The poverty of professionalization: a critical analysis of strategies for the occupational advancement of nursing

Abstract

The purpose of this paper is to evaluate critically the strategies of occupational advancement used by nurses. It is noted that these are frequently framed within the paradigm of professionalization. However, despite the ubiquity of its use, it is argued that this model is inappropriate. Specific strategies are examined. Attempts to appropriate the title of profession by demonstrating that nursing possesses the relevant attributes are dismissed as rhetorical exercises. The rise of managerialism, despite being cloaked in the guise of professionalism, is seen as anti-professional because it restricts the autonomy of individual practitioners. Clinical 'professionalization' is also regarded as problematic because it does not fit with the definition of a professional as an autonomous practitioner. Examination of patient advocacy, and of attempts to validate nursing diagnosis, demonstrate that the occupational advancement of clinical nurses is increasingly dependent upon the co-operation of health care consumers. This dependence is incompatible with the prescriptive powers and exclusive knowledge that are claimed by traditional professions. It is concluded that nurses should abandon the ideology of professionalization and concentrate on the more pertinent issue of maximizing the efficacy of the occupation.