thesis

Professionalisation in nursing : the Swiss case

Abstract

In this study, the professionalisation of nursing in Switzerland is being investigated with the help of the theoretical approaches of the sociology of professions. These approaches - demand approach and supply approach - represent two opposing lines of argumentation. In the demand approach, the status of being a profession (monopolised autonomy by state licence, social standing) is ascribed to successful political strategies of the professional group. In the supply approach, the professions are seen as institutions which can only be explained in their relationship to the state. Thus, in one line of thought, the constitution of the professions is viewed as a process parallel to the modernisation of the state. Another line of thought understands the professions also as bearers of uncertainty of both individuals and collectives. In the course of global neo-liberal politics, the ethic aspect of this approach has been condensed into the soul of the professions - as an antagonist to the soullessness of state and market. Since the 1950s, leading nurses in teaching and practice in Switzerland have been active to create a new position for professional nursing. Their main concern is to develop autonomous, specific concepts in addition to the traditionally dominant concepts of medicine. As a result, a professional project evolved which aims to gain a state monopoly for professional nursing. The study shows that the demand approach can only explain single aspects and short historic phases in the development of the profession. In each development phase, state and market have created the prevailing conditions of nursing like, so to speak, a mould. This becomes manifest in each phase depending on the federal structures of the state. This corresponds to the supply approach of the sociology of the professions. Nursing has not reached the goal of state licensure. However, if the profession thanks to its professional soul independently stands up for its patients, it fulfils the role typical of professions in this theoretic approach. This soul was present in the nursing profession from its very beginning

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