Helen Sweet MA
Sweet Helen (1994) The creation and subsequent development of the Intensive Care Unit in the United Oxford Hospitals studied in the context of intensive care developments elsewhere, questioning the extent to which this was influenced by developments in medical technology. School of Humanities, Oxford Brookes University
contact: Dr Helen Sweet, Welcome Unit for the History of Medicine, University of Oxford
Abstract
The aim of this research was to explore a wide range of primary and secondary historical sources, in order to investigate the history of development of intesnsive care units within Britain, and to assess the part played in this by technology as a major influential factor. The study focuses particularly on the Oxford hospitals, but contextualised within a wider framework. This fairly recent development in hospital medicine still awaits a substantial historical investigation since the mainstream development has occurred over the last twenty-five years.
The introductory chapter sets out to clarify the authorial intent and problems encountered. This describes the restrictions imposed upon the dissertation, and explains the fundamentals of Intensive Care and its historical implications within the wider field of the history of medicine. The difficulties in questioning technological determinism and influence and in considering the historical sources available, are summarised, and their advantages and disadvantages outlined, with more specific reference to the oral sources employed.
The following chapter provides a synopsis of the history of British Intensive Care, with brief reference to the history of respiratory technology contemporary to the period under study (1945-1994). This explores and questions the establishment and subsequent development of I.T.U.'s (and the part played in this by technology), the Intensive Care concept, and professionalisation within creation of the specialty as reflected in "intensivism", anaesthetics. and intensive care nursing. Brief reference is made to resultant conflicts of professional interests, as well as indicating the variation in take-up of this development between hospitals.
Chapter three focuses on the history of Intensive Care as it developed in the United Oxford Hospitals, comparing this with the more generalised history outlined in the previous chapter, and relating the more specific factors of influence as they appeared to those professionals directly involved. This entails reference to oral histories taken through informal interviews also using a basic questionnaire modified as was deemed appropriate, and to the archives of the United Oxford Hospitals, and of the Nuffield Department of Anaesthetics.
The fourth chapter considers the particular sources upon which chapters two and three have been founded, and uses these to reach some conclusions regarding the influence of technology, firstly in the founding and establishment of I.T.U.'s generally and specifically to Oxford's units' evolution, and secondly to the subsequent development of Intensive Care both in the general and more individual cases. By placing the specific case study within the generalised history of British Intensive Care, this chapter demonstrates the heterogeneous nature of British hospital development, yet establishes several common denominators.
This dissertation concludes by considering the nature of continuous change which characterises this development, and by suggesting how modern medical and nursing history might profit by looking forward in time with the benefit of pat experience. The I.T.U. history described in this study is placed within the wider context of the increasing expectations that are being made of the National Health Service, and the contribution I.T.U. development has made to this. The concept of Intensive Care is perceived as one extremity of a rapidly diversifying spectrum of health-care.
