Bellaby P, Oribabor P
Int J Health Serv. 1980;10(2):291-309. doi: 10.2190/DAP2-YWF4-EW4J-R9MC.
This paper focuses on the position of the nurse in the division of labor in health care and the occupational strategies British hospital nurses have adopted in response to their changing employement situation. The authors suggest a Marxist framework as an alternative to current approaches to the study of occupational strategy, which tend to focus on the level of distribution relations. An adequate analysis of the situation of hospital nurses, the paper suggests, depends upon locating the occupation within the wider setting of the mode of control and delivery of health care. The central feature of this setting is the dominance of medicine and medical technology, and the main factors shaping it are the activities of individual capitalists involved in the health industry and the State operating within the constraints of capital in general and within the context of class struggle. It is suggested that the characteristic feature of nurses' occupational strategy--the vacillation between professionalism and unionism--can best be understood in relation to the changing mode of control and delivery of health care and nurses' contradictory position within the social relations that constitute that mode.
本文聚焦于护士在医疗保健分工中的地位，以及英国医院护士为应对不断变化的就业形势所采取的职业策略。作者提出一个马克思主义框架，作为当前职业策略研究方法的替代方案，当前方法往往侧重于分配关系层面。该论文指出，对医院护士状况进行充分分析，取决于将该职业置于医疗保健控制和提供模式的更广泛背景中。这种背景的核心特征是医学和医疗技术的主导地位，塑造它的主要因素是参与健康产业的个体资本家的活动以及在总体资本约束和阶级斗争背景下运作的国家。有人认为，护士职业策略的特征——在专业主义和工会主义之间摇摆不定——最好从医疗保健控制和提供模式的变化以及护士在构成该模式的社会关系中的矛盾地位来理解。
