Meunier-Beillard Nicolas, Dargent Auguste, Ecarnot Fiona, Rigaud Jean-Philippe, Andreu Pascal, Large Audrey, Quenot Jean-Pierre
Département de sociologie, Centre Georges Chevrier, UMR 7366 CNRS, Université de Bourgogne, Dijon, France.
Department of Intensive Care, François Mitterrand University Hospital, 14 rue Paul Gaffarel, Dijon, France.
Ann Transl Med. 2017 Dec;5(Suppl 4):S39. doi: 10.21037/atm.2017.09.01.
In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient's identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU.
在医疗服务的背景下,重症监护病房(ICU)患者的脆弱性与ICU护理人员日常所经历的脆弱性紧密相连,形成一种共生关系,即受苦的患者反过来可能给护理人员带来痛苦。同样,自身受苦的护理人员也可能成为其患者痛苦的根源。ICU中患者和护理人员的脆弱性是通过一个过程同时形成的,这个过程一方面受到ICU医疗目标的影响,另一方面受到在该ICU接受治疗的患者的依从性的影响。像ICU这样的高科技科室管理中的特定挑战可能会对医疗专业人员的实践和工作条件产生影响。构建患者群体、重新集体定义患者身份并将患者归入特定的医疗轨迹,使专业人员能够界定、控制并对抗患者各种极端的脆弱性。强加这种规范框架是指导这些专业人员日常实践的唯一手段。尽管如此,痛苦的情况仍然是ICU护理关系的一个构成性特征。