Rethinking risk communication in the hospital: infection prevention, risk perceptions, and lived experience.

BACKGROUND: We conceptualize infection prevention and control (IPAC) as a form of risk communication in the hospital and examine how doctors and nurses interpret and adopt IPAC measures in the wards. METHODS: We conducted a 20-week ethnography in a Canadian hospital in which we observed doctors' and nurses' routines, infection prevention practices, and barriers they encountered when following IPAC guidelines. After the observation period, we conducted interviews with doctors and nurses to gauge their perceptions of risk and how they make IPAC decisions while working in the wards. RESULTS: Doctors and nurses perceive the hospital as a site of risk, and expressed this anxiety in disinfection routines and cleansing rituals. This risk prevention behaviour is mediated by situational and lived experience, and not expressed consistently. Doctors and nurses negotiate IPAC protocols with individual perceptions of risk, material limitations, and more pressing needs. CONCLUSION: IPAC behaviour could be reinforced by improving risk communication in the hospital, first, by involving workers as stakeholders in managing the risk of infection, and second, by acknowledging various forms of risk knowledge, including embodied and situated experience, as well as material constraints. We recommend developing participatory models of risk communication that engage stakeholders in long-term dialogue, considering their risk perceptions, risk tolerance, and challenges to comply with guidelines; communicating IPAC measures as a way to protect patients and emphasizing personal risk for hospital workers; and conducting regular in-person training sessions to ensure that any concerns can be voiced.

We are not heroes-The flipside of the hero narrative amidst the COVID19-pandemic: A Danish hospital ethnography.

AIM: To explore how the media and socially established hero narrative, affected the nursing staff who worked in the frontline during the first round of the COVID19-pandemic. BACKGROUND: During the COVID19-pandemic, both media, politicians and the public have supported and cheered on the frontline healthcare workers around the world. We have found the hero narrative to be potentially problematic for both nurses and other healthcare workers. This paper presents an analysis and discussion of the consequences of being proclaimed a hero. DESIGN: Hospital ethnography including fieldwork and focus groups. METHOD: Empirical data was collected in a newly opened COVID19-ward in a university hospital in the urban site of Copenhagen, Denmark. Fieldwork was performed from April until the ward closed in the end of May 2020. Succeeding focus group interviews with nursing staff who worked in the COVID19-ward were conducted in June 2020. The data were abductively analysed. RESULTS: The nursing staff rejected the hero narrative in ways that show how the hero narrative leads to predefined characteristics, ideas of being invincible and self-sacrificing, knowingly and willingly working in risk, transcending duties and imbodying a boundless identity. Being proclaimed as a hero inhibits important discussions of rights and boundaries. CONCLUSION: The hero narrative strips the responsibility of the politicians and imposes it onto the hospitals and the individual heroic health care worker. IMPACT: It is our agenda to show how the hero narrative detaches the connection between the politicians, society and healthcare system despite being a political apparatus. When reassessing contingency plans, it is important to incorporate the experiences from the health care workers and include their rights and boundaries. Finally, we urge the media to cover a long-lasting pandemic without having the hero narrative as the reigning filter.