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Occupational closure in nursing work reconsidered: UK health care support workers and assistant practitioners: A focus group study

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  • Traynor, Michael
  • Nissen, Nina
  • Lincoln, Carol
  • Buus, Niels

Abstract

In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, ‘non-qualified’ workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011 to 13 (6 groups, n = 59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve. Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They ‘usurp’ nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work, while nurses abandon it for largely administrative roles. We conclude that the participants are the not unwilling agents of a managerially led project to reshape the workforce that cuts across existing occupational boundaries.

Suggested Citation

  • Traynor, Michael & Nissen, Nina & Lincoln, Carol & Buus, Niels, 2015. "Occupational closure in nursing work reconsidered: UK health care support workers and assistant practitioners: A focus group study," Social Science & Medicine, Elsevier, vol. 136, pages 81-88.
  • Handle: RePEc:eee:socmed:v:136-137:y:2015:i::p:81-88
    DOI: 10.1016/j.socscimed.2015.05.020
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    Cited by:

    1. Traynor, Michael & Buus, Niels, 2016. "Professional identity in nursing: UK students' explanations for poor standards of care," Social Science & Medicine, Elsevier, vol. 166(C), pages 186-194.
    2. Gerbrand Tholen, 2022. "Within-Occupation Forms of Positional Labour Market Advantage in Three Skilled Occupations," Sociological Research Online, , vol. 27(2), pages 273-291, June.
    3. Ruth Endacott & Margaret O'Connor & Allison Williams & Pamela Wood & Lisa McKenna & Debra Griffiths & Cheryle Moss & Phillip Della & Wendy Cross, 2018. "Roles and functions of enrolled nurses in Australia: Perspectives of enrolled nurses and registered nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(5-6), pages 913-920, March.

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