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Catalogue of critical incidents

The following table provides an overview of the critical incidents collected in the six countries, organised by country, narrator and related sensitive zones.

CI Title Country Narrator Keywords
1 Death among family members Austria Paramedic paramedic; emergency vehicle / emergency medicine; death & dying ; family members mourning; medical procedure; communication style
2 Germs in Blood Austria Paramedic paramedic; ambulance service; infectious diseases; AIDS as stigma, disclosure requirement; medical communication
3 Urine sample Austria Receptionist in doctor’s office reception / waiting room at general practitioner office; urine; sexual organ; shame; medical space
4 Cleaning a peer Austria Personal assistant assisting people with special needs / multiple impairments; sexuality and disability; sexuality and care work; physical contact
5 Father and Son Austria Mobile nurse mobile nursing / home care; informal caregivers; individualism, abuse of the system
6 The Teacher Austria Mobile nurse mobile nursing / home care; veil; islamophobia; minority identity / professional
7 Naked Austria Patient gynaecologist’s practice; patients exposing their bodies; sense of individualism; medical space; non-verbal communication
8 Shaking hands Austria Psychologist aid to refugees; internship / psychologist in training; disrespect; break of reciprocity; handshake; interaction rules
9 Illiterate woman Austria Patient hospital stay; multi-bed room; collectivism; disrespect; praying; medical space; non-verbal communication
10 Sex with patients Austria Doctor’s Assistant general practitioner; ethics in medical practice; communicating with co-workers; professional identity; sexual relations; sexuality
11 The Turkish Terminal Patient Denmark Nurse end of life; family; gender; communication
12 The interpretation mistake Denmark Healthcare Assistant cultural-religious concepts for death; professional responsibility towards all patients; professionalism / indifference / irresponsibility; hierarchy and power distance
13 The insult Denmark Healthcare Assistant ethnic-cultural prejudices; indirect discrimination; stigmatisation of ethnic minorities; abuse of power
14 The embarrassed GP Denmark Patient prejudice; communication; disrespect; professional ethics
15 Homecare in Roma Family Denmark Nurse professional Identity threat (professional intimidation); medical space for treatment vs. homecaring; community-based and cultural suspicion
16 The Complaint Denmark Nurse ethnocentrism, culturalisation and discrimination; lack of intercultural awareness in management; communication verbal and paraverbal
17 The liver transplant Denmark Cultural mediator intercultural communication; culturalisation, cultural determination; treatment 
18 The exclusion Denmark Nurse communication; diversity management; body physical and mental trauma
19 Trialogue Denmark Doctor prejudice; preconception; communication; hierarchy lack of empathy
20 The Desperate Woman Denmark Nurse gender; communication; individuality vs. collectivity; intercultural competences
21 Jehovas witnesses France ER doctor religion; blood; Jehova’s witness; emergency
22 Consultation in Burqa France Anaesthesist gender; religion; dress code
23 Gynecology in Japan France Patient collectivism / individualism; shame; patient’s case
24 The period France Psychologist collectivism / individualism; gender, menstruation
25 Roma Consultation France Medical doctor individualism / collectivism; family; medical space; communication
26 Coarse salt France Nurse rationalities; hygiene; medical space
27 Jewish Reanimation France ER doctor death; religion; medical ethic
28 Cellphone France Phd student prejudice; discrimination; contextual communication
29 Death of a child France Social worker children’s death; funeral rites
30 Baby Massage France Social worker physical contact; babies; baby-massage; motherhood
31 A woman’s duties Hungary Nurse Sexuality; gender; medical space; Roma; child birth
32 Arab doctor Hungary Patient advocate culturalisation; prejudice; gender; medical communication
33 Get me a woman! Hungary Nurse gender; sexuality; oppressed identity; homelessness
34 Arab family with little boy Hungary Paramedic medical space; family; child rearing; immigrant; medical treatment
35 The birthmark Hungary Patient gender; medical communication; power distance; body;  sexuality
36 Baby drinks poison Hungary Paramedic medical communication; class distance; child rearing
37 C like C Hungary Medical doctor prejudice; minority identity; medical communication
38 Chicken stew for granny Hungary Nurse family; individualism; food; medical space; Roma
39 Hairy patient Hungary Medical Assistant body; gender; purity / cleanliness; medical procedure
40 Homeless patient Hungary Medical doctor class distance; prejudice; oppressed identity; medical space; homelessness
41 Cultural Assumptions Italy Intercultural mediator pregnancy; religion; gynaecologist; preconceptions; communication.
42 Fed up Italy Oncologist oncologist; health treatment; concept of urgency
43 Gloves Italy Gynaecologist gynaecologist; intern; racism; gloves; hygiene; discrimination
44 Gratitude Italy Doctor intern; end of life; family reaction
45 Madam Doctor Italy Urologist intern; urology; hierarchy (elderly); gender; separation
46 Parents health and responsability Italy Doctor family; medical treatment; responsibility
47 Pregnant Woman in Lampedusa Italy Cultural Mediator refugees; pregnancy; gender; discrimination
48 Religion at the docks Italy Cultural Mediator religion; dress code; refugees; volunteer; communication
49 The code Italy Nurse emergency room; medical procedure; communication
50 Administering Care UK Patient prejudice-blind to difference; illiteracy; social class
51 Domestic Abuse UK Patient prejudice: culturalisation; treatment of difference: particular rules apply; gender; domestic abuse
52 Hospital Meals UK Patient preconception: culturalisation; threat to cultural identity; autonomy; food
53 Substance misuse UK Interpreter hierarchy; communication style; definition of illness and treatment; autonomy
54 No voice UK Interpreter family; prejudice: culturalisation; end of life / death; individualism; emancipation of women
55 Disable Access UK Auditor body; physical disability
56 End of life UK Interpreter end of life; hospital space; unplugging
57 Friday appointments UK Podiatrist religion; communication
58 Hospital Medication UK Patient’s relative language; religion
59 Deceased Child UK Community nurse death, mourning; food
60 Pagen UK Podiatrist medical treatment; religion; diversity management 

All the critical incidents come from real experiences of either health professional workers (doctors, nurses, but also care givers and administrative staff), patients or relatives of patients, usually implying some challenges.  The situations were analysed together with the narrators according to the analysis grid developed by Margalit Cohen-Emerique that we have slightly modified.  Each incident starts with the description of what happened and how the narrator reacted, felt. These descriptions come directly from the narrators. For each incident we describe who were the actors (narrator and the person(s) provoking the shock) so you can have an idea of the socio-cultural context. This was not always easy, as often the narrators don’t have detailed knowledge about the other people in the situation.  However, the bulk of the work consists in unveiling the cultural values, norms that underlie the behaviour of the narrator and the other protagonist.  In exploring the “cultural references” of the narrator, health sector professionals have participated actively, helping us identify what their key values were that influenced the situation.  However, when we explore the cultural references of the other people, we are necessarily in the realm of hypothesis, as these people were not there with us when we analyzed the incidents.  Our job is to make the most elaborate hypothesis possible, but they do remain hypotheses and not complete certainties.  At this point we usually try to include references to general cultural domains, opening the perspectives offered by the situation, let’s say to learn about femininity or health in an intercultural perspective.

References Cohen-Emerique, Margalit (2015) Pour une approche interculturelle en travail social Théories et pratiques 2nd edition Rennes: PRESSES DE L’ÉCOLE DES HAUTES ÉTUDES EN SANTÉ PUBLIQUE Council of Europe (2016) Gender – Some key Concepts. Accessed on 5th October 2016 at Goldenberg, Jamie; Pyszczynski, Tom; Warnica, Gwendolyn M;, Landau, Mark; and Thomas, Lisa. (2006 September). Ambivalence Toward the Body: Death, Neuroticism, and the Flight From Physical Sensation. Personality and Social Psychology Bulletin 32 (9), 1264-1277 Ross, L. (1977). The intuitive psychologist and his shortcomings: Distortions in the attribution process. In Berkowitz, L. Advances in experimental social psychology. 10. New York: Academic Press. pp. 173–220. Hofstede, Gert (1998). Masculinity and Femininity. The taboo dimension of national cultures. Thousand Oaks, California: SAGE Publications. Hofstede, Geert, Gert Jan Hofstede, Michael Minkov, 1998. “Cultures and Organizations: Software of the Mind,” Third Revised Edition, McGrawHill 2010, ISBN 0-07-166418-1. © Geert Hofstede B.V.