Observing the work of an urban safety-net psychiatric emergency room: managing the unmanageable.
Observing the work of an urban safety-net psychiatric emergency room: managing the unmanageable.
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观察城市安全网精神科急诊室的工作：管理难以管理的情况。
DOI：
10.1111/j.1467-9566.2009.01216.x
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发表时间：
2010
影响因子：
2.9
通讯作者：
Strunin,Lee
中科院分区：
文献类型：
--
作者：
Lincoln,AlisaK;White,Andrew;Aldsworth,Casandra;Johnson,Peggy;Strunin,Lee
精神科急诊室（PER）的工作人员有着苛刻的工作要求，需要在个人和社区的需求和安全，系统资源和工作责任之间取得复杂的平衡，同时提供及时，有效的护理。关于PER工作人员的日常工作活动，他们的互动以及他们对工作的看法的研究很少。本研究探讨了PER工作人员的工作和PER工作环境的组织背景。工作人员的意见进行了公共空间的公共城市PER使用两种观测技术。第一个指标旨在衡量工作人员从事的工作活动类型和在这些工作活动中花费的时间（工作任务数据）。第二种技术是由外围成员研究人员收集观察数据（参与者观察数据）。对工作任务和参与者观察数据进行了分析。结果表明，PER工作人员的大部分时间花在行政和电话任务，而不到三分之一的时间花在直接的临床工作。查明了PER工作的四个重要问题：无法管理的工作量、管理无法管理的工作量、虚假转介以及倾销和保险问题。公共卫生部仍然是医疗和社会服务系统的第一线。在这些背景下所做的工作至关重要;然而，很少有人注意到工作的内容和性质。我们的研究表明，PER的工作人员在许多层面上面临挑战，因为他们与精神和社会危机中的人一起工作的任务。
Staff in the psychiatric emergency room (PER) have demanding jobs requiring a complex balance between the needs and safety of the individual and the community, systemic resources, and job responsibilities while providing timely, effective care. Little research exists concerning day‐to‐day work activities of PER staff, their interaction, and their perceptions of their work. This study explored the work of PER staff and the organisational context of the PER work setting. Observations of staff were conducted in the public spaces of a public urban PER using two observational techniques. The first was designed to measure the types of work activities staff engaged in and the time spent in these work activities (work task data). The second technique was the gathering of observational data by a peripheral‐member‐researcher (participant observation data). Analyses were conducted of both the work task and participant observation data. Results indicate that most PER staff time is spent in administrative and phone tasks, while less than a third is spent on direct clinical work. Four important issues for PER work were identified: a workload that is unmanageable, managing the unmanageable, bogus referrals and dumping and insurance problems. The PER remains the front‐line of the medical and social service systems. Work done in these settings is of critical importance; however little attention is paid to the content and nature of the work. Our study demonstrates that staff of the PER face challenges on many levels as they struggle with the task of working with people presenting in psychiatric and social crisis.