ABSTRACT
This chapter forms part of an empirical research of nurses’ experience of professional work.1 The focus of the research is on nurses’ experience of contemporary forms of ‘professionalism’ in the context of the organisational turbulence affecting the NHS during the past two decades. The chapter discusses the key substantive and theoretical themes, which have informed data collection and analysis. We begin with an overview of key political and economic changes affecting public sector ‘professionalism’, with particular emphasis on nursing. The argument here is that broader economic changes have imparted a business ethos within the public sector that effectively draws professionalism under the influence of public sector managerialism in the attempt to maintain its own status and authority. The consequences for the nursing profession are then assessed. It is argued that modern developments in nursing professionalism are increasingly used as a means for processing the moral management of nursing labour power, in ways that strengthen the political/economic management, which nurses experience through the traditional medium of the management function. In support of this argument, the chapter considers ways in which the moral management of nursing is underpinned by a particular definition of nursing ethics that becomes inscribed in professional codes of conduct and competencies produced by the United Kingdom Council for Nursing, Midwifery and Health Visiting (UKCC). The chapter then assesses the contribution that discourse and critical realist approaches make in providing a broader understanding of issues of control and resistance. It is demonstrated that discourse, in over-emphasising control and docility, closes off an understanding of avenues of resistance, whilst critical realism extends an understanding of the ways in which control and resistance are internally related processes in the management of nursing labour power.
