The article offers a novel perspective on the formation of organizational identity (OI) during major organizational change. The empirical context of our studies is the establishment of a new acute care department and the reorganization of care, where nurses and managers struggle to construct and reclaim a legitimate identity within the hospital and simultaneously strive to gain a leading position among acute care departments in the country. We use Bourdieu’s theoretical ideas combined with a focus on narratives as an original and fertile perspective for studying OI. We propose that OI is inherently temporal, embodied and socially configured and cannot be separated from the institutionalized context of its setting because it is interlaced with (in this case) health professional logics. We show how OI is constructed through the strategizing moves of managers and nurses. This includes their narrative constructions of their quest for care progression and a legitimate OI that function as symbolic, emotional and practical glue.

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The integration perspective on culture that has its base in the intellectual tradition of functionalism seems to be institutionalized in the literature on healthcare mergers. In our analysis of a merger between two hospital departments, we approach culture from a different perspective, when we analyse the merger as a cultural practice developing in the intersection between Bourdieusian habitus field and capital. We believe this framework has the potential to bring deeper insights into the complexities of these processes. We show how the metaphors and stories told by the two groups of merging nurses are used as cultural resources in the nurses' battles to establish distinctive group identities and positions in the new setting. Our results demonstrate that the difficulties of the merger can be explained by the field's unsuccessful attempt at re-defining the capital that structures the work place, rather than in the commonplace explanations of cultural clashes or inflexible employee attitudes.

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The paper draws on Bourdieu's conceptualisation of the symbolic order and his little used concept of ethos in order to gain novel understandings of boundary struggles between nursing and medicine as well as internally in nursing. The constituents of boundary struggles are analysed in the context of healthcare transformation, focusing on organisational, institutional and political boundary undertakings. Changing conditions for boundary demarcations and professionalisation include a preference for evidence-based knowledge and practice, seen as a remedy against common problems in health care. The paper shows how nurses use the changes in 'the space of possible professionalisation' in their struggle for professionalisation when they expand their scope of practice and embark on what is conceptualised as a curing ethos, where nursing is understood as a discipline performing practices that lead to cure. However, this is repudiated by the medical profession at all levels. Moreover, curing stands opposed to the caring ethos in nursing and boundary struggles surface as 'ethos confrontation' between caring-and curing-oriented nurses in practice. The boundary struggles analysed in this paper raise important questions about healthcare manageability and the development of sustainable professional environments.