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Joseph Arroyo
Professor Adler
STACC English 1A #32474
8 April 2016
Nurse Practitioners: The Discourse and Analysis
There are a variety of communities and profession within the strategic world of nursing,
starting from a certified nursing assistant (CNA) to an advanced practice registered nurse
(APRN). In the center of the nursing ladder, there are nurse practitioners (NPs) and conjointly
identify as a specific discourse community, as John Swales calls it. According to John Swales,
The Concept of Discourse Community, Swales declares a discourse community that,
meets all six of the proposed defining criteria: there are common goals, participatory
mechanisms, information exchange, community specific genres, a highly specialized
terminology and a high level of expertise (475). These are six principles Swales uses to define a
discourse community, but at the same time, they fulfill the language and discourse as a whole,
opposed from being just an ordinary community. I would argue that nurse practitioners are a
discourse community for the reason of performing the following criteria of Swales; by genre use,
specialized medical terminology, and a very high level of expertise from years of schooling. Not
only are they a discourse community alone in the workplace; in addition, some professionals are
affiliated with associations, such as the American Association of Nurse Practitioners.
Furthermore, the nurse practitioner uses many different genres throughout their daily
work practice. With these genres, which not only assist NPs but also, ensure solutions to
problematic chronic illness. NPs use these types of genres on a daily basis because they are a
huge component of their work, and it is considered their discourse as one would define it.

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Discourse in the medical field, in general, is most significant due to the language use that
colleagues and patients communicate in at a hospital setting. For one, NPs are allowed to ask
patients to take blood tests to analyze and audit if anything is wrong with their blood. They can
read these tests results and explain to the patient what the problem is or may be. To be precise,
there are a few different things NPs look for in blood tests. These professionals compare and
contrast certain factors in erythrocytes. Erythrocytes are mature red blood cells that contain
oxygen and a specific amount of hemoglobin (Hb). Nurses and doctors identify the blood results
by looking at the normal range of substances in erythrocytes. In general, here are normal
ranges ones erythrocytes should range from. For the volume of blood in females ranges from 45L and for males ranges from 5-6L (in liters). Anything higher or lower within these ranges can
be a warning sign, therefore, NPs and doctors analyze blood tests. These blood tests are quite
common because blood can display many things within.
Supplementary to requesting blood tests, NPs are also allowed to request x-rays from
patients; even though, x-rays are a bit easier than reading blood results. However, when referring
to x-rays the NP can only identify bone, tissue, and muscle. They look at two types of x-rays, the
posteroanterior (PA) x-ray taken from the back to the front of the chest, and anteroposterior (AP)
x-rays starting from front to the back. NPs inspect the front and back to also ensure there are no
abnormalities.
Another genre that is very important in an NPs practice is medicine prescriptions. With
these prescriptions, come with great responsibility. Before NPs and doctors diagnose, they must
consider the varied side effects and symptoms, and then prescribe a medicine to help cure the
chronic illness. Not only do nurses and doctors have to know how to diagnose essentially, but
must also know the allergic reactions of the patient so they will not have one from the medicine

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they are prescribing. The actual document of prescription is fairly small, however, there is a
plethora of information, and prior knowledge needed to create a proper diagnosis. On this
document, doctors and NPs must identify if this prescription is eligible for a refill or not. These
officials need to know how much medicine the patients should take in a day, and if they must
take it with food and drink. In addition, NPs and doctors need to write the patient's name, date of
birth, and address. The prescription is not official if it is not signed by the official prescriber.
Professionals who are able to prescribe due to their authority and certification, attend school for a
long time to learn the most of all the medicine that is used for treatment. It is not only a crime
and indeed illegal to forge a medicine prescription, but this could be deadly if one has an
overdose or an allergic reaction to the medicine. Therefore, it is a great responsibility to prescribe
medicine and become a medical official in general.
In Judy Rashottes Knowing the Nurse Practitioner: Dominant Discourses Shaping Our
Horizons asserts, The dominant discourses within the literature concerning the NP appear to be
centered on the fundamental theme of technology or instrumentalism: the NP viewed as
instrument and the instrumental use by the NP (52). Here, Rashotte is trying to explain the use
of instruments, otherwise called genres, specifically the technology (for x-rays and cancer
research) used to accomplish the common goal. Of course, it is true that without technology it is
very difficult for nurses and doctors to do their jobs because they can only do so much. However,
at present, technology is actually evolving because of the advances created as the years go. With
this being said, technology makes treating peoples need faster and easier. Also, technology now
can view or warn future illness/diseases so that medical officials are able to prevent this from
happening or getting worse. In addition, technology and medicine work well together because
they are two types of treatment that can cure one chronic illness, and sometimes a severe wound.

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The most significant form of communication within NPs and doctors is medical
terminology. As one of these important roles, medical terminology is the language discourse
nurses and doctors use to communicate and explain to one another what is wrong with a patient
or what needs to be done during an emergency. This intricate terminology includes prefixes and
suffixes of body parts and organs throughout the human body. Since only medical professionals
understand these additions, prefixes and root words it is easy for them to understand what the
situation they are looking at and are capable of assisting a surgeon or doctor during an
emergency. For example, abdominal lymph nodes describe the problem in the abdominal cavity
and the issue with the lymph nodes. However, a doctor may call it mesenteric lymphadenitis.
This is an inflammation of the lymph nodes in the abdomen which causes stomach pains. With
these things presented in the medical terminology, there are many references on how they
connect to the body. Moreover, this language is highly intricate and must be learned in school.
Along with Swales concept and definition of a discourse community, Erik Borgs,
Discourse Community agrees with Swales when he writes:
[W]e do not generally use language to communicate with the world at large, but
with individuals or groups of individuals. As in life, for discussion and analysis in applied
linguistics these groups are gathered into communities. One such grouping that is widely
used to analyse written communication is discourse community. John Swales . . .
described discourse communities as groups that have goals and purposes, and use
communication to achieve these goals (398).
Borg agrees with Swales ideology of a discourse community, however, throughout his article
Borg summarizes the definition of discourse community with other professionals and agrees with
them. Borg mentions the participatory component and common goals in Swales original six

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principles. Not only does Borg use Swales for support, he also uses other professionals on the
topic of a discourse community. There are many definitions of a discourse community, but
Swales writes a clarification article of the misconceptions and incomplete ideas that create a
discourse community as a whole. For example, Swales explains how a discourse community
does not have to be academic, he gives an example of one within an umbrella organization in
Hong Kong.
Finally, referring back to Swales criteria, I feel NPs exceed is because they practice what
they learn from years in school. For example, NPs common goal is to heal chronic illness, and
they reach this goal by prescribing medicine, and searching for a cure. In nursing careers, there
are many professional associations in which NPs participate in, such as American Association of
Nurse Practitioners (AANP) or local boards like any other professionals. In addition, in these
professional and scholarly communities mostly involve an exchange of ideas, theories, and
knowledge which take a large part into a discourse community. As an NP, one uses specific
genres in their daily work practice, such as intricate medical terminology and patient
documentation. Even though they use a lot more of these genres, the ones I mentioned earlier are
most significant.
If someone is interested in joining a national association, there are certain requirements
one needs to reach to become an official member. For example, the American Association of
Nurse Practitioners, one shall have at least a bachelors degree in Nursing Science (BSN) and has
to be a certified NP through the state of residence. In addition, one should also have at least
seven years of experience of the practice of a nurse practitioner prior to applying for the
association. However, these are the minimum requirements to become a member of AANP, but
there might be additional requirements due to limited spaces for occasional conferences.

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Works Cited
Borg, Erik. Discourse Community. ELT Journal. Oxford University Press. 2003. Volume 57/4.
Print.
"How to Read and Interpret X-Rays." National Procedures Institute. National Procedures
Institute, n.d. Web. 05 Apr. 2016.
"Lab Tests Interpretation." Springer Reference (2001): n. pag. Continuing Education. Nurses
Research Publications. Web. 5 Apr. 2016
Rashotte, Judy. "Knowing The Nurse Practitioner: Dominant Discourses Shaping Our
Horizons." Nursing Philosophy 6.1 (2005): 51-62. Academic Search Premier. Web. 22
Mar. 2016.
Smith, Jennifer L. "Critical Discourse Analysis for Nursing Research." Nursing Inquiry 14.1
(2007): 60-70. Academic Search Premier. Web. 22 Mar. 2016.
Swales, John. The Concept of Discourse Community. Genre Analysis: English in Academic
and Research Settings. Boston: Cambridge UP, 1990. 21-32. Print.