Le collectif de travail à l'épreuve du risque d'erreur médicale

The health workers are daily faced with multiple decisions that depend both on individual skills and professional practices as well as on the collective action taken. When decisions are made under conditions of uncertainty and emergency, as it is often the case in intensive care unit, they become elicitors of stress. The aim of this study was to examine the links that the health workers usually make between their teamwork functioning and the chance for medical errors when vital prognosis is concerned. More especially, we addressed the main topic of medical error focalizing on the health workers' professional relationships, the way the role played by the team was seen, and the work atmosphere. To this aim, we conducted interviews in two intensive care units with 10 nurses, 10 young and 10 senior doctors who reported having encounter medical error at least on time throughout their career. After transcription, the interview contents were analyzed according to the approach of the interpretative phenomenological method. This qualitative methodology was carried-out in order to identify the discourse's units as well as the core themes. Our findings provided evidence for a team's collective sense of confidence based on the shared view that their procedures stand on scientific and technical rationality, the critical role given to transferable skills for the group cohesion, the core aspect of good atmosphere among workers and the ambivalent influence of heterogeneous functions. Data showed different but complementary interindividual and institutional supports. They also emphasized the risk that health workers fall back on their professional role when they are faced with medical errors. However, results also indicated that the collective dimension of labor relations might promote the knowledge of the reality of the colleagues' work. As a consequence, teamwork can be a relevant alternative to expert's attitude. Strengthening the links among health workers remains the main way to prevent medical errors and to manage individual and collective distress.