The struggle to professionalize: An ethnographic account of the occupational position of Advanced Nurse Practitioners

Abstract

This article considers what happens when subordinate occupations challenge established roles and hierarchically organized professional divisions. Charting the struggles of a group of Advanced Nurse Practitioners to be recognized as a profession, the article considers the ways in which claims to licence, place and mandate are employed to negotiate new occupational spaces. Such spaces are shown to emerge as a consequence of the interplay of individual demands and favourable supply side conditions, the latter being required to support the development of new models of working in marginal positions. In a departure from accounts that place managerialism and entrepreneurialism in opposition to professionalism, the article shows how the executive authority that comes with entrepreneurial ownership can bolster professionalizing claims, disrupting and reversing hierarchically organized professional divisions. Identified as a context specific form of ordinal switching, the article considers whether such reversals herald a long-term shift in dominant—subordinate professional relations.