Boundaries obscured and boundaries reinforced
Incorporation as a Strategy of Occupational Enhancement for Intensive Care
Bibliographic Data
| ID | 2265745 |
|---|---|
| Authors | Simon Carmel (0000-0001-6514-4628, University Hospital Lewisham, corresponding author) |
| Year | 2006 |
| Volume | 28 |
| Issue | 2 |
| Pages | 154-177 |
| Publication date | 2006-03-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Sociology of Health & Illness (JOURNAL) |
| Journal identifiers | ISSN: 0141-9889 • E-ISSN: 1467-9566 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/j.1467-9566.2006.00486.x |
| PMID | 16509951 |
| OpenAlex | W2023772302 |
| Language | EN |
| Citations received | 28 |
| References cited | 42 |
Medical dominance is a recurring theme in sociological analyses of healthcare work. One example of a theoretical framework by which the medical profession is said to dominate other healthcare occupations is Turner's (1995: 138) enumeration of the modes of subordination, limitation and exclusion. As Elston (1991) has noted, however, such frameworks tend to be rather speculative and there is not a great deal of evidence on how these strategies are exercised, for example, at a micro-level. There is also a tendency to portray healthcare occupations as monolithic entities, without acknowledging differences within healthcare occupations, and the relationships between them, which can arise in different clinical locales. Through a micro-level analysis of the practice of intensive care, using ethnographic data collected on three intensive care units (ICUs) in England, this paper proposes a hitherto unidentified strategy -incorporation- for medical dominance at a micro-level. Paradoxically, an enhanced position for both intensive care medicine and intensive care nursing arises, relative to proximal healthcare groups. The argument of this paper is that within the ICU an occupational boundary (doctor-nurse) is obscured, while an organisational boundary which differentiates the ICU from the wider hospital is reinforced. Overall, the power relationship between medicine and nursing in intensive care is not 'zero-sum': the influence of both groups in the wider hospital is increased by this strategy of incorporation
Argument (complex analysis · Dominance (genetics · Health care · Intensive care · Intensive care medicine · Political science · Sociology · Subordination (linguistics · Ethics in medical practice · Healthcare Quality and Management · Law · Management and Organizational Studies · Medicine · Nursing · Psychology · Critical Care Nursing
Vol 10 No 1 (2020)
The Complexities of Boundaries, Task Claims, and Professional Identity in Teamwork
Emerging from the shadow of medicine
The (im)possibilities of clinical democracy
Trust as an analytical concept for the study of welfare programmes to reduce child health disparities
Professional relations in sport healthcare
On the Interplay Between Boundary Work and Organizational Context
Workplace assimilation and professional jurisdiction
Between demarcation and discretion
Integrated care in the emergency department
Performing boundary work
Separating, replacing, intersecting
Accomplishing professional jurisdiction in intensive care
Health care practices, professions and perspectives
Expert nurses and the division of labour in hospitals
There's a lot of tasks that can be done by any
Symbolic power and professional titles
Social access in the workplace
Upsetting the Order of Teamwork
At the Front Stage
Introducing the electronic patient record (EPR) in a hospital setting
Modernisation as a professionalising strategy
Professional legitimacy claims in the multidisciplinary workplace
Re-structuring the negotiated order of the hospital
Who does this patient belong to?' boundary work and the re/making of (NSTEMI) heart attack patients
Risks, dangers and competing clinical decisions on venous thromboembolism prophylaxis in hospital care
Renegotiating inter-professional boundaries in maternity care
Charismatic authority in modern healthcare
Intensive care
Medical power and social knowledge
Social organization of medical work
Ethnography in Organizations
The co-dependency concept
The Doctor-Nurse Game
Profession of medicine
The Discovery of Grounded Theory
Ethnography
Medicine and Nursing
The Performance of Intensive Care Units
Opening Pandora's box
Qualitative Analysis for Social Scientists
Ethical issues and the importance of consensus for the intensive care team
Achieving the Indeterminate
Achieving Rational Management
Participant Observation and Interviewing
Doing Occupational Demarcation
The Technological Regulation of Death
Anaesthetists, the discourse on patient fitness and the organisation of surgery
Discourse, organisation and the surgical ward round
When nurse knows best
The interplay between doctors and nurses-a negotiated order perspective
Controlling the 'bed state
Clinical actions and financial constraints
The Nursing-Medical Boundary
Uncertainty in Medical Prognosis Clinical and Functional
| Unique citing works | 28 |
|---|---|
| Citations per year | 1,4 |
| Citation span | 2006 - 2025 (20) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 28 |