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Taylor & Francis


The vast majority of care for end-stage renal disease (ESRD) patients is provided by skilled (but not formally educated) paraprofessional technicians. Using Goffman's (1959) framing of the performance of self in everyday discourse, this study examines discourse from dialysis technicians and technical aides to explore these paraprofessionals' construction and performance of professional identity and professional communication within the context of an outpatient dialysis clinic. Themes of professionalism—individualized care, vigilance, teamwork, and emotion management—are illustrated via poetic transcription of interviews with technicians. I contend that such representation offers validity equal to that of traditional research accounts while embodying alternative representational strengths.


This is an Accepted Manuscript of an article published by Taylor & Francis in Health Communication in 2011, available online:



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