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工作场所同化与专业管辖权:护士如何学会模糊护理-医疗界限。

Workplace assimilation and professional jurisdiction: How nurses learn to blur the nursing-medical boundary.

机构信息

Centre for the Study of Professions, OsloMet - Oslo Metropolitan University, Pb. 4, St. Olavs plass, 0130 Oslo, Norway.

出版信息

Soc Sci Med. 2018 Mar;201:51-58. doi: 10.1016/j.socscimed.2018.02.004. Epub 2018 Feb 7.

Abstract

In theorising 'the system of professions', Andrew Abbott emphasised how jurisdictional boundaries in the workplace are far fuzzier than those specified in law. A key reason for this fuzziness is the process he characterised as 'workplace assimilation', involving on the job learning of a craft version of another profession's knowledge system. However, despite its centrality, workplace assimilation remains poorly elaborated in the scholarly literature. To address this shortcoming, this study explores the workplace assimilation of nurses in a Norwegian emergency primary care clinic. Using an ethnographic approach, the study shows how nurses learned to blur the nursing-medical boundary by (1) doing physician-like work; (2) interacting with their colleagues; (3) comparing their own clinical assessments to those of physicians (as codified in the patient record) and (4) using medical reference works to guide their clinical decision making. In detailing these aspects of workplace assimilation, the study illuminates how and why workers come to blur jurisdictional boundaries in the workplace.

摘要

在理论化“职业体系”时,安德鲁·艾博特强调了工作场所的管辖边界远不如法律规定的那么明确。这种模糊性的一个主要原因是他所描述的“工作场所同化”过程,即在职学习另一个职业知识体系的工艺版本。然而,尽管这一过程至关重要,但它在学术文献中仍未得到充分阐述。为了解决这一不足,本研究探讨了挪威一家紧急初级保健诊所中护士的工作场所同化。本研究采用民族志方法,展示了护士如何通过以下方式学会模糊护理与医学之间的界限:(1)从事类似医生的工作;(2)与同事互动;(3)将自己的临床评估与医生的评估(如病历中的记录)进行比较;(4)使用医学参考资料指导临床决策。通过详细说明这些工作场所同化的方面,本研究阐明了工人如何以及为什么会在工作场所模糊管辖边界。

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