Changing professional identities : the adjustment of professional delineations in health

![CDATA[Much of the literature claims that professional identities are largely crystalised, bounded, static and unchanging (Abbott, 1988; Ackroyd, 1996; Conrad & Kern, 1994; Freidson, 1970, 1988, 1977; Morgan, Calnan & Manning, 1985; Zola, 1992, 1994). However, in New South Wales, Australia, it appears that professional boundaries are reconstituted in new ways as a result of health reforms, such as increasing use of technologies, market forces, and political and professional influences. The question arises : How do these changes affect the traditional division of labour between doctors and nurses, and how do the forces for change affect the (re)construction of professional identity in terms of autonomy, authority and sovereignty? This paper reports on a study of doctors and nurses working together, conducted in NSW, Australia. The interviews, focus group data and ethnographic journals allow for exploration of the construction and change in the occupational and professional boundaries. This paper will show that due to organisational environmental pressures, the historically anchored medical profession and the newly emerging nursing profession are changing. In addition, demarcation between health care managers and clinicians enforces a boundary that encapsulates both doctor and nurse managers, but separates these managers from doctor and nurse clinicians. The success of implementation of health reform is contingent upon professional interdependence. The interdependence is influenced by professional identity delineations, such as authority, autonomy and sovereignty, and the ability and willingness to make these professional boundaries more permeable. This paper investigates the extent to which the professional boundaries are maintained and changing.]]