ABSTRACT
This chapter aims to highlight the individual, collective and systemic competences that are used to enhance the resilience in acting within a complex work environment like a critical care unit such as the neonatal intensive care unit (NICU). The NICU constitutes a domain where the challenges and opportunities of new medical knowledge and technology converge. Life in the NICU is characterized by continuous struggle and entirely unpredictable changes that result in erratic flows of action. The chapter considers the risks implicated in the treatment's transitional moments and explores the organizational level of work itself. It focuses on the effects that the distribution of knowledge and experience over time and place has on reliability of staff's performance. A focus on the complexities of human decision-making in the face of uncertainty allows people to identify the 'hidden competences' that are required to ensure the continuity of medical intervention in the NICU despite high degrees of diagnostic and prognostic uncertainty and unpredictable events.
