This paper investigates the changed roles and strategies of professionals in a context of hybrid welfare state reform. This context exposes public professionals to market regulation and rationalization (new public management), and simultaneously expects them to work across professional borders to co-produce public services together with their clients, colleagues and other stakeholders (new public governance). Adopting a comparative perspective, we studied different types of professionals for their views on the implications of this reform mix on their work. Hence, we investigate ‘strategy’ at the macro level of public sector reform and at the micro level of professionals’ responses. The study is based on literature and policy documents, participatory observations and especially (group) interviews with professionals across Dutch hospitals, secondary schools and local agencies for welfare, care or housing. We found that professionals across these sectors, despite their different backgrounds and status, meet highly similar challenges and tensions related to welfare state reform. Moreover, we show that these professionals are not simply passive ‘victims’ of the hybrid context of professionalism, but develop own coping strategies to deal with tensions between different reform principles. The study contributes to understanding new professional roles and coping strategies in welfare state reform, in a context of changing relationships between professions and society.

New standards like checklists are introduced to establish so-called "connective professionalism," but it is difficult to work with checklists in daily circumstances. Professionals might comply with standards, but they might also neglect or resist them. By linking the sociology of professions to routine theory, we develop a relational perspective on working with standards, which is sensitive to the actual usage of standards, not so much "by" but "in-between" professionals. We analysed whether and how checklists are part of daily professional routines. Our ethnographic data show that medical professionals pragmatically cope with checklists. They "tick boxes," but also use standards to improve case treatment, depending on the nature of cases, time pressure, and team composition. Connections between professionals not so much result from standards, but are a prerequisite for using standards. Professionals themselves rather than checklists establish collaboration, but checklists might be important devices for using "connective potential." Keywords: Professional work, surgery, standards, implementation, routines, copingThe past few decades, many scholars have emphasized that routines are crucial for how organizations accomplish their tasks (Cyert & March, 1963; Nelson & Winter, 1982). Routines are "recognizable, repetitive patterns of interdependent action carried out by multiple actors" that structure work and are a basic necessity to carry out complex work in organizations (Feldman, Pentland, D'Adderio, & Lazaric, 2016, p. 505;Feldman & Pentland, 2003;Novak et al., 2012). Routines were mostly associated with stability and inertia (Cyert & March, 1963; Nelson & Winter, 1982) but a more recent perspective in the literature explicitly focuses on routines as a source for coping with complexity and change (e.g., Becker et al., 2005, Feldman & Pentland, 2003Feldman et al., 2016;Parmigiani & Howard-Grenville, 2011).Building on this, studies paid explicit attention to how organizational routines are changed triggered by exogenous events (Nigam, Huising, & Golden, 2016). Fundamental transitions in the context of work, such as new governmental regulations, knowledge and technologies, client demands and budgetary restraint (for an overview see Noordegraaf, 2015;2016) explicitly affect work in professional service domains and urge professionals to adapt their ways of working.More specifically, the complex interplay of service pressures has made professional service delivery more multifaceted, and this calls for multi-professional action (Noordegraaf, 2011;2016 healthcare require cooperation between various professionals. They might come from different (sub)disciplines. Professionals need to find ways to organize collaboration and create new routines that are connective (Noordegraaf, 2016;Noordegraaf, Schneider, van Rensen, & Boselie, 2016;Noordegraaf, van der Steen, & van Twist 2014). Put differently, the "recognizable, repetitive patterns of interdependent action carried out by multiple actors" need to be reconfigu...

The academic contribution to the field is twofold. Firstly, the paper identifies co-creation drivers and barriers from the professionals’ point of view ‒ a largely overlooked perspective in the relevant literature. Secondly, by being placed in the Slovenian administrative context, the paper complements and enriches the debate on co-creation shaped predominantly by the experience of Northern and Western Europe. Purpose: By focusing on the Slovenian public sector, as a traditionally hierarchical administrative context, the paper aims to identify factors that stimulate professionals to implement co-creation in their everyday work, as well as factors that impede their decision and behaviour in this direction. Design/methodology/approach: The paper relies on two Slovenian case studies capturing the experience of professionals from the Ministry of Public Administration and the Municipality of Ljubljana. The key data-gathering methods were qualitative open-ended interviews with ‘lead professionals’ (at managerial positions) and focus groups with professionals who have regular contact with service users/external stakeholders and/or experience with co-creation. Findings: The findings of the paper indicate that professionals implement co-creation even in ‘unfavourable’ hierarchical and centralised settings. A key driver for them to co-create in such a context is strong political support at the highest level. However, a more profound internalisation of co-creation depends on the redefinition of their professional identity, as well as on the (personal or collective/organisational) interest in co-creation. Originality/significance: The paper makes a pioneer step in providing an in-depth look into the drivers and barriers professionals face when implementing co-creation in the Slovenian public sector. As such, it provides valuable input for further comparative analyses of co-creation drivers and barriers faced by professionals across Central and Eastern Europe.

In Western countries, the occupational discipline of nursing is undergoing processes of professionalization. Although professionalization offers an appealing perspective on occupational advancement, it is an ambiguous process, especially in the context of ongoing reforms of advanced liberal states. More specifically, there is a confusing relationship between the professionalization of nursing and the state. This relation is underexamined in theories of nursing professionalization. Instead of seeing the state and professions as two distinct spheres, this article highlights their interconnectedness. It argues that nursing professionalization can be understood as a strategy of advanced liberal governmentality. Through an empirical analysis of the professionalization of Dutch nursing from a Foucauldian perspective, it shows how the appeal to ‘professionalism’ functions as a disciplinary mechanism that produces forms of advanced liberal ‘(bio)power’. This generates academic and practical questions, since nurses—the largest group of healthcare professionals—have distinctive relations with their patients, who regard them as ‘independent’ and ‘caring experts’. Furthermore, it sheds light on the academic debate about the reconfiguration of professionalism by showing how certain ‘professional’ reconfigurations are not only unavoidable but unavoidably (bio)political as well.

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