Collaborative work represents a communicative context in which organizational actors navigate the blurring of knowledge and authority boundaries as they address complex problems. This article theorizes about expertise tension that arises when individuals with valuable insights lack corresponding authority to act, or vice versa. Using observations and interviews, we studied how physicians and nurses navigated this tension in problem-solving situations in a hospital emergency department. We found that nurses, who identified emergent problems, simultaneously asserted their situational authority and displayed a veneer of deference by asking physicians, “What do you want to do [in this situation]?” The question prompted one of three problem-solving activities (i.e., instruction by demand, reversed instruction, and collaborative improvisation) depending on the situation’s urgency and ambiguity. We discuss how nurses and physicians managed expertise tension without undermining their different claims to expertise and authority, highlighting the value of a communication-centered view in examining such dynamics.

中文翻译：

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“What do you want to do？”：急诊护士与医生互动中的专业知识紧张和权威谈判


协作工作代表了一种交流环境，组织参与者在解决复杂问题时驾驭模糊的知识和权威界限。本文对具有宝贵见解的个人缺乏相应的行动权限时出现的专业知识紧张进行了理论分析，反之亦然。通过观察和访谈，我们研究了医生和护士如何在医院急诊科解决问题的情况下驾驭这种紧张关系。我们发现，发现紧急问题的护士在维护他们的情境权威的同时，通过询问医生，“你想 [在这种情况下] 做什么？根据情况的紧迫性和模糊性，这个问题引发了三种解决问题的活动之一（即需求指导、反向指导和协作即兴创作）。我们讨论了护士和医生如何在不破坏他们对专业知识和权威的不同主张的情况下管理专业知识紧张局势，强调了以沟通为中心的观点在研究此类动态方面的价值。