PROFESSIONALIZATION AT WORK: THE CASE OF NURSING AT MILL CITY MEDICAL CENTER.
Contributors: Brandeis University.
Published: 1993
Number of pages: 177
Subjects: Sociology, Industrial and Labor Relations.; Women's Studies.; Sociology, Theory and Methods.
Description: Over the past twenty years, the development of professional practice models in hospital nursing has emerged as a major professionalizing trend. This case study examines how the changing political economy of a hospital supported the innovations associated with professional nursing practice models, and how nurses experienced the changing structures, relationships, and culture of their work organization.

A case study approach was selected to provide a community and historical context for change. Data was collected over a two year period using participant observation, interviews, and archival materials. The case hospital, located in a small city in the Northeastern United States, was selected using such criteria for the analysis of professional models as a case management approach to care, a decentralized management system, and a career ladder system.

Analysis of the multiple data sources demonstrated the importance of the changing political-economic realities of health care regulation, reimbursement, hospital competition, and labor force availability as catalysts for innovation. The organizational climate of the hospital placed a high value on innovation and education that further supported the professional ideology as a framework for change. The nurses reported that the shift to a professional model was stressful due to changes in both their work structure and relationships. The shift in work culture from a common background and social support system to a culture of professionalism emerged as a central theme. Nurses cited increased intensification, isolation in their work, and a breakdown of mutual help systems. A related trend was increased competition between nurses and a decline in work group cohesion. Additional trends were the increased tension between nurses and physicians and the increased alienation of nurses and physicians from the hospital administration.

This study demonstrates how organizational culture and history shape innovations which lead to professional practice models and how changes in organization and work structure have major effects on work group relationships.
Notes: Source: Dissertation Abstracts International, Volume: 54-04, Section: A, page: 1559.

Thesis (PH.D.)--BRANDEIS UNIVERSITY, 1993.

School code: 0021.