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eight - Educating generalists: flexibility and identity in auxiliary nursing in Finland

Published online by Cambridge University Press:  19 January 2022

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Summary

Introduction

The discourse of professionalism, consisting of a set of normative values and identities, is currently spreading to new occupational and organisational contexts (Evetts, 2003). It is a mechanism for the control of work and workers, mobilised by employers as a form of self-discipline for employees (Fournier, 1999). The discourse of professionalism is employed in organisations as an ideology of occupational powers to divide work within and between occupations (Fournier, 2000). This chapter examines the dynamics of this discourse in the context of changes in the welfare state, taking both its disciplinary and enabling aspects into account. The constitution of a normative professional identity is considered a collective achievement that builds on the internal and external claims made. In turn, the normative professional identity that the discourse of professionalism offers as a point of reference plays a vital role in the way individual professionals make sense of their workplace reality. The analysis thus links the shaping of micro-level experiences to macro-level actions.

The flexibilisation of Finnish auxiliary nursing started with the educational reform that was introduced in the early 1990s. It included the training of healthcare assistants, social service assistants, paramedics, childcare workers and similar occupations. The central aim in combining a health and social care orientation in one occupation was to make it more flexible from the point of view of service management. As a result, the paths leading to the new degree and the actual skills acquired through education vary greatly. The creation of the new practical nurse as an official occupational category is an example of public policy support for organisational professionalism. This chapter examines how the discourse of flexibility is reflected in the professional identities of workers in this new occupational class.

So-called ‘support workers’ in professional services are of central theoretical interest for the study of the dynamics of professional fields (see also Saks, this volume). In the traditional taxonomic approach to the study of professions, auxiliary nursing, when recognised at all, is conceptualised as a ‘non-profession’ and demoted by the terminology ‘auxiliaries’ or ‘support workers’. Such confining terminology carries organisational discourse about divisions of labour in healthcare.

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Rethinking Professional Governance
International Directions in Health Care
, pp. 127 - 140
Publisher: Bristol University Press
Print publication year: 2008

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