Difference between revisions of "Caronia-etal2020"

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Caronia-etal2020
BibType ARTICLE
Key Caronia-etal2020
Author(s) Letizia Caronia, Marzia Saglietti, Arturo Chieregato
Title Challenging the interprofessional epistemic boundaries: The practices of informing in nurse-physician interaction
Editor(s)
Tag(s) EMCA, In press, Epistemics, Nurse-physician interaction, Medical interaction, Informings
Publisher
Year 2020
Language English
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Journal Social Science & Medicine
Volume 246
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Pages
URL Link
DOI https://doi.org/10.1016/j.socscimed.2019.112732
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Organization
Institution
School
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Howpublished
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Abstract

Interprofessional management of knowledge in health care settings appears to be particularly vital for the ways in which information circulates, medical decisions are taken, and nursing practices are implemented. Drawing on an extensive ethnographic fieldwork in an Italian Intensive Care Unit, this article investigates how the nurses orient to and concurrently challenge the nurse-physician epistemic boundaries by the different ways through which they perform “informing”, and make it work as a diagnostic-relevant activity. Adopting an ethnographic-nurtured discursive approach to a dataset of video-recorded morning briefings, we analyze the nurses' informing contributions in terms of sequential position, turn-taking and turn design. We identify five practices of informing and show how they display different degrees of agency and differently impact on the team's “infectious diseases diagnostic reasoning”. This article contributes to nurse-physician interaction studies by showing how the epistemic imbalance at play is interactionally accomplished by participants one interaction at a time. Particularly, the analysis demonstrates that the nurses actively contribute to the teamwork by a skillful management of knowledge that precedes the exercise of the physicians' epistemic and deontic rights implied in diagnosing and planning. Our findings illustrate how the nurses: a) exert their interactional agency without crossing the institutionally sanctioned epistemic and deontic boundaries to which they are observably oriented to; b) cautiously challenge the epistemic imbalance at play in nurse-physician interaction and c) actively contribute in setting the premises of the team's collective decisions. Conclusion and practical implications are proposed.

Notes