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Paper and people: the work of the casualty reception clerk
Author(s) -
Hughes David
Publication year - 1989
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/1467-9566.ep11373441
Subject(s) - discretion , categorization , accountability , situational ethics , interpretation (philosophy) , bureaucracy , psychology , work (physics) , public relations , social psychology , sociology , applied psychology , political science , law , epistemology , engineering , computer science , mechanical engineering , philosophy , politics , programming language
This paper examines the exercise of discretion by casualty reception staff, focussing on the problems of accountability that arise when their judgements help shape the process of patient categorization that culminates in clinical diagnosis. Rules and guidelines which ostensibly relate to bureaucratic objectives, are applied in ways which reflect situational exigencies of reception work, and values embedded in organisational culture. But reception staff are reluctant to acknowledge the importance of their decisions, and, particularly where judgements relate to patient condition, present rule‐use as a straightforward and certain activity in which interpretation plays little part.