New arenas, old arguments - science-practice interplay in care work
Tampere School of Public Health University of Tampere Finland,
The epistemic and institutional domain of nursing practice has undergone profound changes in Finland, including the requirement for a scientific knowledge core of professional practice, expressed e.g. in the evidence-based practice agenda. Within nursing, educational and occupational changes have raised the issue of science-practice interplay. Nursing has become more regulated with specified, measured and assessed achievement targets. By the practitioners concerned, these changes are often perceived as more work and additional responsibilities with no corresponding increase in status, salary or client satisfaction. One result of these changes is a form of identity crisis: increased inter- and intra-professional disputes which touch upon the contested boundaries of basic research, applied research and practical development work.
In this paper the science-practice interplay is investigated through the tensions evoked in nursing practice by academization. The aim is to examine the conflicts caused by contested gendered expectations of academization among nurses in different hierarchical positions. The focus is on a public definitional struggle over the characteristics of the "proper nurse", initiated by the minority of the women-dominated profession, male nurses, and the cultural understandings, myths and symbols used concerning the science-practice interplay.
Empirically, the paper discusses a display of resistance against the epistemic authority of nursing science, mobilizing identity work among nurses. Triggered by an experience of prolonged dissatisfaction with existing trade union policies, an Internet discussion forum for health professionals was set up by male nurses in the aftermath of a highly contested income policy agreement in 2003. The paper asks: What kind of boundary-work is used by nurses to (re)gain professional and symbolic authority within nursing practice vis-à-vis nursing science? What kinds of rhetorical strategies are used in reconfiguring the moral orders of nursing?
The paper illuminates the dynamics and tensions among the profession and shows that gaining an academic status is not just an educational phenomenon touching the elite core of the professionals but a multi-dimensional political and cultural phenomenon challenging prevailing disciplinary, organisational and occupational orders, old practices and shared ways of knowing and belonging.