Paper short abstract:

Drawing on observations of ambulance call centres and paramedic work, I describe how togetherness is enacted in ambulance work. I argue the importance of looking beyond aggregated technological descriptions of togetherness to explore social effects.

Paper long abstract:

In this paper I draw on ethnographic observations of ambulance call centres and paramedic work to describe how togetherness is enacted in ambulance work. I consider how methods of resource coordination, based on the "feed 'em and flog 'em" formula, create technological appearances of organisational togetherness and coherence. Through describing the coordination of resources, I explore how moving vehicles from one territory to another, across fluid and flexible geographical boundaries, enables the organisation to meet response times and provide emergency care in a timely manner, meeting targets. The advantages of such organisational flexibility is often used for political and economic purposes with aggregated technological overviews providing persuasive arguments for alignment, for sharing resources and, increasingly, given current periods of austerity, cost savings.

However, through analysis of ethnographic examples, I reveal the social impacts of togetherness in ambulance work. The "feed 'em and flog 'em" removes interpersonal communication between coordinators and ambulance crews, fracturing togetherness between these two parts of the service. Furthermore, requirements for crews to straddle geographical boundaries engenders serious consequences for individuals and patients. For example, experiences of crews being lost while responding to a call and impacts on individuals' work life balance and professional development due to ever increasing travel time.

The consequences of making togetherness in ambulance services in periods of austerity heighten the imperative to look beyond aggregated descriptions to explore individual and local effects.