Description
University of Toronto Press Paramedics on and Off the Streets by Michael K. Corman
In Paramedics On and Off the Streets, Michael K. Corman embarks on an institutional ethnography of the complex, mundane, intricate, and exhilarating work of paramedics in Calgary, Alberta. Corman's comprehensive research includes more than 200 hours of participant observation ride-alongs with paramedics over a period of eleven months, more than one hundred first hand interviews with paramedics, and thirty-six interviews with other emergency medical personnel including administrators, call-takers and dispatchers, nurses, and doctors. At the heart of this ethnography are questions about the role of paramedics in urban environments, the role of information and communication technologies in contemporary health care governance, and the organization and accountability of pre-hospital medical services. Paramedics On and Off the Streets is the first institutional ethnography to explore the role and increasing importance of paramedics in our healthcare system. It takes readers on a journey into the everyday lives of EMS personnel and provides an in-depth sociological analysis of the work of pre-hospital health care professionals in the twenty-first century. CHAPTERS 1. INTRODUCTION 1.1. Opening vignette - Getting Hooked 1.2. Being a "Good" Academic 1.2.1. Historical Roots of EMS and Paramedics 1.2.2. Paramedics' training and organizational oversight 1.2.3. Paramedics' Work 1.3. Why Paramedics? Why Now? 1.4. Purpose of the Book 1.4.1. In and out of the field 1.4.2. Overview of book - Summary of Chapters Part 1 2. SETTING THE SCENE 2.1. The Station 2.2. The Ambulance 2.3. The Tones 2.4. Assessment Work - "We're trying to play a chess match, 3, 5 moves ahead" 2.5. "REPAC please" 2.6. The Hospital 2.7. The ePCR 2.8. "One, Two, Three" - Stretcher Work 3. "THE HOSPITAL'S GOING TO COMPLAIN" 3.1. At the Hall 3.2. Hospital Relief 3.3. Lack of Sympathy? 3.4. Downtime - Coffee 3.5. "I've been burned several times" 4. "THAT WAS A GOODER" 4.1. "Cold Cocked" 4.2. "That was a Gooder" 4.3. Code Room 4.4. "On our truck, everyone is 36.5" 4.5. Treating the Patient, not the Protocol, not the Machine 4.6. The "Social Stuff" 4.7. Self-Policing 4.8. Fortying - "You Call, We Haul" - and Convincing Work 5. Epilogue - Overview and Discussion of Chapters 2-4 5.1. Overview 5.2. A Reflection on the Diversity of Ride-Alongs 5.3. Orienting to the What Ifs 5.4. Taken-for-granted Work: What Counts and What is Being Counted 5.5. Other Players in Emergency Medical Services Part 2 6. THE "BRAINS" OF EMS 6.1. Introduction 6.2. EMD and ProQA - "911, for what City?" 6.3. Dispatchers - Alpha 1 6.4. Dispatchers - Alpha 2 6.5. On the Centre's Floor - Interfacing or Discretionary Work 6.6. Conclusion 7. TAMING AND CREATING KNOWLEDGE OF FRONT-LINE WORK 7.1. Introduction 7.2. Protocols and the Targeting of Clinical Practice 7.3. The Electronic Patient Care Record (ePCR) 7.4. Producing Compliance and Quality on the Front Lines 7.5. Business Intelligence - "Analyze and Effect Change" 7.6. Tracing Relations of Governance and Accountability 7.7. Conclusion Part 3 8. SO WHAT? WHERE DO WE GO FROM HERE? 8.1. Overview of Book 8.2. Cause for Concern? 8.2.1. Doing More With Less 8.2.2. Changing Professional Mandate 8.2.3. Reformation of Time 8.3. Broader Implications 8.4. Closing Remarks