Palliative Care as Collaborative Work in an Acute Nursing Ward

Abstract

This paper describes the collaborative work of palliative care nurses in an acute medical ward - an ethnomethodology in which multiple participants collaborate to acknowledge, share information on, and manage patients’ pain. First, we outline the palliative care history of a female cancer patient based on interviews with nurses, who report that they acknowledge her condition has stabilized. Second, we analyze a video of a palliative care conference to explicate how this acknowledgement is shared among other nurses. During the conference, an experienced nurse quotes the words of the patient that indicate she has no pain, and this process helps a junior nurse to understand the situation. Third, we analyze the video of a handover, during which the night staff reports that the patient claimed of pain and received rescue medication. From this analysis, we were able to explicate how the pain control/caring plan was decided on the basis of this information sharing. Finally, by analyzing field notes, we understand that the practical management of medication involves collaborative work by many participants in the nursing station.