Time-oriented decisions in Palliative Care team meetings

Abstract

In a wide diversity of workplaces time and temporality are an omnirelevant feature of the praxeological and material environment, as observable by the pervasiveness of chrono-metrical and chronological technologies and artifacts, and by workers’ orientation to matters of punctuality, productivity and other aspects of task dispatch and managerial organization. Professionals’ orientation to time takes an additional complexity in healthcare settings, given the multiple temporalities involved – biological, institutional, social – and the implications of timely professional intervention in the progression of patients’ health. In palliative care, we argue, a practical concern with time and temporality is a constitutive feature of the work of professionals and teams, visible in and built in their interactions. Furthermore, such orientation to time is related to the collective production of justifications for actions. Drawing on conversation analysis of a corpus of audio recordings, we examine how, in team meetings and interactions with other healthcare staff, palliative care professionals make sense of patients’ end of life trajectories in a situated and joint manner, grounding their proposals for action in terms of timeliness – or lack thereof – concerning patients’ current situation and prognoses on their more-or-less foreseeable unfolding, accomplishing a valid rationale for palliative intervention.