'The Chronicle of Nightmares': Emergency Nurses' Frontstage and Backstage Communication in the Emergency Department.

Effective emergency nurse-patient (EN) communication and ENs' communication with other healthcare workers have implications for patient outcomes. Effective EN-patient communication informs and empowers patients. This study sought to better understand ENs frontstage and backstage interactions in a metropolitan emergency department (ED). The researcher engaged in participant observation of 15 different ENs' healthcare interactions with patients and other healthcare workers in the ED for a total of 47 hours and 30 minutes. Iterative analysis of field notes builds reveal two key observations. First, frontstage and backstage spaces are fluid in nature, where healthcare workers simultaneously engage in backstage and frontstage communication regardless of physical space or audience. Second, frontstage communication processes can be categorized into three groups: information seeking and sharing, informally attending to patients and rapport building, and acting out of character. Further, a novel type of front stage interaction, "acting out of character" is conceptualized as when ENs act in ways that are inconsistent with their typical role when communicating with a patient. Implications for health communication practice and theorizing are discussed.