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

Xyrichis, Andreas, Lowton, Karen and Rafferty, Anne Marie (2017) Accomplishing professional jurisdiction in intensive care: an ethnographic study of three units. Social Science and Medicine, 181. pp. 102-111. ISSN 0277-9536

[img] PDF - Published Version
Restricted to SRO admin only

Download (302kB)
[img] PDF - Accepted Version
Restricted to SRO admin only until 23 March 2018.

Download (312kB)

Abstract

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.

Item Type: Article
Schools and Departments: School of Law, Politics and Sociology > Sociology
Subjects: H Social Sciences
H Social Sciences > H Social Sciences (General)
Depositing User: Karen Lowton
Date Deposited: 08 May 2017 12:01
Last Modified: 10 Aug 2017 23:48
URI: http://sro.sussex.ac.uk/id/eprint/67731

View download statistics for this item

📧 Request an update