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As emergency departments and ambulance services face rising demand, a considerable share of patients present with needs deemed “non-urgent”, generating strain, frustration and moral judgement across care systems.
The first of its kind to apply Bourdieusian field theory to emergency care, this book analyses how changing classificatory practices reshape professional boundaries, expectations of care and notions of legitimate urgency. Using an in-depth case study of emergency care services in a German city, the book reveals emergency care as a contested social field in which struggles over meaning, authority and moral worth occur and reproduce institutional inequalities.
Moving beyond debates on workload and safety, this book reveals the broader social and institutional implications of rising demand in emergency care.
Introduction
Part I: Classifying ‘the Emergency’: Moral Economies and Social Diagnoses of Change in Emergency Care
1. Beliefs in Unambiguous Categories and Institutional Arrangements
2. Providers’ Social Diagnoses for the Patient Increases in Emergency Care
Part II: The ‘Chain of Rescue’: Medical Encounters between Low-Acute Patients and Emergency Care Providers
3. Hopes and Hierarchies: Patients’ First Step in the Chain of Rescue
4. A Sense for Urgency: Providers' Vetting of Low-Acute Patients in the EMS and ED
5. Admission or Discharge: ‘It’s Not Bad Enough for the Hospital'
Part III: Grappling with Classificatory Change and its Consequences for Patients, Providers, and Planners
6. From Frontline Discretion to Institutional Accountability
7. Accountable to Patients or Coworkers at the Service Provision Frontline? The Zero-Sum Dilemma of Planners
8. The Changing ‘Game' of Emergency Care: Hysteresis and Disillusio at the Service Provision Frontlines
Conclusion
Appendix