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Professional boundary work in the face of change to generalist working in community nursing in Scotland.

Gray, Carol, Hogg, Rhona and Kennedy, Catriona (2011) Professional boundary work in the face of change to generalist working in community nursing in Scotland. Journal of Advanced Nursing, 67 (8). pp. 1695-1704. ISSN 0309 2402

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Abstract/Description

Aim. The present study explored how community nurses and managers constituted changes towards generalist working.

Background. Following international trends moving from acute care towards community care, changes within community nursing in the United Kingdom have been subject to debate in recent years. Sociological insights into ‘boundary work’ in professional disciplines are informative for understandings about proposed new roles in community nursing. Recently, radical changes to the role of the community nurse from specialist disciplines to a generalist community health nurse model were proposed in Scotland and tested in four health boards.

Methods. Focus group discussions were held with 27 community nurses and semi-structured interviews with three managers during January–March 2009 in a purposive sample from one health board. Discussions were audio-recorded and transcribed verbatim. Initial thematic analysis was used to highlight key themes from the data and later a discursive analysis focused on the rhetorical strategies used by participants.

Findings. Four key themes were identified along with the rhetorical devices associated with these including: the undermining of the generalist model through the ‘jack of all trades, master of none' metaphor through associations of loss of specialisms; how the re-establishment of specialist discipline boundaries occurred; how current roles were validated and how managers and nurses accounted for future changes to the profession.

Conclusion. The qualitative study explored here has implications for discussions about future role change debates within community nursing as well as the specialist–generalist debate internationally. Managers and policy-makers involved in organizational changes are required to give greater credence to the perceived professional status of community nursing.

Item Type: Article
Print ISSN: 0309 2402
Electronic ISSN: 1365-2648
Uncontrolled Keywords: community nursing; generalist working; primary care; professional boundary work; rhetorical strategies
University Divisions/Research Centres: Faculty of Health, Life & Social Sciences > School of Nursing, Midwifery and Social Care
Dewey Decimal Subjects: 600 Technology > 610 Medicine & health > 610.7 Medical education, research & nursing > 610.73 Nursing
Library of Congress Subjects: R Medicine > RT Nursing
Item ID: 5508
Depositing User: Dr Carol Gray Brunton
Date Deposited: 26 Jun 2012 10:26
Last Modified: 20 Dec 2013 13:18
URI: http://researchrepository.napier.ac.uk/id/eprint/5508

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