"You should have addressed it directly": the ideals and ideologies of managing interaction problems in healthcare...

An "open communication culture" in the workplace is considered a key contributor to high-quality interaction and providing means to address problems at work. We study how the ideals of "open communication" operate in healthcare.

We use discourse analysis to investigate the audio-recorded data from 14 workshop team discussions in older people services.

We found four imperatives concerning the interactional conduct of their colleagues in problematic situations that nursing professionals prefer: (1) Engage in direct communication and avoid making assumptions, (2) Address problems immediately, (3) Deal directly with the person involved in the matter and (4) Summon the courage to speak up. Through these imperatives, the nursing professionals invoke and draw upon the "open communication" discourse. Although these ideals were acknowledged as difficult to realize in practice and as leading to experiences of frustration, the need to comply with them was constructed as beyond doubt.

Workplace communication should be enhanced at a communal level, allowing those with less power to express their perspectives on shaping shared ideals of workplace interaction.

The expectation that an individual will simply "speak up" when they experience mistreatment by a colleague might be too much if the individual is already in a precarious position.