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dc.contributor.authorJohannessen, Lars E. F.
dc.date.accessioned2017-09-20T10:55:03Z
dc.date.accessioned2017-09-26T11:44:23Z
dc.date.available2017-09-20T10:55:03Z
dc.date.available2017-09-26T11:44:23Z
dc.date.issued2017
dc.identifier.citationJohannessen LEF. Beyond guidelines: Discretionary practice in face-to-face triage nursing. Sociology of Health and Illness. 2017;39(7):1180-1194language
dc.identifier.issn0141-9889
dc.identifier.issn1467-9566
dc.identifier.urihttps://hdl.handle.net/10642/5252
dc.description.abstractThis article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses’ discretionary application of guidelines. Specifically, it analyses nurses’ discretionary use of the Manchester Triage System (MTS) when performing face-to-face triage, that is, assessing the urgency of patients’ complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning. The findings also show how nurses’ reasoning led them to override guidelines both overtly and covertly. Based on this evidence, it is argued that nurses’ assessments relied more on internalised ‘triage mindlines’ than on codified triage guidelines, although the MTS did function as a support system, checklist and system for supervisory control. The study complements existing research on standardisation in nursing by providing an in-depth analysis of nurses’ methods for navigating guidelines and by detailing how deviations from those guidelines spring from their clinical reasoning. The challenges of imposing a managerial logic on professional labour are also highlighted, which is of particular relevance in light of the drive towards standardisation in modern healthcare.language
dc.language.isoenlanguage
dc.publisherWileylanguage
dc.rightsThis is the accepted version of the following article: Johannessen, L. E. (2017). Beyond guidelines: discretionary practice in face‐to‐face triage nursing. Sociology of Health & Illness., which has been published in final form at http://dx.doi.org/10.1111/1467-9566.12578language
dc.subjectTriagelanguage
dc.subjectDiscretionlanguage
dc.subjectNursinglanguage
dc.subjectStandardizationlanguage
dc.subjectGuidelineslanguage
dc.subjectMindlineslanguage
dc.titleBeyond guidelines: Discretionary practice in face-to-face triage nursinglanguage
dc.typeJournal articlelanguage
dc.typePeer reviewedlanguage
dc.date.updated2017-09-20T10:55:02Z
dc.description.versionacceptedVersionlanguage
dc.identifier.doihttps://doi.org/10.1111/1467-9566.12578
dc.identifier.cristin1495831
dc.source.journalSociology of Health and Illnes


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