Campbell M L
Faculty of Human and Social Development, University of Victoria, British Columbia, Canada.
Int J Health Serv. 1992;22(4):751-65. doi: 10.2190/4BWC-E82R-A998-H55R.
This article draws on a body of research conducted by the author over the past ten years on the social organization of nursing work. It explores questions surrounding nurses' contemporary labor process control and its meaning for nurses' professionalization and proletarianization. Both are dynamic processes, changing as public administration of the Canadian health care system changes and as nurses are successful in winning more complete self-regulation. Nurses are currently being articulated more and more securely to dominant ideas of public sector management through textually mediated technologies. Nurses find new upwardly mobile careers and challenging, responsible, and more respected work. However, as the generation of objective information for professional accountability, cost-accounting, and managerial decision-making becomes unified in computerized patient information systems, producing and using such information becomes a central and determining core of everyday nursing work. It organizes nurses into a "managed" practice of patient care, contradictory for them in many ways. Outstanding among these contradictions is a new professionalized standpoint of cost-efficiency that subordinates nurses' traditional interests and grounding of their work in the standpoint of care.
本文借鉴了作者在过去十年中对护理工作社会组织开展的一系列研究。它探讨了围绕护士当代劳动过程控制及其对护士专业化和无产阶级化的意义的问题。这两者都是动态过程，随着加拿大医疗保健系统公共管理的变化以及护士成功争取到更全面的自我监管而发生变化。目前，通过文本媒介技术，护士与公共部门管理的主导理念联系得越来越紧密。护士找到了新的向上流动的职业以及具有挑战性、责任重大且更受尊重的工作。然而，随着用于专业问责、成本核算和管理决策的客观信息生成在计算机化患者信息系统中趋于统一，生成和使用此类信息成为日常护理工作的核心和决定性要素。它将护士组织成一种“受管理”的患者护理实践，这在很多方面对他们来说是矛盾的。这些矛盾中突出的一点是一种新的成本效益专业化立场，它将护士的传统利益以及他们基于护理立场的工作基础置于次要地位。
