concession on the part of patients seen in the silent ward, 2. the nurses' unrecognized service to understand the intentions of patients without using verbal expressions, and 3. a realm that neither group can enter. It is suggested that the nurses acquire an excellent skill in using their sensitiveness to actually understand the physical feeling that the patients experience, which may be called “common feelings.” Using these feelings the nurses take care of the patients by understanding their intentions without relying on verbal communication. It is also suggested that mutual constraint and dependence results from the relationship between the nurses and patients that requires such minimal use of words, which directs the relationship to a point where both of them try to avoid referring to the patient's death.