• Ann-Charlott Wikström and Ullabeth Sätterlund Larsson.
• Doctoral Student, Department of Nursing, University of Trollhättan/Uddevalla, Box 1236, SE-462 28 Vänersborg, Sweden. anncharlott.wikstrom@htu.se
• J Clin Nurs. 2004 Jul 1;13(5):555-61.

BackgroundThe present study focuses on human-machine interaction in an intensive care unit in the West of Sweden.AimsThe aim of the present study was to explore how technology intervenes and challenges the ICU staff's knowing in practice. THEORETICAL PERSPECTIVE: The study's theoretical starting point draws on workplace research tradition. Workplace studies encompass the interaction between the actors' situated activities and the technological tools that make their activities possible.MethodFieldwork or in situ studies of everyday practice in an intensive care unit documented in written field notes constituted the data.ResultsThe findings show first how technology intervenes in the division of labour when the taken-for-granted "old" everyday practice is disrupted when a new machine intervenes in the morning's work; secondly, it reveal how technology challenges practical knowing and thirdly, it shows how technology reformulates practice. Staff members' awareness of routine problems is often connected to the ability to see, which is always related to cultural/contextual competence.ConclusionIt is concluded that it is not talk alone that helps the caregivers to "(dis)solve" the problems. The ability to see the problems, the work environment and to find the relevant supporting tools for "(dis)solving" the routine problems is also crucial. But it is not possible to say that it is the skillful work of humans that solve problems, nor do we claim it is the tools that do so. Humans and tools are interwoven in the problem-solving process. Relevance to clinical practice. Routine problems in the intensive care unit are not "(dis)solved" through the cognitive work of individual staff members alone. Problems are also "(dis)solved" jointly with other staff members. Staff members "borrow" the knowing from each other and problems are re-represented through communication. The knowing has to be distributed among the intensive care unit staff to make the everyday work flexible.

30 keywords...

hide…