The business of caring : practice nurses in primary health care
Degree GrantorUniversity of Canterbury
Degree NameMaster of Arts
The professional strategies, relational positioning and day-to-day work of practice nurses form the focus of this thesis. It utilises and extends the ways Anne Witz (1994) and Andrew Abbott (1981, 1988) have theorized about nursing, and the construction of professions and professional boundaries. While their salaries are largely subsidized by the regional health authorities, practice nurses are employed by general practitioners. In this context they use a variety of discursive strategies to construct themselves as "collegial practitioners". Drawing on a survey of practice nurses in Canterbury, fieldwork in general practices and indepth interviews with practice nurses, this study challenges any simplistic view of practice nurses as "subordinate" health care workers. It indicates the ways in which practice nurses are actively negotiating their relationships with general practitioners against a background of increasing commitment by regional health authorities to health promotion, and the general restructuring of primary health care delivery. The thesis also addresses the importance of the "caring" work done by practice nurses within the individual businesses of general practice. It analyses the professionalisation of their competence in caring "for" and caring “about". The gendered features of the ways in which practice nurses balance the demands of general practitioners and patients/clients is also a crucial component of this study.