Boundaries obscured and boundaries reinforced: incorporation as a strategy of occupational enhancement for intensive care

Sociology of Health & Illness
Simon Carmel

Abstract

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 organisati...Continue Reading

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Citations

Jan 14, 2010·Physiotherapy Theory and Practice·Di Thomson
Dec 25, 2010·Social Science & Medicine·Dominic Malcolm, Andrea Scott
Feb 23, 2008·Sociology of Health & Illness·Tom Sanders, Stephen Harrison
Jan 3, 2013·Sociology of Health & Illness·Dawn Bacon, Alan M Borthwick
Dec 13, 2012·Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association·W Stanley, A M Borthwick
Feb 15, 2011·Sociology of Health & Illness·Judith GreenNick Black
Mar 21, 2012·Community Dentistry and Oral Epidemiology·Cecilia Franzén
Mar 19, 2014·Sociology of Health & Illness·Olga BoikoChristian A Gericke
Mar 19, 2014·International Journal of Nursing Studies·Elizabeth WestColin Sanderson
Oct 16, 2010·Social Science & Medicine·Peter NugusJeffrey Braithwaite
Jun 23, 2011·Health·Simon Carmel, Denise Baker-McClearn
Jun 30, 2018·Sociology of Health & Illness·Helen CramerKatie Featherstone
Feb 3, 2019·Sociology of Health & Illness·Peter Nugus

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