Professional Engagement in Articulation Work: Implications for Experiences of Clinical and Workplace Autonomy

Abstract

Autonomy has long been established as a critical component of professional work. Traditionally, autonomy has been examined as the extent to which an individual or a professional group controls the decisions and knowledge used in their work. Yet, this framework does not capture the additional work activities that professionals are increasingly expected to perform. Therefore, this chapter argues for theoretically expanding our understanding of professional autonomy by bringing in the concept of articulation work. Using the case of healthcare organisational change, this study assesses how shifts in work practices impact autonomy. Data come from longitudinal ethnographic fieldwork and in-depth interviews conducted at a Neonatal Intensive Care Unit as it underwent significant structural changes. Findings show that professionals were forced to change articulation work strategies in response to new organisational structures. This included changes in the way professionals monitored, assessed, coordinated and collaborated around patient care. Furthermore, these shifts in articulation work held important implications for both workplace and professional autonomy, as professionals responded to changes in their work conditions.

Citation

VanHeuvelen, J.S. (2020), "Professional Engagement in Articulation Work: Implications for Experiences of Clinical and Workplace Autonomy", Gorman, E.H. and Vallas, S.P. (Ed.) Professional Work: Knowledge, Power and Social Inequalities (Research in the Sociology of Work, Vol. 34), Emerald Publishing Limited, Leeds, pp. 11-31. https://doi.org/10.1108/S0277-283320200000034005