Negotiating situated roles in a transitional health care system :

Abstract

The central problem is the exploration of ways in which varying occupational positions, subjective perceptions of professional identity, and professional commitment determine attitudes toward work roles and environment, and occupation. Both objective and subjective factors are found to influence attitudes toward work conditions, relationships, nursing as a profession, and health care reform.

Findings support the significance of microscopic analyses of social processes, interactional models, and use of perceptions and interpretations to refine macroscopic approaches in social and cultural anthropology.

In local context, the study is a comparison of the attitudes of individuals and occupational segments within nursing toward their hospital organization and occupation in a health care system undergoing social change. Nurses' attitudes are considered as responses to, and potential influences on trends toward increasing professionalization and bureaucratization of health care personnel and services. Based on a survey conducted in 1978, the attitudes of Registered and Licensed (Enrolled) Nurses in a community hospital in the industrial town of Kwun Tong--the locus of an innovative community health project--are compared and interpreted.

This is a study of the significance of work and professional identity to nurses as members of a professionalizing occupation in the transitional setting of Hong Kong. The analysis draws on interactional and social psychological perspectives in anthropology, the sociology of occupations and professions, and organizational research to complement structural approaches in these fields and in comparative research on health care systems.