Temporal typifications as an organizational resource: Experiential knowledge and patient processing at the emergency department

Abstract

The connection between time and power has been studied extensively. A common strategy through which street-level bureaucrats exert power and dominance over their clients consists of imposing protracted waiting and maintaining uncertainty regarding the outcomes of waiting. In this study, I argue that another facet of power in organizations is related to the temporal typification of cases. By exploring the triage work in two emergency departments (EDs), I show that nurses and clerks identify patterns in the temporal distribution of visits and attach clinical and moral meanings to them. The temporal typifications are sense-making devices through which triage workers orient to patients. They form a stock of tacit experiential knowledge that delineates specific expectations about the legitimacy of cases and the worth of patients. These expectations impact the unfolding and structure of triage admission interviews and contribute to the prioritization of cases. The study brings into conversation the sociological literature on time and power with the study of the moral evaluation of patients to examine temporal typifications as an organizational resource in healthcare settings. It contributes to a better understanding of triage workers’ experiential knowledge and the practical accomplishment of moral evaluation in EDs.