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Abstract
In recent years, the practice of emergency medicine has been forced to negotiate
between its traditional mission of saving lives and the social pressures accruing
from a severe shortage of qualified nurses. Moreover, the demographics of
emergency room visitors have changed dramatically due to inadequate levels of
health insurance and ineffective mental health and substance abuse treatment.
This 18-month ethnographic study of communication in an urban emergency
room investigated the organizing practices used to cope with these changes,
highlighting the various disconnects between current practices and traditional
models of emergent care. A narrative description of the ER culture produced by
the researchers served as an impetus for practical improvements at this site and
prompted a better appreciation for the complex interdependencies characterizing
emergency care today.