The infrastructure of telecare: Implications for nursing tasks and the nurse-doctor relationship

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A unique experience of confidence between patient and nurse can be provided through the practical set-up in telemedicine. This embraces new standards for professional discretion among nurses, but also an increasingly complicated relation to doctors. This provides a dilemma that we characterise as ‘paradoxical accountability’. The study draws on ethnography in relation to a large 5 mio euro project at four hospitals in Copenhagen caring for 120 patients with COPD. Twenty screen mediated conferences was observed and two workshops focusing on nurses’ photo elucidation of the practice of telecare with focus on shifting tasks was undertaken. Furthermore, the method of ‘Interview to double’ was used the analytical ambition being to explore the becoming of tasks and relations. Analytically the study draws predominantly on Stars notion of ‘infrastructure’. Infrastructure is seen as human and non-human conduct that is embedded into wider organisational conventions, sites and structures. The analysis argues and demonstrates that the nurse is imposed to a new responsibility, but also a decreased access to clinical decision makers. It is discussed how these cartographies of relations integrate the professions they constitute with functions of power and we point to the ethical problem of leaving the nurse increasingly accountable and dependent.

OriginalsprogEngelsk
TidsskriftSociology of Health and Illness
Vol/bind41
Nummer1
Sider (fra-til)67-80
Antal sider15
ISSN0141-9889
DOI
StatusUdgivet - 7 jan. 2019

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