Conflicted Health Care
Professionalism and Caring in an Urban Hospital
From 3,200 hours of participant-observation and 500 hours of follow-up interviews with twenty-one doctors, thirty registered nurses, twenty-one respiratory therapists, twenty medical social workers, and eighteen occupational, physical, and speech therapists, the authors create a complex picture of the workplace conflicts that different types of health care practitioners face. Though all these groups espouse caring ideals, professional interests and a curative orientation dominate in patient care and interoccupational relations. Because emotive caring is not supported by the organization of health care in the hospital, it becomes an individual virtue that overworked staff find hard to perform, and it takes on an ideological form that obscures the status hierarchy among practitioners. Conflicts between practitioners rest upon the ranking of each group's knowledge base. They manifest in efforts to work as a team or set limits on practitioner responsibilities and in differing views on unionization.