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困境工作:新冠疫情重症护理中的慢性强制与困境

Distressed Work: Chronic Imperatives and Distress in Covid-19 Critical Care.

出版信息

Hastings Cent Rep. 2023 Jan;53(1):33-45. doi: 10.1002/hast.1458.

Abstract

This ethnographic study introduces the term "distressed work" to describe the emergence of chronic frictions between moral imperatives for health care workers to keep working and the dramatic increase in distress during the Covid-19 pandemic. Interviews and observant participation conducted in a hospital intensive care unit during the Covid-19 pandemic reveal how health care workers connected job duties with extraordinary emotional, physical, and moral burdens. We explore tensions between perceived obligations of health care professionals and the structural contexts of work. Key findings cluster around the moral imperatives of health care work and the distress that work engendered as work spaces, senses of vocation, patient and family interactions, and end-of-life care shifted. While the danger of working beyond limits has long been an ordinary feature of health care work, it has now become a chronic crisis. Assessing this problem in terms of distressed work and its structural contexts can better address effective, worker-informed responses to current health care labor dilemmas.

摘要

本民族志研究引入“苦恼工作”一词,用以描述在新冠疫情期间,医护人员继续工作的道德义务与压力剧增之间出现的慢性摩擦。在新冠疫情期间,对一家医院重症监护病房进行的访谈和参与观察揭示了医护人员如何将工作职责与特殊的情感、身体和道德负担联系起来。我们探讨了医护人员的感知义务与工作结构背景之间的紧张关系。主要发现围绕着医护工作的道德义务以及工作空间、职业使命感、患者和家属互动以及临终关怀转变所带来的困扰。虽然工作超出极限的危险长期以来一直是医疗保健工作的一个普通特征,但现在它已成为一个慢性危机。根据苦恼工作及其结构背景来评估这一问题,可以更好地应对当前医疗保健劳动力困境中的有效、以工作人员为导向的应对措施。

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