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.
Daniela Krüger is a postdoctoral research assistant in Health Services Research in Emergency and Acute Medicine in the Departments of Emergency Medicine (Campus Charité Mitte and Campus Virchow-Klinikum) at Charité – Universitätsmedizin Berlin.
IntroductionPart 1: Classifying “the” Emergency: Moral Economies and Social Diagnoses of Change in Emergency Care1. Beliefs in Unambiguous Categories and Institutional Arrangements2. Providers’ Social Diagnoses for the Patient Increases in Emergency CarePart 2: The “Chain of Rescue”: Medical Encounters between Low-Acute Patients and Emergency Care Providers3. Hopes and Hierarchies: Patients’ First Step in the Chain of Rescue4. A Sense for Urgency: Providers Vetting of Low-Acute Patients in the EMS and ED5. Admission or Discharge: “It’s not bad enough for the hospital.”Part 3: Grappling with Classificatory Change and its Consequences for Patients, Providers and Planners6. From Discretion at the Frontline to Institutional Accountability7. Accountable to Patients or Coworkers at the Frontline? The Zero-Sum Dilemma of Planners8. The Changing “Game” of Emergency Care: Hysteresis and Disillusio at the FrontlinesConclusionReferencesAppendix