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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.
N° | 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 http://www.coe.int/en/web/compass/gender 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.