Patient on display – a study of everyday practice in intensive care

Authors

  • Ann-Charlott Wikström RN DipNursEd,

    1. Doctoral Student, Department of Nursing, University of Trollhättan/Uddevalla, Vänersborg; and Institute of Health Care Pedagogics, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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  • Ullabeth Sätterlund Larsson PhD RN DipNursEd

    1. Doctoral Student, Department of Nursing, University of Trollhättan/Uddevalla, Vänersborg; and Institute of Health Care Pedagogics, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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Ann-Charlott Wikström, Department of Nursing, University of Trollhättan/Uddevalla, Vänersborg, Box 1236, SE-462 28 Vänersborg, Sweden. E-mail: anncharlott.wikstrom@htu.se

Abstract

Background. This study investigates the situated organization in a workplace producing intensive care, that is an intensive care unit (ICU). The workplace research tradition concerns work and interaction/communication in technology-intensive environments. Communication is seen as social action and cannot be separated from production or from the context in which the activities are situated.

Aim. The aim of the present study was to explore how intensive care is produced by analysing a recurrent situated activity in the ICU, namely the delivery and reception of a patient coming from the operation unit.

Method. In the fieldwork, participant observations was used to study everyday practice in an ICU, combined with written field notes.

Findings and discussion. Intensive care is to a great extent produced through routine practices. The division of labour is marked and is taken for granted: everyone knows what to do. The actors’ physical location in the room is connected to their functions and work with supportive tools. Verbal reports, visual displays and activities make the information transmission available to everyone in the patient room. Shared understanding of the situation seems to make words redundant when the activities of competent actors are co-ordinated. There is also coordination between the actors in the ICU and the technological equipment, which constantly produces new information that must be interpreted. Enrolled Nurses are physically closest to the patients, the physician is the one most physically distant from patients and Registered Nurses bridge the gap between them. These actors produce and re-produce intensive care through constant sense-making in the here and now at the same time as the past is present in their activities.

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