A Rhythm of Unpredictability: Conceptualizing Temporalities in the Emergency Department
摘要
The emergency department is generally regarded as one of the most time-critical facilities in the healthcare system, where the urgency of medical treatment determines the care processes. However, a deeper understanding of temporality in the emergency department from the patient’s perspective is lacking. Analyzing temporality in the emergency department requires a conceptual heuristic that takes complexity and the variance of experiences into account. This chapter presents a heuristic that can be used to describe temporality in the emergency department using conceptual tools from sociological practice theory and rhythm analysis. Participant observations were conducted in emergency departments (n = 72). A semi-structured observation protocol was used to record all events in chronological order, including time stamps for each event. For the analysis, all protocols were analyzed using an inductive, adaptive coding system. For each case, the timestamps were tabulated and interpreted for patterns. The courses of treatment can be characterized by the following temporal aspects: events, duration, sequentiality, idleness, and body time. Overall, the temporal experiences of patients are centrally characterized by unpredictability. The specific constellation of duration, events, idle times, process structures, and body time ‘creates’ an absence of expectability and anticipation possibilities.