Tillbaka till livet : Att skapa säkerhet i hjärtintensivvården

Sammanfattning: This study analyses how medical personnel in cardiac intensive care create safety despite the uncertainties and dangers involved in this type of care. Using an ethnographic approach, involving participant observation and interviews, the author studies the means by which the staff, as a part of their everyday work, achieve safety - in their relationships to patients, medical technology and each other. The analysis uses perspectives from symbolic interactionism, medical sociology and organization studies, and sets everyday interaction in an organisational power perspective.The medical staff take various measures to achieve safety and to reproduce their socially shaped understanding of what safety is. First: safety for them is defined as the capacity, and the possibility, to make their own relevant and competent interpretations of the signals that machines and patients give off, and of each other-s capability to handle specific situations. Second: safety is related to the competent handling of machines and the patients- bodies, which involves knowledge about how to connect and disconnect machines and bodies at the right time and sequence. Third: creating safety also involves making the patients into active subjects, or -co-operative patients-, who participate in the illness trajectory work and co-operate with the medical staff. Fourth: safety is achieved when the cardiac intensive care unit as a whole is represented as a safe place to be in and the individuals who work there are seen as having relevant and sufficient competence. Fifth: safety is, finally, defined as the capacity to have influence over one-s own work - especially in critical situations. The study shows what the medical staff do to reach these goals and create what they perceive as safety in intensive care.