Coburn D
Department of Behavioural Science, University of Toronto, Canada.
Int J Health Serv. 1988;18(3):437-56. doi: 10.2190/1BDV-P7FN-9NWF-VKVR.
In this article, the development of nursing in Canada is described in terms of three major time periods: the emergence of lay nursing, including organization and registration, 1870-1930; the move to the hospital, 1930-1950; and unionization and the routinization of health care, 1950 to the present. This development is viewed in the light of the orienting concepts of professionalization, proletarianization, and medical dominance (and gender analysis). This historical trajectory of nursing shows an increasing occupational autonomy but continuing struggles over control of the labor process. Nursing is now using theory, organizational changes in health care, and credentialism to help make nursing "separate from but equal to" medicine and to gain control over the day-to-day work of the nurse. Nursing can thus be viewed as undergoing processes of both professionalization and proletarianization. As nursing seeks to control the labor process, its occupational conflicts are joined to the class struggle of white-collar workers in general. Analysis of nursing indicates the problems involved in sorting out the meaning of concepts that are relevant to occupational or class analysis but which focus on the same empirical phenomenon.
1870年至1930年非专业护理的出现，包括组织与注册；1930年至1950年向医院护理的转变；1950年至今的工会化及医疗保健的常规化。这一发展是从专业化、无产阶级化和医学主导地位（以及性别分析）等导向性概念的角度来审视的。护理行业的这一历史轨迹显示出职业自主性不断增强，但在劳动过程控制方面仍持续存在斗争。如今，护理行业正在运用理论、医疗保健领域的组织变革以及资格认定制度，以使护理行业“独立于医学但与医学地位平等”，并实现对护士日常工作的掌控。因此，护理行业可被视为正经历专业化和无产阶级化的过程。随着护理行业试图控制劳动过程，其职业冲突也与一般白领工人的阶级斗争联系在一起。对护理行业的分析表明，在梳理与职业或阶级分析相关但聚焦于同一实证现象的概念含义时会遇到一些问题。
