The Sociology of the Caring Professions (original) (raw)
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Problematising public and private work spaces: Midwives' work in hospitals and in homes
Midwifery, 2012
as the boundaries between public and private spaces become increasingly fluid, interest is growing in exploring how those spaces are used as work environments, how professionals both construct and convey themselves in those spaces, and how the lines dividing spaces traditionally along public and private lines are blurred. This paper draws on literature from critical geography, organisational studies, and feminist sociology to interpret the work experiences of midwives in Ontario, Canada who provide maternity care both in hospitals and in clients' homes. qualitative design involving in-depth semi-structured interviews content coded thematically. Ontario, Canada. community midwives who practice at home and in hospital. the accounts of practicing midwives illustrate the ways in which hospital and home work spaces are sites of both compromise and resistance. With the intention of making birthing women feel more `at home', midwives describe how they attempt to recreate the woman's home in the hospital. Similarly, midwives also reorient women's homes to a certain degree into a more standardised work space for home birth attendance. Many midwives also described how they like `guests' in both settings. there seems to be a conscious or unconscious convergence of midwifery work spaces to accommodate Ontario midwives' unique model of practice. we link these findings of midwives' place of work on their experiences as workers to professional work experiences in both public and private spaces and offer suggestions for further exploration of the concept of professionals as guests in their places of work.
Continuity of Midwifery Care in England: A New Professional Project?
Gender Work and Organization, 2008
Over the last decade, an increasing amount of research has examined the relationship between gender and professionalization using female professional projects to illustrate how the generic notion of a profession has been a gendered one.This paper develops Witz's (1990) theory of professional strategies in female-dominated occupations particularly regarding midwives in Britain in the twentieth century and suggests that an important dimension that also needs to be critically examined in midwifery history is the interaction of gender and social class within midwifery. Furthermore it documents the traditional emphasis in midwifery on the single woman's career path. This historical analysis has resonance today as midwifery in Britain is undergoing a renaissance. The role of the midwife and the current organization of the maternity services are being reviewed with the intention of providing increased choice and control over the reproductive process for women and increased continuity of care with a midwife. These changes are viewed as midwives' new professional project and the implications for midwives and women discussed.The aim of this paper is to explore the explanatory power of these approaches to current developments in maternity care and by drawing historical parallels, consider the impact that this professionalizing strategy may have for those who are excluded from this process of ‘dual closure’. Furthermore, this paper asks whether this new way of working empowers midwives, women, both or neither?
2019
This thesis examines the occupational discourse(s) of a group of nurses working on a single medical unit in a Scottish NHS hospital, in light of debates concerning the contemporary function and focus of nursing. There are a number of (seemingly conflictual) impulses concerning how the work of nurses might be conceptualized and the study here aims to demonstrate how nurses’ discursive practices seek to negotiate these varying demands and expectations. Principally, the research comments on the relationship between ‘care’ and ‘profession’ which, as the thesis establishes, are mutable concepts whose discursive elaboration can be variously realized. Recent efforts to establish nursing as an independent profession have identified ‘care’ as the theoretical basis of professional knowledge, with the recent move to degree-level study seemingly providing the academic credentials to support this. Some have argued however that a professional, academic outlook is antithetical to authentic caring,...
Midwifery, 2012
Aim: to ascribe meaning to the everyday experiences of midwives during their first year of practice as they interact with their social environment. Design: a qualitative, ethnographic study. Setting: a major maternity department located in the West Country, UK. Participants: seven newly qualified midwives working in the chosen setting. Measurements: as befits an ethnographic approach, observant participation and interviews in the field were the selected data collection tools. Reflexivity was at the hub of the research process. A field diary was kept in order to ensure that the researcher took into account both her own perceptions and the interactions with participants and significant others. This paper draws on data that illustrates some of the predispositions that may constitute the midwifery habitus. Findings: the main themes that emerged from the data were in relation to the culture of midwifery, fitting into the culture and determining what type of midwife the neophytes wanted to be ('what is a midwife?'). To enhance transparency, the latter theme is focused upon in this paper using a model that is a synthesis of some of the findings and Bourdieu's notion of habitus. Key conclusions and implications for practice: this research provides insight into the professional and cultural experiences of newly qualified midwives, especially how cultural interactions, education and expectations may shape the midwifery habitus. It would seem that midwives who take a critical and reflective approach to practice are key players in the cultural recreation of midwifery. Accordingly, to enable the aforementioned approach to practice, it is important that reflective and reflexive practices are an integral part of midwifery education. Nevertheless, the implications for practice are not merely one-dimensional. Observations in the field suggest the importance of making the quality of midwives' working lives a priority by facilitating a more supportive working environment. Moreover, midwives should not be marginalised for preferring to work in the community, the birth centre or the high-risk environment. Future planning of the maternity services needs to consider how a 'being with the woman' approach can be facilitated for all women, balancing the virtues of both the medical and midwifery models of care. & 2011 Elsevier Ltd. All rights reserved. also required a detailed exploration of the literature related to the nature of midwifery and its cultural framework. Transition literature The literature suggests three phases of transition: the rite of separation, social limbo (neither one thing nor another) and the rite of incorporation (Glaser and Strauss, 1971; Turner, 1982). In relation to the first phase, Godinez et al. (1999) discovered that real nursing work was quite different from what nurses had been schooled for, and identified this phenomenon as 'reality shock'. Kramer (1974) first used this term to make the point that many ideals and values espoused during nurses' professional education are not operational and go unrewarded in the work setting. More recently, in a survey sent to a group of newly graduated certified Contents lists available at ScienceDirect
The professional socialisation of midwives: Balancing art and science
Sociology of Health & Illness, 1989
Mastery of esoteric knowledge is one of the central features assigned by sociologists to fully professionalised service occupations, together with an orientation towards public service. There are, nevertheless, different views about the best way in which this education and socialisation can be provided for new recruits for practitioner roles. Some maintain that the university provides an ideal training ground. Critics of this view, however, call for a rejection of 'university diploma mills' and a retum to the type of apprenticeship socialisation common during the premodern era. This paper tests the usefulness of these perspectives in understanding the occupational socialisation of Newfoundland and Labrador midwives. Three major styles of training -traditional apprenticeship, vocational schooling and university education -can be discerned. In comparison to both apprenticeship and academic styles of occupational socialisation, only vocational training nicely blended the art and science of midwifery to produce competent and committed professionals.
Researching Gender Professions: Nurses as Professionals
Journal of Curriculum and Teaching, 2018
Nurses as professionals of health, childhood education teachers, social workers and caregivers, join a group of "feminine professions" which grew through policies of a welfare state in postwar constructive period, or in times of postwar accords (Jones, 1983). These professions are under challenge because of neoliberal policies and practices in the 21st century. In the paper, we want to give lights to the contradictory situations nurses face, as workers and as care keepers. Nurses, suffer of a combination of public and private functions, at work, at home, and when caring family relatives. The way women feel about their role as professionals, and as women and workers, is illuminative, as we enquired in a funded research developed with nurses in the community of Navarra, Spain, first from 1993 to 1996, and next, checking a continuity each ten years, 2006 and next 2016.
The culture of midwifery in the National Health Service in England
Journal of Advanced Nursing, 1999
The culture of midwifery in the National Health Service was examined in order to foster understanding of the context of midwifery practice. In-depth interviews were conducted with midwives in ®ve, very different, sites across England. The culture which emerged was one of service and sacri®ce where midwives lacked the rights as women which they were required to offer to their clients. There was a lack of mutual support and of positive role models of support with considerable pressure to conform. Guilt and self-blame were common as was learned helplessness and muting. The dilemmas of this culture are considered and the resistance which it offered to change in relationships. Change was either resisted, brought about by stealth or strategically planned to equip midwives to change their culture.
Administration
This paper argues that professional regulatory frameworks are shaped by sociocultural factors and prevailing ideologies that stem from society’s interactions with and expectations of the regulated professions. Taking a century of Irish nursing and midwifery regulation as a case reflection, the paper highlights five regulatory pivot points to provide a historical narrative of how adopting a sociocultural perspective can enlighten our understanding of the current regulatory form. A form that in early twenty-first-century Ireland resulted in the establishment of a professionally contentious, non-professional (lay) majority on the regulatory board for these frontline professions. The paper concludes by suggesting that when viewed through a sociocultural lens, regulatory change is to be expected. As prevailing ideologies change, power, influence and cultures alter to support and reinforce the new ideology. Professional regulation thereby becomes reflective of society’s views on professio...
Abstract Globalisation, ‘reflexive modernisation’, a growing awareness, real or otherwise, of contextual risk (Giddens 1990; Beck 1992; Dent and Whitehead 2002) and recruitment crises in some professions have prompted neo-liberal post-welfare states (Australia, Canada and the UK) to apply new mechanisms of corporate governance to the public sector. As positivist knowledge (knowledge as a ‘given’) comes under challenge so the boundaries of the professions are revealed as contested spheres of practice – cultural artefacts produced by a ‘labour of division’ (Fournier 2000). Marketisation, managerialism and consumerism are discourses that have heralded new interdisciplinary collaborative practices. The paper reports on the responses of professional workers within one Australian maternity unit to the challenges of collaborative care. Boundaries are simultaneously blurred and renegotiated around (1) conflicting interpretations of ‘risk’ 2) veto power of decision-making; (3)‘emotion management’ (Bolton 2002; Hoschchild 1983); (4) professional accountability and (5) relationships with consumers. Revaluing midwifery ‘emotion work’ has the potential to realise professional equivalence although formidable cultural barriers remain in situ.
Discursive constructions of student midwives' professional identities: A discourse analysis
Nurse Education in Practice, 2024
Background: The construction and performance of professional identity is significant to broader socio-cultural understandings of who 'professionals' are and what they do. Importantly, it is also implicated in the development and enactment of policy, regulation, education, and professional practice. Professional identity is linked to self-esteem, self-efficacy, professional value, confidence and success. The salience of this in relation to midwifery practice is highly significant; aspects of autonomy, confidence, competence, responsibility, and accountability are all implicated in the provision of safe and effective care. Aim: To explore how student midwives are constructed in the discourses of policy, professionalism, and learning, to provide new perspectives to inform, policy, education, and practice. Methods: An adapted critical discourse analysis of the United Kingdom (UK) Nursing and Midwifery Council's 2009 Standards for pre-registration midwifery education, using a three-step process: exploring discourse at the level of (1) discursive practice (2) linguistic features of the text, and (3) social practice. Findings/ Discussion: The discourses that relate to midwifery education and practice emerge within socio-political and historical contexts. Constructions of identity are articulated through a rule-bound framework which includes competence, confidence and 'good health and good character'. There is a requirement for midwives to 'be' responsible, accountable, autonomous, professional, competent, and confident. Regulatory power is reinforced through medico-legal discourses, with the status of midwifery discursively presented as inferior to medicine. Conclusion: According to the Standards, midwives must be a lot of things in their role and function. The Standards' discourses are authoritative, legislative and controlling, creating an ideology about professional status and agency which constructs an 'imaginary autonomy'; becoming a midwife is more automatic (with the perception of control), than agentic. All of which has significance for the social practice of midwifery.