Balancing Machine Work, Comfort Work, and Sentimental Work: A field study of patient care in the ambulance

To improve prehospital care ambulances carry increasingly sophisticated equipment aimed at initiating patient care already at the scene of injury. The competent use of this equipment is central to prehospital care but it also competes for increasing amounts of the ambulance crew’s time and attention. We investigate ambulance care in three of Denmark’s five healthcare regions, which staff ambulances with emergency medical technicians, paramedics, and physicians. Using the concept of illness trajectory we analyse how the ambulance crews balance machine work, which involves continuously monitoring the equipment, comfort work, which is actions taken to relieve the pain or discomfort of the patient, and sentimental work, which is care for the patient’s physical and mental well-being, often verbal in nature. The analysis shows that comfort and sentimental work often takes priority over machine work, but also that this has negative consequences. Equipment for use in ambulances should aim at supporting the ambulance crews in competently and dynamically balancing the different types of work and should, consequently, avoid binding the crew’s attention for unbroken periods of time.