Abstract :
In this talk I’ll be exploring the work of ‘crash teams’ resuscitating patients in the Paediatric Intensive Care Unit of a London hospital. Crash teams need to act under significant time pressure and high levels of uncertainty, often without warning, while coordinating work that is distributed over five staff members or more, including nurses, physicians and anaesthetists. My focus is on their ‘planning work’; I’ll describe how they specify, seek, offer, and accept work.
The complexity of resuscitation team work (in terms of the tasks involved in completing it) provides a ground for testing the limits of existing schemas accounting for what is now often described in CA as ‘recruitment of assistance’. I’ll show, first, that in resuscitation teams, work planning happens through requests and offers to join an ongoing course of action; and that the role being considered for the joining member may be that of ‘assistant’ or indeed ‘leader’. Second, I’ll expand the analytical frame further and draw attention to a higher level of work planning, where new courses of action are planned and coordinated. Third, I’ll explore the differing roles of different team members (including the designated ‘team leader’) in the planning of their work at each of these levels.
Data include video-recordings of in-situ, ‘high fidelity’ simulations of resuscitation teams. Thus the participants operated in their own PICU on an advanced manikin that can be ventilated, intubated, given chest compression, administered drug, and so on. The simulations were orchestrated by experienced trainers, who created scenarios based on real-world events.
