THE CULTURE OF WAITING IN EMERGENCY DEPARTMENT: A FOCUSED ETHNOGRAPHIC STUDY

Gaining an in-depth understanding of the cultural beliefs and behaviors of patients, their relatives, and healthcare professionals (HCPs) in the emergency department (ED) can have a significant impact on patients' and their relatives' ED experiences, expectations, satisfaction, and outcomes. This study aims to explain and describe what it is like to wait in an Iranian ED by focusing on its ongoing cultural features.

Based on Spradley’s (1980) developmental research sequence, a focused ethnographic approach was conducted at the ED of Imam Reza University Hospital in Tabriz, Iran. Purposive sampling was used to identify eligible participants from patients, their relatives, and the healthcare professionals in this ED. Data collection involved participant observation, ethnographic interviews, and examination of related documents and artifacts, which continued until data saturation was achieved.

The study identified six cultural patterns as follows: (1) patients and their relatives experience uncertainty due to a lack of information; (2) relatives feel obliged to insist on their presence; (3) the presence of relatives is perceived as having both constructive and destructive aspects; (4) a lack of empathy undermines reciprocity in the healthcare system; (5) healthcare approaches are mostly one-dimensional; and (6) self-organized HCPs dynamically address the disorganization in the ED.

The findings of this study can provide a foundation for designing effective strategies to promote technical and interpersonal dimensions of quality in ED care. These strategies should be closely aligned with patients' and their relatives' needs, expectations, and preferences.