PEDIATRIC NURSE PRACTITIONERS AND THE CHANGING HEALTH CARE SYSTEM (NURSES).
Contributors: University of Illinois at Chicago.
Published: 1993
Number of pages: 223
Subjects: Sociology, General.; Health Sciences, Nursing.
Description: A significant trend in the American work place has been the shift from professionals working independently or for professional peers to professionals working for organizations. Accompanying this shift is the replacement of the standard interprofessional division of labor with an internal intraorganizational division of labor.

This dissertation will analyze the relationship between work arrangements in pediatric primary care units and the professional autonomy of an occupational group, pediatric nurse practitioners. Work arrangements represent the persisting features of the work setting which directly influence the way participants carry out their work.

I begin by describing the structural context of each of the settings. Four occupational settings were analyzed in detail, all of which provided autonomy in varying degrees. The organization of work in HMOs, neighborhood health centers, university affiliated clinics and a private practice force us to question simpler definitions of professionalism and instead examine the relationship of the occupation and its practitioners to other aspects of the social structure.

Data from in-depth face-to-face interviews with a total of 43 practitioners reveal that structural dimensions of the practitioner's work setting exert an important influence over autonomy. Features such as the pace and content of the work, demand for services, as well the patient appointment systems, and work relationships serve to influence the practitioners' control over professional practice.

Finally, the dissertation suggests that autonomy is not a static construct and advanced practice roles for nurse practitioners and the accompanying freedom and independence are often negotiated for and expand with time and experience. Autonomy for some practitioners is a double edged sword because autonomy, in some cases, may be accompanied by uncertainty and anxiety.
Notes: Source: Dissertation Abstracts International, Volume: 54-04, Section: A, page: 1548.

Thesis (PH.D.)--UNIVERSITY OF ILLINOIS AT CHICAGO, 1993.

School code: 0799.