Routine Dynamics at a Cardiac First-Aid Unit: How Context, Emotions, and Identities Drive the Adaptation of Action Patterns

Emotions are a catalyst for actions. They are therefore important for developing an understanding of organizational routines as generative patterns of interdependent actions. To investigate how the performances and action patterns of routines are impacted by emotion changes brought about by alterations in the context of routine enactment, we conducted an ethnographic inquiry centring on a diagnostic routine at a hospital's cardiac first-aid unit. Our findings show that context changes from off-peak to peak times and vice versa engendered differences in the emotions of doctors and nurses because of, respectively, conformity and non-conformity between their salient identities and their situated experiences. This triggered actions that produced variation in routine performances and action patterns. Drawing on our findings, we present a grounded model that theorizes two complementary emotions and identity-linked mechanisms that explain variety and stability in action patterns. We discuss the theoretical contributions and implications of our model and findings for research on routine dynamics.