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The organisation of work and the occupational strategies of hospital nurses

Oribabor, P Ehi

Authors

P Ehi Oribabor



Abstract

Hospital nurses occupy a contradictory position in the mode of control and delivery of health care. Their ambiguous posi­tion and the way that this has manifested itself in the occupational strategies adopted by British hospital nurses is the focus of this study. It is largely based on an intensive study of the organisa-tion of work, the attitudes and the work behaviour of strategically selected nurses in one Area Health Authority (West-mid). But it is a central argument that consciousness relates to specific historical situations (both objective and cultural) and must be understood in relation to these. I have sought, therefore, to show that an adequate understanding of nurses' attitudes to work and their occupational strategies depends upon locating the occupation within the changing relations of control and delivery of health care. The historical development of nursing in Britain is traced in order to locate analysis of the present practices in its proper context, and the emergent situ­ation is then analysed. It is shown that the present situation of the nurse, as in the past, is characterised by a paradox: progressive 'deskilling' and 'hierarchical control' versus the potential for 'autonomy' in the health labour process. This ambiguity is likewise reflected in the attitudes of nurses to work and to professionalism and unionism as appropriate forms of occupational strategies. The current pattern of occupational activities by nurses suggests a resurgence of unionism, but this may well be ephemeral, and an under­ standing of the path to the present situation is necessary to make sense of future changes.

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