‘Get me the airway there’: Negotiating leadership in obstetric emergencies

Abstract

The article discusses leadership enactment in medical emergencies. We draw on video recordings of simulated obstetric emergencies and investigate how senior clinicians ‘do being’ the leader discursively in the spatiomaterial context of the emergency room. We take an interactional analysis approach, combining conversation analysis and interactional sociolinguistics and look specifically into the ways in which professional roles do interactional control using directives and questions in the material space of the obstetric room. We discuss this interactional performance in relation to the clinical performance of the teams. Our analysis shows that leadership in medical emergencies is multimodally achieved; professionals draw on discursive strategies, the affordances of material space, body and gaze orientation, which build on each other and converge in indexing leadership. Our findings highlight the situated nature of negotiating responsibility, illustrating that leadership in our context is claimed, projected and resisted discursively. We provide a typology of the functions of questions in the emergency encounter, and close the article by foregrounding the implications of our study and providing directions for further research.

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“…• Which traits, attributes, or qualities predict gaining or losing influence and informal leadership over time? Anderson et al, 2001;Anderson et al, 2020;Bendersky & Shah, 2013;Cheng et al, 2013;Gerpott et al, 2018;Judge et al, 2002;Maran et al, 2019 Leadership styles and leader-follower relations Ashrafa et al, 2018;Exline et al, 1975;Härgestam et al, 2016;Mesinioti et al, 2020;Stahnke & Blömeke, 2021;Tsuchiya et al, 2021…”

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“…Our research shows that teams do teamwork in and through an emplaced/embodied interactive practice and negotiate their roles and coordinate in situ. Our work [32,33] on the management of obstetric emergencies shows that teams with strong clinical performance tend to declare the emergency, do direct task allocation, and maintain tight control of the floor, including only task-related The table provides a useful digest and can be also associated with making the use of information protocols such as SBAR more consistent.…”

“…The junior doctors have not been included in Fig. 2, as they appear more fluid in the data; we have provided different readings on this in earlier work [32,33].…”