Antrobus S
RCN Institute, London, England.
J Adv Nurs. 1997 Mar;25(3):447-53. doi: 10.1046/j.1365-2648.1997.1997025447.x.
This paper intends to analyse the effects of recent health policy changes in the United Kingdom upon nursing, examining some of the anomalies raised by the rhetoric of the politics and the actualities of the change process and exploring and analysing nursings' presence within that change process. Specific reference will be paid to the philosophy and ideology of the reforms and comparisons made with some of the original factors underpinning the purpose and functioning of the British National Health Service and professional groups within it. In particular, this paper considers the functioning of nursing as an holistic, intuitive, humanistic, and caring act within the context of the scientific, rational, performance and outcomes-orientated new public management ideology presently sweeping the health service. The resultant tensions this apparent dichotomy is causing nursing will be tentatively explored. Lastly, an agenda for change will be proposed which will identify ways in which nursing can respond and, more importantly, be proactive within the contextual changes highlighted.
本文旨在分析英国近期卫生政策变化对护理工作的影响,审视政治言论与变革过程实际情况所引发的一些反常现象,并探究和分析护理行业在这一变革过程中的表现。将特别提及改革的理念和意识形态,并与支撑英国国民医疗服务体系及其内部专业群体宗旨和运作的一些初始因素进行比较。尤其是,本文探讨了在当前席卷医疗服务领域的科学、理性、注重绩效和结果导向的新公共管理意识形态背景下,护理工作作为一种整体、直观、人文且关怀性的行为的运作情况。将初步探讨这种明显二分法给护理工作带来的紧张关系。最后,将提出一个变革议程,确定护理行业能够做出回应的方式,更重要的是,在突出的背景变化中积极主动地采取行动。