Shifting boundaries and negotiations on knowledge: interprofessional conflicts between nurses and nursing assistants in Norway

In: The international journal of sociology and social policy, Band 23, Heft 4/5, S. 139-158

Abstract

This chapter deals with a long and intense conflict between nurses and nursing assistants within the context of the Norwegian health care system. Caring work is culturally coded as female. A major issue embedded in the conflict concerns the definition of knowledge. The issue, it is argued, is not so much what constitutes knowledge, but what counts as professional expertise and theoretical knowledge when it comes to women's work, which is devalued. As a middle‐class women's occupation, nurses have strong aspirations that their work be acknowledged as a full profession. Their knowledge base is a combination of practical and theoretical knowledge, profoundly different from medicine they themselves argue. Such a "professionalisation" of care work is, however, threatened by the mere presence of nursing assistants and the overlapping work they do. For various reasons – not least strategic – the concept of basic care was introduced more than ten years ago. The term was rather vaguely defined, but seems to comprise all personal care for the patient and the patient's body, including intimate tasks such as washing, dealing with bodily waste products, feeding, etc. Making basic care the exclusive preserve of nurses and delegating the more "housewifely" tasks to nursing assistants effectively excludes the latter from caring work and, not surprisingly, they strongly oppose existing working boundaries and the redistribution of tasks. We investigate the power relationship between the two occupational groups and examine dual closure strategies. Interestingly, nurses have invested in a precarious strategy by reclaiming the hands‐on bodywork that is often labelled "dirty work". In Western societies these tasks are commonly left to working‐class women. The conflict is thus about both gender and class in an androgynous professional world. The aim is to explore the occupational conflict and to trace some of its implications for theorising professions. Professional tasks, knowledge claims, and the concept of dirty work are addressed, and professional projects and strategies discussed from a gender perspective.