Deprofessionalization in Nursing?

Abstract

The thesis of this study is that the occupation of nursing is undergoing a process of deprofessionalization, not a process of professionalization as most of the major works in the nursing literature would seem to assume. The central purposes underlying this study were to reexamine and expand the concepts "profession" and "professionalization," develop the concept "deprofessionalization," and test the thesis in question. The approach used was that of a comparative social analysis, using current and historical data; the technique employed was that of a scholarly analysis of the literature. Because the concept "deprofessionalization" is a poorly developed one and because the thesis required that the concepts "profession" and “professionalization" be -developed, including an assessment of the impact of bureaucratization upon professionalization,four ..chapters _w￡tre devoted to these areas. Two major definitions of deprofessionalization were evolved: functional deprofessionalization was described as a process of "diseased professionalization," and dysfunctional deprofessionalization as a process of moving from a state of excessive professionalization to a state of functional professionalization. On the basis of the literature on professionalization, a documented case of deprofessionalization in law occurring in the nineteenth century, and upon examination of what would seem to constitute a case of deprofessionalization in diplomacy in the current century, a beginning typology was developed, the chief categories being: (1) direction (dysfunctional, functional), (2) duration (temporary, irreversible), (3! socio-political boundaries (international, continental, national, regional, state, local), (4) intraoccupational boundaries (intended to permit classification of deprofessionalization in "segments" of an occupation, e.g., criminal as opposed to corporate law, the bench as opposed to the bar), and (5) work-setting (underbureaucratized, bureaucratized, over-bureaucratized). Comparisons were made between professionalization in nursing c. 1920 and c. 1960, the former period being chosen because it both coincided with the heyday of solo practice in nursing, a characteristic frequently associated with the process of professionalization, and preceded the bulk of the immigration of nurses into bureaucratized work.-settings, a factor which the literature would suggest might contribute toward deprofessionalization. It was concluded that within the social context of the times, the occupation of nursing c. 1920 exemplified to a greater degree the characteristics of professionalization than is true of nursing today, some of the primary reasons being; (1) the relative integrity of the substantive knowledge-skill component, (2) the existence of a wellintegrated professional culture, (3) the substantial articulation of nursing roles with roles of related health personnel, (4) the relatively high degree of functional autonomy of the nursing practitioner, and (5) advancement in nursing was largely co-terminal with advanced technical expertise in nursing. Relevant categories of deprofessionalization were then applied to nursing c. 1960 and it was concluded that nursing is undergoing a process of dysfunctional deprofessionalization of the national and over-bureaucratization types. Whether it is of a temporary or irreversible nature, only history will reveal.