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Background: Critically ill patients have the right to communicate and participate in their treatment to avoid adverse medical outcomes due to the severity of their illness, their responsiveness, and level of consciousness. This human right has often been neglected by health care professionals, as a result of limited alternative communication support provided to patients who are unable to speak due to, for example, endotracheal intubation. Despite the successful use of alternative communication strategies in critical care units (CCUs) in other countries, limited implementation in South African hospitals has been reported. Aims and objectives: This study aimed to determine the perspectives of South African nurses working in CCUs on the frequency of use of alternative communication strategies to support patient‐centred communication with critically ill adult patients. Design: The study followed a quantitative non‐experimental survey research design. Methods: A total of 210 nurses working in both private and public hospitals completed a survey on their perspectives on the use of alternative communication strategies in CCUs. Results: Nurse participants reported experience working with critically ill and communication‐vulnerable patients. Nurse–patient communication mainly involved the use of pen and paper, facial expressions and gestures to obtain information relating to patients' needs and their health history. Limited use of speech‐generating communication devices was reported. Conclusion: Nurse training on the use and implementation of alternative communication strategies, such as communication boards or electronic speech‐generating devices, should be investigated to improve nurses' communication with communication‐vulnerable patients in South Africa. Relevance to clinical practice: The results are applicable in clinical practice due to patients' need for alternative communication. The nurses mainly used low‐tech solutions, which are cheap and easy to access. However, there exists an opportunity to increase the use of available digital solutions. [ABSTRACT FROM AUTHOR]

The collection of South African urban language phenomena called Tsotsitaal, Scamtho, Ringas (in short ‘Tsotsitaals’) etc,have been described differently as code-switching, mixed languages, or essentially slang vocabulary. These descriptions however, fail to acknowledge the centrality of performance to these phenomena. Tsotsitaals draw on extra-linguistic modes of identity performance such as body language, clothing, and other facets of what could commonly be called ‘style’. This article uses Coupland's (2007) description of style to understand how tsotsitaals can be viewed as discursive practices performed to achieve social meaning. The research draws on fieldwork conducted in Cape Town in 2006–2007 to expand our understanding of tsotsitaals. It considers perceptions of the style associated with tsotsitaals from the viewpoint of both speakers and listeners in a township community in Cape Town. We argue that current terminology used for varieties of this sort is inadequate to describe the combination of performance, lexicon and style associated with tsotsitaals. [ABSTRACT FROM AUTHOR]