Accomplishing organizational compassion in critical care settings: An artifact analysis of the visitors’ book agency

Hospitalization in Intensive Care Unit (ICU) is a dramatic disruption of the taken-for-granted flow of everyday life for the patient's family members. Especially in the case of long-stay hospitalization, the emotional and physical burden makes them “secondary patients”. As the recent “compassion turn” in healthcare normatively maintains, the staff's individual communicative competences are crucial for providing empathic and compassionate forms of care, oriented to the ecology of family life. However, personal skills and interpersonal communication cannot alone fulfill the requirements of compassion-oriented patient- and family-centered care. A question arises as to how to move from individual-based compassion toward a compassionate healthcare environment. Which organizational conditions, artifact-based supports can foster taking care of the patient's relatives' suffering? Drawing on scholarship on sociomaterality, this paper reports findings from a corpus-based study on a narrative-care practice implemented in three Italian ICUs: the visitors' book (VB). Integrating artifact analysis and texts analysis, we illustrate how VB accomplishes organizational compassion, therefore ventriloquizing the ward's orientation toward it. We advance that adopting VB in an ICU can be a way to enact context-based, situated and distributed compassion-oriented family-centered care, which can complement forms of care relying on individual attitudes and interpersonal communication skills.