Communication and Culture in the Surgical Intensive Care Unit
Boundary Production and the Improvement of Patient Care
Bibliographic Data
This ethnography explores communication around critically ill surgical patients in three surgical intensive care units (ICUs) in Canada. A boundary framework is used to articulate how surgeons', intensivists', and nurses' communication practices shape and are shaped by their respective disciplinary perspectives and experiences. Through 50 hours of observations and 43 interviews, these health care providers are found to engage in seven communication behaviors that either mitigate or magnify three contested symbolic boundaries: expertise, patient ownership, and decisional authority. Where these boundaries are successfully mitigated, experiences of collaborative, high-quality patient care are produced; by contrast, boundary magnification produces conflict and perceptions of unsafe patient care. Findings reveal that high quality and safe patient care are produced through complex social and cultural interactions among surgeons, intensivists, and nurses that are also expressions of knowledge and power. This enhances our understanding of why current quality improvement efforts targeting communication may be ineffective
Discipline · Ethnography · Intensive care · Intensive care medicine · Intensive care unit · Perception · Professional boundaries · Qualitative research · Sociology · Family and Patient Care in Intensive Care Units · Medicine · Nursing · Palliative Care and End-of-Life Issues · Patient-Provider Communication in Healthcare · Psychology
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| Unique citing works | 7 |
|---|---|
| Citations per year | 0,78 |
| Citation span | 2017 - 2026 (10) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 7 |