Workplace assimilation and professional jurisdiction: How nurses learn to blur the nursing-medical boundary

Abstract

In theorising ‘the system of professions’, Andrew Abbott emphasised how jurisdictional boundaries in the workplace are far fuzzier than those specified in law. A key reason for this fuzziness is the process he characterised as ‘workplace assimilation’, involving on the job learning of a craft version of another profession’s knowledge system. However, despite its centrality, workplace assimilation remains poorly elaborated in the scholarly literature. To address this shortcoming, this study explores the workplace assimilation of nurses in a Norwegian emergency primary care clinic. Using an ethnographic approach, the study shows how nurses learned to blur the nursing-medical boundary by (1) doing physician-like work; (2) interacting with their colleagues; (3) comparing their own clinical assessments to those of physicians (as codified in the patient record) and (4) using medical reference works to guide their clinical decision making. In detailing these aspects of workplace assimilation, the study illuminates how and why workers come to blur jurisdictional boundaries in the workplace.