The Politics of Nursing Knowledge

Rafferty, Anne Marie; Hamilton, Diane

doi:10.1891/1062-8061.7.1.214

Cited by 30 publications

(14 citation statements)

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“…This is the basis of their license ' (1984: 375). The fragility of nurses' jurisdictional claims has been well documented (see, for example, Rafferty 1996, Dingwall et al 1988, Davies 1995. Historically, one of the main obstacles to nurses achieving professional status is that most nursing tasks are undertaken by unqualified caregivers: paid auxiliaries and care-assistants or unpaid carers.…”

Section: Participatory Practice and Claims To Professionmentioning

confidence: 99%

Negotiating the role of expert carers on an adult hospital ward

Allen

2000

Sociology Health & Illness

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Contemporary systems of welfare are increasingly underpinned by the assumption that families should care for their dependent adult relatives. Yet, the burgeoning empirical literature in this area has given little attention to the ways in which family caregivers fit into the service system. Drawing on interactionist theories of the division of labour, this paper employs ethnographic data, taken from a recent study, to explore the ways in which formal and informal carers negotiate`care' on an adult medical ward. It is argued that established family carers (referred to as expert carers) constitute a special case in understanding the negotiation of care in the hospital context because of the challenge they pose to fundamental features of the social organisation of the work: nurses' control over caring processes, their claim to expertise and their license to define standards of care.

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Section: Participatory Practice and Claims To Professionmentioning

confidence: 99%

Negotiating the role of expert carers on an adult hospital ward

Allen

2000

Sociology Health & Illness

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“…The indeterminate position, the ‗moralists', argued that medicine was characterised by science and rationality and ‗by contrast, nursing was qualitatively different and ‗good' nursing could not be tested by examination' (Rafferty, 1993: 56;Rathbone, 1892). Generally speaking those promoting the more technical position emerged as influential by the opening decades of the 20 th century (Rafferty, 1996). Thus, a strong emphasis on the indeterminate features of decisionmaking in current professional discourses could be seen as counteracting some of the work done to position nursing within a technical, scientific basis for practice (Dingwall, Rafferty, & Webster, 1988).…”

Section: Introductionmentioning

confidence: 99%

Professional autonomy in 21st century healthcare: Nurses’ accounts of clinical decision-making

Traynor

Boland

Buus

2010

Social Science & Medicine

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Autonomy in decision-making has traditionally been described as a feature of professional work, however the work of healthcare professionals has been seen as steadily encroached upon by State and managerialist forces. Nursing has faced particular problems in establishing itself as a credible profession for reasons including history, gender and a traditional subservience to medicine. This paper reports on a focus group study of UK nurses participating in post-qualifying professional development in a London university in 2008. Three groups of nurses in different specialist areas comprised a total of 26 participants. The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille in 1970. The analysis draws on notions of interpretive repertoires and elements of narrative analysis. We identified two interpretive repertoires: ‗clinical judgement' which was used to describe the different grounds for making judgements; and ‗decision-making' which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille's theory proved useful for interpreting instances where the nurses collectively withdrew from the potential dangers of too extreme claims for technicality or indeterminacy in their work. However, their theory did not explain the full range of accounts of decision-making that were given. Taken at face value, the accounts from the participants depict nurses as sometimes practising in indirect ways in order to have influence in the clinical and bureaucratic setting. However, a focus on language use and in particular, interpretive repertoires, has enabled us to suggest that despite an overall picture of severely limited autonomy, nurses in the groups reproduced stories of the successful accomplishment of moral and influential action.

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“…This is work that builds on seminal texts in nursing history, in particular the political history of nursing within the UK (Rafferty, 1996), and the historically constructed nature of nursing work in the US (Reverby, 1987) . All of this scholarship helps to develop a more critical approach to nursing knowledge and thence practice as these histories remind us that nurses have often been at the forefront of advances in health care, and that they negotiated complex issues such as science, gender and race in order to do so.…”

Section: Practicementioning

confidence: 99%