Recent research has focused on how gender and computer technology contribute to the structuring of professional roles. A case study was carried out at a long-term care facility in Winnipeg, Canada, in which a nursing unit-based automated system had been installed to control the distribution of medication to patients. A questionnaire was distributed to all nursing staff, and detailed interviews were carried out with pharmacists and nursing administrators. It was found that gender and technological change did interact to produce an (...) ambivalent impact on professional practice and identities. New clinical pharmacy positions were established; however, the pharmacy was split into clinical and deskilled data entry positions. Nurses hoped the new system would improve medication accuracy, but they resented features that controlled their time and their autonomy. Neither group accepted the new system as a boundary object effectively linking the nursing and pharmacy departments, and it eventually was returned to the manufacturer. (shrink)

An examination of the salient literature on hospital clinical directorates (CDs) is presented. A critique of the largely managerialist, instrumental, hortatory and normative extant literature about CDs is offered. In analysing the literature this way the earlier promotional and critical literature is eschewed in favour of an evaluative approach. CDs are then reconceptualised by locating them within two overarching accounts of social structure—formalised, prescribed frameworks, and enacted, patterned interactions—following the kinds of distinctions made by Giddens, Weick, social action and institutional (...) theorists. Social structure as it relates to culture is also considered, following Martin. Such an approach facilitates an understanding of the general weaknesses of health service perspectives and methods of analysis, and exposes the strengths of Giddens–Weick type paradigms. (shrink)