The governmentality of nursing professionalization in advanced liberal societies

Abstract

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.

Job crafting as retention strategy: An ethnographic account of the challenges faced in crafting new nursing roles in care practice

“…In the Netherlands, attempts to develop distinct nursing roles go back 50 years 5 . Nurse differentiation was a driving force behind the establishment of vocational and bachelor‐level training programmes in the 1970s, and prompted the development of occupational nursing profiles in the 1990s 40 Yet despite having distinct nursing profiles and training programmes, all Dutch nurses continued to do similar work and received similar wages, and their engagement in healthcare decision‐making remained weak and/or unrecognised. As such, much of the knowledge and skills acquired by bachelor‐trained nurses was pushed to the background in everyday nursing practice 5 .…”

Expert Authority in Crisis: Making Authority Real Through Struggle

“…Consequently, the expert becomes a framer of policies and programs, as well as constructing the knowledge systems and organizational technologies whereby they can be rolled out by a streamlined, but more strategic, neoliberal state apparatus through which free-market principles become saturated across a potentially limitless range of organizational settings (Springer, 2016). For example, Hoff and Kuiper (2021) demonstrate how a professionalization project of nursing in the Netherlands involves, "a reconceptualization of nursing expertise as a set of technical and decontextualized managerial competencies aimed at rationalizing the management of health" (p. 44), and thus transfers the responsibility of health management from the state to the individual.…”