This work is a sociological analysis of the physician-nurse relationship in home health care. Data include observation, interview, and survey sources. Results confirm that, largely because of the physician's distance both physically and symbolically, home care nurses take on a more primary care role with patients than do nurses in hospitals. There are fewer instances of conflict between physician and nurse in this setting, as doctors yield more responsibility to nurses than they may in hospitals. In the end, though nurses claim higher levels of autonomy, patients appear to be the true beneficiaries of the in situ shift in nursing responsibility.
Get full access to this article
View all access options for this article.
References
1.
Abbott, A. (1988). The system of professions: An essay on the division of expert labor. Chicago: University of Chicago Press.
2.
Aiken, L. H., & Sloane, D. M. (1997). Effects of specialization and client differentiation on the status of nurses: The case of AIDS. Journal of Health and Social Behavior, 38, 203-222.
3.
Campbell-Heider, M., & Pollack, D. (1987). Barriers to physician-nurse collegiality: An anthropological perspective. Social Science & Medicine, 25(5), 421-425.
4.
Chambliss, D. F. (1996). Beyond caring: Morality and organization in hospital nursing. Chicago: University of Chicago Press.
5.
Fisher, S. (1995). Nursing wounds: Nurse practitioners, doctors, women patients and the negotiation of meaning. New Brunswick, NJ: Rutgers University Press.
6.
Freidson, E. (1970). The profession of medicine. New York: Harper and Row.
7.
Freidson, E. (1986). Professional powers: A study of the institutionalization of formal knowledge. Chicago: University of Chicago Press.
8.
Kanter, R. M. (1977). Men and women of the corporation. New York: Basic Books.
9.
Light, D. (2000). The medical profession and organizational change: From professional dominance to counterveiling power. In C. Bird, P. Conrad, & A. Fremont (Eds.), Handbook of medical sociology (5th ed., pp. 201-216). Upper Saddle River, NJ: Prentice Hall.
10.
Maas, M, & Jacox, A. K. (1977). Guidelines for nurse autonomy/patient welfare. New York: Appleton-Century-Crofts.
11.
Marken, S. (1997). Learning to listen. American Journal of Nursing, 97(4), 16D-16F.
12.
Marrone, C. (1999). Professional and patient responsibilities in home health care nursing. Lewiston, NY: Edwin Mellen Press.
13.
Melosh, B. (1982). The physician's hand: Work, culture, and conflict in American nursing. Philadelphia: Temple University Press.
14.
Morse, J.M. (1991). Negotiating commitment and involvement in the nurse-patient relationship. Journal of Advanced Nursing Research, 16(4), 455-468.
15.
Porter, S. (1992). Women in a women's job: The gendered experience of nurses. Sociology of Health and Illness, 14, 510-527.
16.
Reverby, S. (1987). Ordered to care. New York: Cambridge University Press.
17.
Sperling, R. (1997). Frequently asked questions about OASIS: Answers from a rural agency participant. Home Healthcare Nurse, 15(5), 340-342.
18.
Stein, L. I. (1967). The Doctor-Nurse game. Archives of General Psychiatry, 16, 699-703.
19.
Stein, L. I., Watts, D. T., & Howell, T. (1990). The Doctor-Nurse game revisited. New England Journal of Medicine, 322(8), 546-549.
20.
Williams, C. L. (1989). Gender differences at work: Women and men in nontraditional occupations. Berkley, CA: University of California Press.
21.
Wills, E. M. (1996). Nurse-client alliance: A pattern of home health care caring. Home Healthcare Nurse, 14(6), 455-458.
22.
Zussman, R. (1992). Intensive care: Medical ethics and the medical profession. Chicago: University of Chicago Press.
