Face attack and patients’ response strategies in a Kenyan hospital

Abstract

Social power can be exercised by face attack where power differentials are sufficiently great and significant retaliation or sanctions are unlikely. Such exercise of social power is common in military contexts. It is not commonly observed in hospital settings yet some nurses in Kenya’s public hospitals routinely attack the face of their patients. Using data from interactions observed in a provincial hospital, it is illustrated how nurses initiate conflict and how patients counter the face-attackingmoves. The investigation shows that nurses use a high frequency of utterances that violate the dignity of patientswhile the latter prefer conflict avoidance strategies.Nurses generally make no attempt to mitigate the impact of most of their face-threatening utterances while patients demonstrate awareness of the need to preserve mutual face and reclaim dignity. Three strategies used by patients to reclaim dignity – namely silence, retaliatory face damage and face repair – are illustrated.