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Xyrichis et al SSM 2017.pdf (305.56 kB)

Accomplishing professional jurisdiction in intensive care: an ethnographic study of three units

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posted on 2023-06-09, 06:10 authored by Andreas Xyrichis, Karen LowtonKaren Lowton, Anne Marie Rafferty
This paper reports an ethnographic study examining health professional jurisdictions within three intensive care units (ICUs) in order to draw out the social processes through which ICU clinicians organised and delivered life-saving care to critically ill patients. Data collection consisted of 240 h observation of actual practice and 27 interviews with health professionals. The research was conducted against a backdrop of international political and public pressure for national healthcare systems to deliver safe, quality and efficient healthcare. As in many Western health systems, for the English Department of Health the key to containing these challenges was a reconfiguration of responsibilities for clinicians in order to break down professional boundaries and encourage greater interprofessional working under the guise of workforce modernisation. In this paper, through the analysis of health professional interaction, we examine the properties and conditions under which professional jurisdiction was negotiated and accomplished in day-to-day ICU practice. We discuss how staff seniority influenced the nature of professional interaction and how jurisdictional boundaries were reproduced and reconfigured under conditions of routine and urgent work. Consequently, we question theorisation that treats individual professions as homogenous groups and overlooks fluctuation in the flow and intensity of work; and conclude that in ICU, urgency and seniority have a part to play in shaping jurisdictional boundaries at the level of day-to-day practice.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Social Science and Medicine

ISSN

0277-9536

Publisher

Elsevier

Volume

181

Page range

102-111

Department affiliated with

  • Sociology and Criminology Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2017-05-08

First Open Access (FOA) Date

2018-03-23

First Compliant Deposit (FCD) Date

2017-05-08

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