Communication at work often occurs among people from different power, culture, or language groups. Communicating with a difficult co-worker can become a major source of job dissatisfaction. This chapter introduces communication accommodation theory and the exit, voice, loyalty, and neglect model as theoretical lenses for exploring the case of a recent immigrant healthcare worker experiencing job dissatisfaction because of unsatisfying interactions with a co-worker. This chapter then applies these theoretical frameworks to discuss how tensions between co-workers can arise in communicative forms such as convergence, divergence, and overaccommodation and how an employee responds to a deteriorating work condition stemming from difficult interpersonal communication.
TopIntroduction
The workplace is often a site of communication among people who are from different generations, power groups, and/or cultural or linguistic backgrounds. In this context, work demands and varying interests may escalate tensions that already exist among colleagues from differing backgrounds. Thus, communication at work in general, and communicating with a difficult co-worker more specifically, can become a source of job dissatisfaction (e.g., Ducharme & Martin, 2000). These challenges may give rise to some questions for those interested in organizational communication. For example, how do tensions arise from communication between two organizational members from very different backgrounds? How can an employee respond to a difficult interpersonal issue and address the resulting job dissatisfaction? By considering the case of an immigrant healthcare worker in the intensive healthcare setting, this chapter describes these communicative tensions, the motives behind them, and one employee’s response(s) to adverse situations in the workplace.1 This chapter starts with an overview of immigrants’ experiences in the U.S. nursing workforce. Then, Communication Accommodation Theory (CAT; Giles et al., 1987) and the Exit, Voice, Loyalty, and Neglect (EVLN) model (Farrell, 1983; Hirschman, 1970) will be introduced as theoretical lenses for analyzing the case study. Next, the case of a Korean immigrant registered nurse (RN) having difficulties communicating with a co-worker will be presented. In the last section, the theoretical lenses will be applied to the case and the key concepts will be explained with specific examples.
Immigrants in the U.S. Nursing Workforce
Immigrants in the U.S. are overrepresented in healthcare occupations. As of 2018, over 1.5 million immigrants were employed as physicians, RNs, and pharmacists (Batalova, 2020). Nursing, in particular, is one of the fields that has seen an influx of foreign-born healthcare workers. The U.S. has “imported” foreign-born nurses to fill the labor shortage. As a result, foreign-born RNs represent a growing proportion of the nursing workforce. According to the Organization for Economic Co-operation and Development (OECD, 2020), foreign-born nurses account for 16.4% of the total nurses in the U.S. In fact, some states in the U.S. have twice as many foreign-born nurses compared to the national average: Nevada (36%), California (35%), Maryland (30%), and New York (29%). Over 20% of foreign-born nurses are either permanent residents or temporary visa holders. Although their English proficiency is higher than the total foreign-born population, 16% of foreign-born nurses in the U.S. reported speaking English ‘less than very well’ (Batalova, 2020).
Research on the experiences of foreign-born nurses has pointed out that they struggle with communication barriers, different expectations for nursing roles, discrimination, marginalization, and exploitation (e.g., Connor & Miller, 2014; Ea et al., 2010; Cheng & Liu, 2011, Xu, 2007). Culture-related attributes such as acculturation and language skills are associated with the job satisfaction of immigrant nurses (Ea, 2007; Xu, 2007). Specifically, Kim and colleagues (2017) reported that resilience and culture are significantly associated with job satisfaction in a sample of Korean American nurses. Due to cultural and linguistic barriers, immigrant nurses are likely to face challenges in communicating with not only their patients but also their colleagues, which in turn can influence their job satisfaction.
Communication plays a central role for these immigrant nurses in navigating the challenges they face in the workplace and potentially responding to job dissatisfaction. Communication can be the source of job dissatisfaction for immigrant nurses, but at the same time when they respond to job dissatisfaction, they are likely to employ communication strategies to navigate issues at hand. CAT suggests that communicative strategies are used when immigrant nurses negotiate their social identity and distance with their colleagues in the workplace. Also, although the original EVLN model does not necessarily tease out the communicative aspects of employee responses to job dissatisfaction, EVLN concepts can be applied to make sense of the patterns of responses from immigrant nurses who experience job dissatisfaction. The following section discusses CAT and the EVLN model as the theoretical frameworks for analyzing the case study.