Professions and Professionalism https://journals.hioa.no/index.php/pp <p><em>Professions and Professionalism</em> (P&amp;P) is an open-access journal that invites research-based empirical, theoretical or synoptic articles focusing on traditional professions as well as other knowledge based occupational groups approached from any perspective or discipline.</p> Oslo and Akershus University College of Applied Sciences en-US Professions and Professionalism 1893-1049 Authors who publish with this journal agree to the following terms:<br /><br /><ol type="a"><ol type="a"><li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="http://creativecommons.org/licenses/by/4.0/" target="_new">Creative Commons Attribution 4.0 License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li></ol></ol><br /><ol type="a"><ol type="a"><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li></ol></ol><br /><ol type="a"><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a title="The Effect of Open Access" href="http://opcit.eprints.org/oacitation-biblio.html">The Effect of Open Access</a>).</li></ol> Organizational Professionalism: Social Workers Negotiating Tools of NPM https://journals.hioa.no/index.php/pp/article/view/2381 <p>This article examines how social workers and managers perceive meaningful work and expertise in six care and treatment facilities in Denmark. Based on 29 interviews with social workers (n=22) and managers (n=7), the article shows how New Public Management-inspired tools such as scoring schemas align with social work values such as “client-centeredness” and working with the individual welfare recipient face-to-face. The article finds that fitting social work into organizational schemas changes the work practices of social workers and also the way members of this profession define meaningful work and expertise. In addition, the article also finds that scoring schemas cause conflicts among social workers regarding the character of expertise when values of social work (to meet a welfare recipient’s need) must be aligned with NPM-inspired values of organizations (to meet managers’ demand for documentation).</p> Nanna Mik-Meyer ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-05-14 2018-05-14 8 1 10.7577/pp.2381 Medi(c)ation Work in the Emergency Department: Making Standardized Practice Work https://journals.hioa.no/index.php/pp/article/view/2298 <p>Medication review, the systematic examination of an individual patient’s medicines in order to improve medication therapy, has been advocated as an important patient safety measure. Despite widespread use, little is known about how medication review is conducted when implemented in routine health care. Drawing from an ethnographic case study in a Swedish emergency department and using a practice-based approach, we examine how medication review is practically accomplished and how knowledge is mobilized in everyday practice. We show how physicians construct and negotiate medication safety through situated practices and thereby generate knowledge through mundane activities. We illustrate the centrality of practitioners’ collective reflexive work when co-constructing meaning and argue here that practitioners’ local adaptations can serve as important prerequisites to make “standardized” practice function in everyday work. Organizations need to build a practical capacity to support practitioners’ work-based learning in messy and time-pressured &nbsp;health care &nbsp;settings.</p> Ursula Reichenpfader Anette Wickström Per Nilsen Madeleine Abrandt Dahlgren Siw Carlfjord ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-04-30 2018-04-30 8 1 Fighting the Enemy Within? Challenging Minor Principles of Professionalism in Care and Welfare https://journals.hioa.no/index.php/pp/article/view/2265 Wilensky’s seminal article on professionals mentions three identifying characteristics besides the familiar specialized knowledge, autonomy and professional ideology. These are the referral principle, which states that professionals should refer clients to a colleague with a different specialty if necessary, the principle of sloughing off, which dictates that professionals allocate less rewarding parts of their job to lesser paid assistants, and the principle of impersonal service delivery, which admonishes professionals to treat clients equally. A changing clientele in health care and social care warrants a reappraisal of these three principles. Population ageing necessitates a reappraisal in health care. The deinstitutionalization of people with psychiatric or mental disabilities necessitates a reappraisal in social care. Referral, sloughing off and impersonal service delivery are professional characteristics that concur with managerial or political objectives. Managers and politicians are partly responsible for their widespread application. Hence, professionals need their help to fight this “enemy within professionalism.” Margo Trappenburg Mirko Noordegraaf ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-04-17 2018-04-17 8 1 10.7577/pp.2265 Hospital Administration as a Profession https://journals.hioa.no/index.php/pp/article/view/2112 <p>Many benefits accrue to an occupation that is described as a “profession,” including the ability to influence public debate, such as the current one over health policy in the United States. The label of profession frequently enhances the status, prestige, power, and legitimacy of an occupation, which usually translates into additional resources and power. This article examines the current status of the occupation—hospital administration—with respect to the literature pertaining to the concept of a profession. Hospital administration is assessed in terms of its relation to three common attributes associated with professions: collegial traits, knowledge base, and service orientation. The analysis indicates that there are important obstacles to be overcome before hospital administration can be considered a profession based on these three attributes.</p> Cory E. Cronin Kristin A. Schuller Doulas S. Bolon ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-04-10 2018-04-10 8 1 10.7577/pp.2112 Special Issue: Complexity, Routines, and Reflexivity in Professional Work https://journals.hioa.no/index.php/pp/article/view/2657 Vol 8, No 1 (2018) Jens-Christian Smeby ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-03-21 2018-03-21 8 1 10.7577/pp.2657 Editorial https://journals.hioa.no/index.php/pp/article/view/2655 Editorial Florent Champy ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-03-13 2018-03-13 8 1 e2655 e2655 10.7577/pp.2655 Theorising Risk Work: Analysing Professionals’ Lifeworlds and Practices https://journals.hioa.no/index.php/pp/article/view/1988 <p>The proliferation of risk logics within public and private sector organisational contexts where many professionals work has been studied as a phenomenon itself, as governance and in its impact on clients. The everyday experiences and practices of (para)professionals where risk has become a key and in some cases (re)defining feature or logic of everyday work—in assessing, intervening, advising and/or communicating—has received much less attention. We develop a theoretical framework for analysing this risk work, identifying three core and interwoven features—risk knowledge, interventions, and social relations. Central to our argument is that these features often stand in tension with one another, as intrinsic and implicit features of risk knowledge—probabilities, categories and values—become explicit and awkward in everyday practices and interactions. We explore key analytical trajectories suggested by our theoretical framework—in particular, the ways in which tensions emerge, remain (partially) hidden or are reconciled in practice.</p> Patrick Brown Nicola Gale ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-02-23 2018-02-23 8 1 e1988 e1988 10.7577/pp.1988 Complex Professional Learning: Physicians Working for Aid Organizations https://journals.hioa.no/index.php/pp/article/view/2002 <p>This article addresses the issue of professional learning of Swedish physicians returning from their work for international aid organisations in the global South. It is a qualitative case study based on 16 in-depth interviews, which uses a thematic narrative analysis, a typology of knowledge, and the concept of symbolic capital. The doctors’ assignments in settings radically different from the welfare state context meant professional challenges, including an initial feeling of de-skilling, but also enhanced reflexivity and intensive and complex learning. The doctors acquired new medical and organisational knowledge, improved diagnostic skills, new perspectives on different health care systems, cultural contexts, global power relations, and postcolonial hierarchies. Since their return to Sweden, they have encountered a friendly but rather shallow interest in their experiences. Their new insights and ideas for change have not been easy to validate as symbolic capital, and their intensive individual learning is seldom utilised for organisational learning.</p> Katarzyna Wolanik Boström ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-02-23 2018-02-23 8 1 e2002 e2002 10.7577/pp.2002 Connective Routines: How Medical Professionals Work with Safety Checklists https://journals.hioa.no/index.php/pp/article/view/2251 <p>New standards like checklists are introduced to establish so-called “connective professionalism,” but it is difficult to work with checklists in daily circumstances. Professionals might comply with standards, but they might also neglect or resist them. By linking the sociology of professions to routine theory, we develop a relational perspective on working with standards, which is sensitive to the actual usage of standards, not so much “by” but “in-between” professionals. We analysed whether and how checklists are part of daily professional routines. Our ethnographic data show that medical professionals pragmatically cope with checklists. They “tick boxes,” but also use standards to improve case treatment, depending on the nature of cases, time pressure, and team composition. Connections between professionals not so much result from standards, but are a prerequisite for using standards. Professionals themselves rather than checklists establish collaboration, but checklists might be important devices for using “connective potential.”Various exogenous developments force professions to organize collaboration. New standards, like checklists, are introduced to reconfigure work and organize so-called ‘connective professionalism’. Despite serious efforts, it has proven difficult to incorporate these standards in daily practice. Different perspectives on the reconfiguration of professional work explain noncompliance. While implementation science employs a solely instrumental perspective, Sociology of Professions literature employs a broader social perspective mostly focusing on maintaining professional power. By combining Sociology of Professions and Routine Theory, this paper provides an analytical perspective that embraces possibilities for change of routines. A critical case in surgical care is used to empirically show how a checklist (re)creates professional routines. Our ethnographic data show that rather than the result of active professional resistance, differences between checklists and routines emerge from pragmatic coping with checklists amidst high-paced circumstances. Though deviating from the formal rule, these might be meaningful action patterns. </p> Marlot Kuiper ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-02-23 2018-02-23 8 1 e2251 e2251 10.7577/pp.2251 Prescribing Antibiotics: General Practitioners Dealing with “Non-Medical Issues”? https://journals.hioa.no/index.php/pp/article/view/1983 <p style="margin: 0cm 0cm 0pt; line-height: 200%;">The medical professions will lose an indispensable tool in clinical practice if even simple infections cannot be cured because antibiotics have lost effectiveness. This article presents results from an exploratory enquiry into “good doctoring” in the case of antibiotic prescribing at a time when the knowledge base in the healthcare field is shifting. Drawing on in-depth interviews about diagnosing and prescribing, the article demonstrates how the problem of antimicrobial resistance is understood and engaged with by Danish general practitioners. When general practitioners speak of managing “non-medical issues,” they refer to routines, clinical expertise, experiences with their patients, and decision-making based more on contextual circumstances than molecular conditions—and on the fact that such conditions can be hard to assess. This article’s contribution to knowledge about how new and global health problems challenge professional actors affirms the importance of such a research agenda and the need for further exploration of the core problems posed by transnational sociology of professions.</p> Inge Kryger Pedersen Kim Sune Jepsen ##submission.copyrightStatement## http://creativecommons.org/licenses/by/4.0 2018-02-23 2018-02-23 8 1 e1983 e1983 10.7577/pp.1983