Twenty years of management of care in Chile: what we know, what we do not know, what is yet to come. An analysis of arguments

Abstract

For over 20 years, the notion of 'management of care' has been foregrounded as key in the jurisdiction of the nursing profession, with the aim of detaching itself from the wider medical umbrella. A number of voices have advocated such centrality. These include juridical, academic and occupational perspectives. Critical stances, although peripheral, have also been voiced. These have been received, at best, with a 'polite silence' in mainstream circles.By looking at the arguments surrounding the 'management of care' circulated in these two decades, this article reports the various forms of discursive practice that participate in the political process of autonomy building. Particularly, we focus on the validity of the arguments as well as the cohesion arguments within the knowledge system. In doing so, we evaluate its main premises and foundations, the reach of the conceptualisation and its disjointed, differing and incomplete bases. Similarly, we used an inferential technique for the reconstruction of omitted and unexpressed assertions.The article introduces an approach of the humanities that is seldom seen in healthcare. It also proposes a research agenda in regard to management of care for the upcoming decades.

The system of nursing in Chile: Insights from a systems theory perspective

“…Further, professional ideologies do not always go hand in hand with academic interests. For this new core role has been received in scholarly circles with some ambivalence—celebrating the upward mobility of the profession and yet paying lip service to scholarship on this area (Ayala, ). Indeed, the only textbook on the subject (Ayala, Torres, & Calvo, ) was not written until seventeen years after the occupational shift was established by law.…”

“…Hence, this caring‐managing dichotomy is possibly one of the biggest ideological challenges that contemporary nursing in the country is facing, largely silenced on the grounds of the status quo agreement. Criticism has recently arisen within academic nursing (Hernández & Caballero, ) but without being given full consideration in the broader community of nurses (Ayala, ). There is no debate on the topic.…”

“…Further, professional ideologies do not always go hand in hand with academic interests. For this new core role has been received in scholarly circles with some ambivalence-celebrating the upward mobility of the profession and yet paying lip service to scholarship on this area (Ayala, 2018).…”

“…Noticeably, however, management of care is not without problems. Although repeatedly claimed and legally mandated as the core of contemporary nursing, recent analyses (Ayala, 2018;Hernández & Caballero, 2014) suggest that this area has some degree of conceptual differentiation from the umbrella caring ethos (Watson, 1999), but still sits on an uncomfortable position within the nursing knowledge (Ayala, 2018 (Guzmán & Bustos, 2015), who are in turn perceived as lacking the academic skills of former generations of nurses.…”

“…Criticism has recently arisen within academic nursing (Hernández & Caballero, 2014) but without being given full consideration in the broader community of nurses (Ayala, 2018). There is no debate on the topic.…”