Godin P
City University, St Bartholomew School of Nursing, Whitechapel, London, England.
J Adv Nurs. 1996 May;23(5):925-34. doi: 10.1046/j.1365-2648.1996.10110.x.
In this paper the author argues that the development of community psychiatric nursing can be understood as a professional project. However, the case of community psychiatric nursing cannot be adequately understood from mainstream literature on the subject of professionalization within the health care division of labour. The inadequacy of such literature is that it either concentrates upon the pre-eminent case of medicine or regards nursing's professionalization as being unitary. The author posits that the professional projects of general nursing and community psychiatric nursing have different and even opposing interests. To contextualize community psychiatric nurses' (CPNs') professional project the author examines: the history of mental nursing, from which community psychiatric nursing evolved; the development of community mental health care, which allowed for the inception of community psychiatric nursing; CPNs' relationships with both psychiatrists, whose patronage assisted CPNs' initial growth as para-professionals, and general practitioners, who later assisted a more functionally autonomous role for CPNs in primary care; and social policy towards community care that enhanced CPNs' growth. In conclusion the author argues that recent government-led changes in the management of community mental health care now impel CPNs to change the direction of their strategy for occupational survival and advancement.
在本文中，作者认为社区精神科护理的发展可被理解为一个专业项目。然而，仅从医疗保健分工领域内关于专业化主题的主流文献，无法充分理解社区精神科护理的情况。这类文献的不足之处在于，它要么专注于医学这一卓越范例，要么将护理的专业化视为单一的。作者认定，普通护理和社区精神科护理的专业项目有着不同甚至相悖的利益诉求。为将社区精神科护士（CPNs）的专业项目置于具体情境中，作者审视了：精神科护理的历史，社区精神科护理由此演变而来；社区精神卫生保健的发展，它为社区精神科护理的创立创造了条件；社区精神科护士与精神科医生的关系，精神科医生的支持助力社区精神科护士作为准专业人员初步发展，以及与全科医生的关系，全科医生后来帮助社区精神科护士在初级保健中发挥更具功能自主性的作用；还有促进社区精神科护士发展的社区护理社会政策。总之，作者认为近期政府主导的社区精神卫生保健管理变革，如今促使社区精神科护士改变其职业生存与发展策略的方向。
