Thèse de doctorat en Études anglaises
Sous la direction de Monica Charlot.
Soutenue en 1993
à Paris 3 .
This theisis aims to analyse change and continuity in the nursing profession in great britain since its construction at the end of the 19th century. The present period is studied through a case-study of an oxford teaching hospital : three questionnaire surveys and 50 semi-structured interviews of nurses, students and managers were carried out. In 1988, the press reported that nurses were leaving the nhs and demonstrating against the new grading structure. In order to analyse the underlying causes of this phenomenon, several issues were studied : education, professionalisation, nursing hierarchy and the position of nursing within the medical division of labour. In the hospital, most nurses viewed nursing as a profession and were opposed to striking. This position is endorsed by the statutory bodies and the royal college of nursing. However, the professional ideology is continually contradicted in practice. In particular, nurses'work remains dominated by medical work. It is argued that this contradiction leads to dissatisfaction and high turnover rates. An additional contradiction is that the professional ideology promoted by the rcn is targeted at senior nurses rather than at all nurses. Following recent reforms in the nhds (nhs and community gare act, 1990; 1993). The scope of nursing practice is likely to increase more quickly in the community sector than in the acute sector, where a division of labour along
Continuity and change in the nursing profession in great britain : case study of an oxford hospital
Cette these a pour but d'analyser les changements et les permanences de la profession d'infirmiere en grande bretagne depuis sa construction a la fin du siecle dernier. L'epoque presente est etudiee par le biais de trois enquetes par questionnaire et de 50 entretiens semi-directifs aupres d'infirmieres, d'etudiantes et de cadres. En 1988, de nombreuses infirmieres quittaient le service national de sante et manifestaient leur dissatisfaction. Afin d'analyser les causes de ce malaise, la formation, la regulation de la profession, l'organisation du travail infirmier et la position de la profession dans la division du travail medical ont ete etudies. Nous avons trouve que les infirmieres s'identifaient au discours "professionaliste" des organismes officiels bien que ce discours soit constamment dementi par les conditions de travail penibles dans lesquelles elles travaillent et par la position subaterne q'elles continuent d'occuper vis a vis de la profession medicale. Cette contradiction entraine la dissatisfaction de nombreuses infirmieres et des departs de la profession. La politique et le discours des organismes officiels s'adressent a une elite d'infirmieres (les cadres et les infirmieres hautement qualifiees) plutot qu'a l'ensemble. Suite a des reformes gouvernementales dans le secteur de la sante communautaire, le changement rique de s'effectuer plus rapidement dans ce secteur que dans le milieu hospitalier ou des divisions traditionnelles strictes dentre le travail infirmier et le travail medical demeurent.