Ayala Ricardo, Binfa Lorena, Vanderstraeten Raf, Bracke Piet
Department of Sociology, Ghent University , Ghent , Belgium .
J Interprof Care. 2015 May;29(3):216-22. doi: 10.3109/13561820.2014.956863. Epub 2014 Sep 15.
This article explores issues of historical disputes between nurses and midwives based in Chile. The interaction of these two professions in that country has become an arena of competition which leads to conflicts periodically, such as those related to the ownership of the care of new-borns, and that of projects aimed at relieving nurse shortages by enhancing midwives' nursing skills. Specifically, this article aims to build on historical and contemporary resources analysed from a sociological perspective, and present comparatively a rationale concerning nursing/midwifery jurisdictional conflicts through a social history account. Our analysis suggests that nurses/midwives interaction has been shaped by social-historical transformations and the continuous evolution of the healthcare system as a whole, resulting in a race towards technologisation. These interprofessional conflicts can be explained partly by mechanisms of boundary expansion within an organisational/interpretive domain, as well as varying degrees of medicalisation; and partly by a competition possibly originating from a middle-class consciousness. An eventual merger of the two professions might lead to the enhancement of the political power of the caring professions and integrated care.
本文探讨了智利护士与助产士之间的历史争端问题。这两个职业在该国的互动已成为一个竞争领域,不时引发冲突,比如与新生儿护理的归属权有关的冲突,以及旨在通过提高助产士护理技能来缓解护士短缺问题的项目相关的冲突。具体而言,本文旨在基于从社会学角度分析的历史和当代资源,通过社会历史叙述来比较性地呈现关于护理/助产管辖权冲突的基本原理。我们的分析表明,护士/助产士的互动受到社会历史变革以及整个医疗体系持续演变的影响,从而导致了一场技术化竞赛。这些跨专业冲突部分可由组织/解释领域内的边界扩张机制以及不同程度的医学化来解释;部分则可由可能源于中产阶级意识的竞争来解释。这两个职业最终的合并可能会增强护理职业的政治权力并实现综合护理。