Catherine L Ringham1, Karen MacKinnon2. 1. Faculty of Nursing and Alberta Health Services, University of Calgary, Calgary, Alberta, Canada. 2. School of Nursing, University of Victoria, Victoria, British Columbia, Canada.
Abstract
BACKGROUND: While maternal or infant transfer is generally the safest course of action when health complications arise, the process of shifting from one hospital to another is stressful for mothers and their infants. There is limited understanding of how institutional processes coordinate patient transfer in ways that increase tensions for women and their families who are trying to navigate the institutional systems during health crises. METHODS: This institutional ethnographic study explored womens' experience of transfer. Interviews were conducted with a purposive sample of six childbearing women. The analysis highlights tensions and contradictions between patient care and institutional demands and shows how ordinary institutional decision-making practices impacted participants in unexpected ways. RESULTS: Women experienced uncertainty and stress when trying to convince health-care providers they needed care. Before, during, and after transfer, participants navigated home responsibilities, childcare, and getting care closer to home in difficult circumstances. CONCLUSION: The effort and skill women need to care for their infants and families as they are transferred is extraordinary. This study offers insight into the resources and support childbearing women need to accomplish the work of caring for their families in the face of perinatal crisis and multiple transfers.
BACKGROUND: While maternal or infant transfer is generally the safest course of action when health complications arise, the process of shifting from one hospital to another is stressful for mothers and their infants. There is limited understanding of how institutional processes coordinate patient transfer in ways that increase tensions for women and their families who are trying to navigate the institutional systems during health crises. METHODS: This institutional ethnographic study explored womens' experience of transfer. Interviews were conducted with a purposive sample of six childbearing women. The analysis highlights tensions and contradictions between patient care and institutional demands and shows how ordinary institutional decision-making practices impacted participants in unexpected ways. RESULTS: Women experienced uncertainty and stress when trying to convince health-care providers they needed care. Before, during, and after transfer, participants navigated home responsibilities, childcare, and getting care closer to home in difficult circumstances. CONCLUSION: The effort and skill women need to care for their infants and families as they are transferred is extraordinary. This study offers insight into the resources and support childbearing women need to accomplish the work of caring for their families in the face of perinatal crisis and multiple transfers.
Keywords:
Canadian health services; Perinatal; institutional ethnography; mothering work; neonatal nursing; transfer