Sudden death processing: an ethnographic study of emergency care

Abstract

The following doctoral thesis provides an ethnographic account of sudden deathwork performed by emergency personnel. The study centres on three accident and emergency departments in the North East of England. Sudden death practices and perceptions are revealed using thick description from focus groups, narratives and informant accounts. Three emergency disciplines: accident and emergency nurses, police traffic officers and paramedics provide the backdrop to describing three sudden death trajectories, which take the dead body from a state of collapse to a mortuary. Particular attention is paid to the significance of status passage as a temporal dimension of deathwork with due consideration being given to the concept of body handling as 'dirty work'. A feminist concept of embodiment challenges the dominant discourse of the death processing industry in relation to beneficence and non- maleficence for those who are left behind to grieve. The theatrical representation of the body to relatives is discussed within a dramaturgical frame, questioning what is appropriate and achievable within the boundaries of an emergency care environment. An exploration of the roles of emergency personnel illuminates problems of dealing with a phenomenon, which annihilates the possibility of a sense of order and emotionally incapacitates emergency personnel. The procedural base to sudden death is presented through accounts of emergency personnel contact with human suffering and emotional pain with the intention to build a substantive theory of a sudden death milieu. Finally, Schutzian relevances highlight key concepts of significance within the data demonstrating how, despite an evidence-base to practice, some myths are highly influential in shaping the behaviours of emergency personnel throughout the sudden death event. It is hoped that insight gained may provide a catalyst to inform change where needed, in service provision and enhance interprofessional working relationships.