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Power and conflict in intensive care decision making

Power and conflict in intensive care decision making
Power and conflict in intensive care decision making
It is clear that current government policy places increasing emphasis on the need for flexible team working. This requires a shared understanding of roles and working practices. However, review of the current literature reveals that such a collaborative working environment has not as yet, been fully achieved. Role definitions and power bases based on traditional and historical boundaries continue to exist.
This ethnographic study explores decision making between doctors and nurses in the intensive care environment in order to examine contemporary clinical roles in this clinical speciality. Three intensive care units were selected as field sites and data was collected through participant observation, ethnographic interviews and documentation.
A key issue arising in this study is that whilst the nursing role in intensive care has changed, this has had little impact on how clinical decisions are made. Both medical and nursing staff identify conflict during patient management discussions. However, it is predominantly nurses who seek to redress this conflict area through developing specific behaviours for this clinical forum. Using this approach to resolve such team issues has grave implications if the government vision of interdisciplinary team working is to be realised.
Intensive care, Ethnography, Decision making, Interdisciplinary team working, Clinical decision making
0964-3397
125-135
Coombs, M.A.
e7424ed2-6beb-481d-8489-83f3595fd04c
Coombs, M.A.
e7424ed2-6beb-481d-8489-83f3595fd04c

Coombs, M.A. (2003) Power and conflict in intensive care decision making. Intensive And Critical Care Nursing, 19 (3), 125-135. (doi:10.1016/S0964-3397(03)00040-5).

Record type: Article

Abstract

It is clear that current government policy places increasing emphasis on the need for flexible team working. This requires a shared understanding of roles and working practices. However, review of the current literature reveals that such a collaborative working environment has not as yet, been fully achieved. Role definitions and power bases based on traditional and historical boundaries continue to exist.
This ethnographic study explores decision making between doctors and nurses in the intensive care environment in order to examine contemporary clinical roles in this clinical speciality. Three intensive care units were selected as field sites and data was collected through participant observation, ethnographic interviews and documentation.
A key issue arising in this study is that whilst the nursing role in intensive care has changed, this has had little impact on how clinical decisions are made. Both medical and nursing staff identify conflict during patient management discussions. However, it is predominantly nurses who seek to redress this conflict area through developing specific behaviours for this clinical forum. Using this approach to resolve such team issues has grave implications if the government vision of interdisciplinary team working is to be realised.

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More information

Published date: 2003
Keywords: Intensive care, Ethnography, Decision making, Interdisciplinary team working, Clinical decision making

Identifiers

Local EPrints ID: 9297
URI: https://eprints.soton.ac.uk/id/eprint/9297
ISSN: 0964-3397
PURE UUID: 157d5244-90cd-4254-93d0-d7944b79c136

Catalogue record

Date deposited: 21 Oct 2004
Last modified: 17 Jul 2017 17:11

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