• Nicolas Meunier-Beillard, Auguste Dargent, Fiona Ecarnot, Jean-Philippe Rigaud, Pascal Andreu, Audrey Large, and QuenotJean-PierreJPDepartment of Intensive Care, François Mitterrand University Hospital, 14 rue Paul Gaffarel, Dijon, France.Lipness Team, Inserm Research Center LNC-UMR1231 and LabExLipSTIC, University of Burgundy, Dijon, France.Inserm CIC 1432, Clinica.
• Département de sociologie, Centre Georges Chevrier, UMR 7366 CNRS, Université de Bourgogne, Dijon, France.
• Ann Transl Med. 2017 Dec 1; 5 (Suppl 4): S39.

AbstractIn the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient's identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU.

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