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Patients claiming their rights: an analysis of utterances from a Kenyan hospital

Abstract There has been a widespread public perception that nurses in Kenya's public health facilities are rude and impolite towards their clients. In response, the government of Kenya has recently initiated reforms aimed at improving all aspects of health service provision. In the second National Health Sector Strategic Plan of 2005–2010, the Ministry of Health projects that in the coming years service provision will become humane, compassionate and dignified. One area of focus is the intention of improving customer care to enhance client satisfaction. Consequently, a patients' charter that spells out the patients' rights, duties and obligations has been promulgated. Using the parameters of the theory of linguistic politeness propounded by Brown and Levinson (1987), I analyse data collected through non-participant observation at a public provincial hospital in Nyanza Province, Kenya. The utterances presented here constitute clients' strategies of assertion of their rights. The clients' utterances were found to challenge the nurses' authority and autonomy and hence had the potential to jeopardise smooth interpersonal communication. Therefore, practical ways in which nurses can avert the clients' face-threatening utterances by being responsive to client needs are explored as a way of yielding mutual positive politeness in the nurse-client encounters.