The paper seeks to show that narrative close call reporting is one strand of an ongoing collaborative inquiry project with 300 staff aiming to improve teamwork in operating theatres in a large UK hospital. How teams deal with close calls (“accidents waiting to happen”) reveals resourcefulness but exposes flaws, including resistance to basic safety practices such as briefing and debriefing.
In this paper over 400 issues from close call reports over two years have been thematically analysed to map a variety of (mis)communications. This paper goes beyond this descriptive level of data analysis to a deeper level, where close calls are read textually. The most common rhetorical strategies are reported, shown in around a quarter of all reports.
The paper finds that accounts are neither transparent nor objective, but offer a medium for the exercise of rhetorical strategy, a main function of which is construction and management of identity. Practitioners maintain traditional boundaries between professions by stereotyping the “other” professional in the team, serving to stabilise identity. Work is typically presented as on the edge, close to collapse, serving to shape an identity of “heroic survivors” for team members.
In the paper habitual practices that impede teamwork are challenged, such as stereotyping. Reporting can encourage “fearless speech” – regardless of position on the traditional hierarchy – that is an empowering form of “plain speaking” underpinned by moral courage.
The paper shows that close calls are typically treated instrumentally. A deeper, aesthetic and ethical reading is offered. Education in “fearless speech” in close call reports may offer a reflexive stance and new context for identity construction.
Bleakley, A. (2006), "You are who I say you are: the rhetorical construction of identity in the operating theatre", Journal of Workplace Learning, Vol. 18 No. 7/8, pp. 414-425. https://doi.org/10.1108/13665620610692980Download as .RIS
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