The Fight To Get In: Space, Place, and the Meaning of Rounds in the ICU

• In Event: 540 - Section on Science, Knowledge, and Technology Roundtable Session (one-hour).
  In Refereed Roundtable: Table 03. Biomedicine and Health I

Abstract

Medical rounds are a critical part of the education and socialization of new doctors in teaching hospitals. While historically they were the sole domain of physicians, pushes for interprofessionalism in recent years and calls for patient involvement in care have transformed the intended audience of rounds. In this paper, we discuss several ways the practice of rounds has not matched this new inclusive rhetoric through an analysis of the “spatial grammar” of rounds (Lynch, 1991). Our data come from a comparative ethnographic study of four intensive care units across two cities in the United States: Downtown, Hilltop, Lakeside, and Midtown. Findings are organized using Gieryn’s (2000) three necessary and sufficient conditions of place: the geographic location of rounds, their materiality, and their meaning. Rounds are shown to be spatially anchored, to have an embodied materiality, and to be polysemic. We argue that materiality does not have to be made “of stuff,” as Gieryn argued, but rather that bodies can act as a physical barrier for an otherwise ephemeral and meaningful spatial arrangement. We conclude by suggesting that opening spatial analysis to ephemeral, embodied places can extend our analysis to previously ignored and sociologically significant places.

Authors

• Elise Paradis, University of Toronto

• Myles Leslie, Johns Hopkins University