McKeown M
J Nurs Manag. 1995 Mar;3(2):67-73. doi: 10.1111/j.1365-2834.1995.tb00083.x.
This paper offers a critical discussion of how current and planned changes in the labour process within the National Health Service (NHS), with particular reference to nursing as an occupational group, are likely to influence the industrial relations aspects of nursing management. An attempt is made to apply concepts developed within the wider sociology of work, to the reality of latter day nurses' experience. In this respect, the question will be addressed: do management approaches to the reorganization of work in health care settings constitute, or herald, an actual 'transformation' of nurses' work? The approach adopted places concern over the introduction of productivity or performance related pay, or the implementation of nursing skill-mix reviews within an analytic context which considers issues of control over working practices. As such, management and unions' responses to NHS Executive calls for increasing reorganization of nurses' work and remuneration structures may be illuminated by an understanding of this issue of control. This would entail a departure from simplistic analyses, focused solely upon narrowly defined efficiency concerns.
本文对英国国家医疗服务体系（NHS）内当前及计划中的劳动过程变化进行了批判性讨论，特别提及了作为一个职业群体的护理工作，探讨这些变化可能如何影响护理管理中的劳资关系。本文尝试将更广泛的工作社会学中发展出的概念应用于当代护士的实际工作体验。在这方面，将探讨以下问题：医疗保健机构中工作重组的管理方法是否构成或预示着护士工作的实际“变革”？所采用的方法将对引入与生产率或绩效挂钩的薪酬，或实施护理技能组合评估的关注置于一个分析背景中，该背景考虑了对工作实践的控制问题。因此，通过理解这一控制问题，或许能够阐明管理层和工会对NHS管理层要求进一步重组护士工作及薪酬结构的回应。这意味着要摒弃单纯聚焦于狭义效率问题的简单化分析。
