Professionalism E-Book

Alan Cribb

• Herausgeber: John Wiley & Sons
• Kategorie: Geisteswissenschaft
• Serie: Key Themes in Health and Social Care
• Sprache: Englisch

Seitenzahl: 256

Veröffentlichungsjahr: 2015

Beschreibung

Professionalism is a complex and highly disputed idea of crucial importance in a range of fields, not least health and social care. It can inspire people by reminding them of workplace ideals and the value of occupational expertise. But it can also feel threatening and de-motivating; for example, if it is used to demand ever more from people working in very challenging circumstances. The language of professionalism can evoke a special relationship of trust between service users and practitioners. But it can also suggest a social distance between two classes of people; high status professionals and their lower status 'non-professional' clients.

This book is an original and accessible guide to these ambiguities and complexities. Cribb and Gewirtz clarify the nature of professionalism and explain and defend its importance, providing an understanding of, and an analytical engagement with, both idealistic and critical perspectives. In addition, the authors assess the implications of contemporary policy trends for professional work, showing how they may be radically altering our understanding of the 'good' professional.

This inviting and reflective study draws upon examples and case studies and weaves in a range of relevant theoretical concepts and perspectives. Written in a style that encourages and supports further reflection on this complex topic, Professionalism is the only book of its kind for practitioners, researchers and students in health and social care.

Leseprobe

Contents

Cover

Title Page

Copyright

1 Heroes and Anti-Heroes

Gods and angels

Murderers and demons

Idealistic and critical readings of professionalism

Conclusion

Notes

2 Varieties of Professionalism

Professions

‘New professionalism’

Conclusion

Notes

3 Impossible Dreams

No more special occupations

The decline of deference and ‘client revolt’

An unsuitable world for vocations

Working at the limit

Stuck in the middle

Standardizing the person?

Conclusion

Notes

4 Licensed to Care

An example

Professionalism as a mode of social coordination

Professionalism as the embodiment of admirable qualities

Pulling things together: professionalism as expertise-based social authority

What professionalism demands

Conclusion

Notes

5 Integrity at Work

An example

Collective good or individual good?

Control and autonomy in professional roles

Living with power: a fundamental challenge for professionals

Conclusion

Notes

6 Supporting Professionalism

Managing professionals – accountability as audit

Learning and leading – enabling intelligent accountability

An example

Conclusion

Notes

7 Professional Identities

Am I a professional? Am I professional?

Can my expertise be used for good?

How can I work with others respectfully?

Who are my exemplars?

Is professionalism a practical possibility for me?

How can I handle dilemmas and routine moral stress?

Is my role a mask for vice or a scaffold for virtue?

Conclusion

Notes

Index

End User License Agreement

Guide

Cover

Table of Contents

Begin Reading

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Key Themes in Health and Social Care series

Nick J. Fox, The Body

Janet Hargreaves & Louise Page, Reflective Practice

Professionalism

ALAN CRIBB AND SHARON GEWIRTZ

polity

Copyright © Alan Cribb and Sharon Gewirtz, 2015

The right of Alan Cribb and Sharon Gewirtz to be identified as the Authors of this Work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

First published in 2015 by Polity Press

Polity Press65 Bridge StreetCambridge CB2 1UR, UK

Polity Press350 Main StreetMalden, MA 02148, USA

All rights reserved. Except for the quotation of short passages for the purpose of criticism and review, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher.

ISBN-13: 978-0-7456-9043-8

A catalogue record for this book is available from the British Library.

Library of Congress Cataloging-in-Publication Data

Cribb, Alan, author.Professionalism/Alan Cribb, Sharon Gewirtz.p. ; cm.Includes bibliographical references and index.ISBN 978-0-7456-5316-7 -- ISBN 978-0-7456-5317-4 (pb)I. Gewirtz, Sharon, 1964-, author. II. Title.[DNLM: 1. Health Occupations. 2. Professional Role. 3. Ethics, Professional. 4. Social Work. W 21]R690610.69--dc23

2014043492

The publisher has used its best endeavours to ensure that the URLs for external websites referred to in this book are correct and active at the time of going to press. However, the publisher has no responsibility for the websites and can make no guarantee that a site will remain live or that the content is or will remain appropriate.

Every effort has been made to trace all copyright holders, but if any have been inadvertently overlooked the publisher will be pleased to include any necessary credits in any subsequent reprint or edition.

For further information on Polity, visit our website:politybooks.com

Preface

This is, obviously, only one of the many short books about professionalism that could be written. One such book might usefully start by looking at codes of professional practice and reviewing and advocating the standards of behaviour and quality that apply to health and social care practitioners. What is required of practitioners, for example, when it comes to confidentiality, honesty or stewardship of scarce resources? Another book might begin from critiques of professional power and argue that professionalism is no longer a credible notion in contemporary social conditions. The latter text would have a predominantly sceptical, even dismissive, tone.

This book, although it covers similar themes and material, takes neither of these lines. We hope it is an encouraging text and one that might help support the understanding – and exercise – of professionalism. However, it does not take the idea of professionalism for granted. The two broad organizing questions that lie behind the book’s arguments are: Is professionalism desirable and is professionalism possible? Taking these questions seriously means not taking all of the social apparatus surrounding professionalism (for example, codes of practice and the professional bodies that issue them) at face value. It means standing back and asking about the visions, ideals and personal virtues that lie behind the language of professionalism, and asking whether or not these visions, ideals and virtues are meaningful and practicable for current health and social care systems and practitioners.

We believe, and will argue, that these questions can be answered in the affirmative. But in order to come to this conclusion, we suggest, it is first necessary to be clear about the many challenges posed by such questions, including the challenges of critics and sceptics. Much of the book’s focus is on professional dilemmas, but here our primary interest is not in the specific dilemmas that might face practitioners (for example, those concerning compulsory treatment, euthanasia, allocating budgets, etc.) but rather the fundamental dilemmas of determining what it means to be a professional in current working contexts. In very broad terms, this involves, for example, balancing a traditional emphasis on being an ‘autonomous expert’ with ever-increasing demands to be responsive and accountable to both service users and managers. Those occupying roles in health and social care operate under immense pressure not only from sheer volume of work but also from this constant need to balance competing perspectives and voices. What can and should professionalism look like under these circumstances?

We start, in chapter 1, by thinking about the image of professionals as socially special, and perhaps particularly admirable, individuals. How does this image connect to the fact that some professionals can do bad things? Our hope is to begin to shed light on how professional status and roles place people in relatively powerful positions – for good or ill. In chapter 2, we consider the idea that the language of professionalism has spread so widely and thinly as to become an empty public relations ‘brand’, but then go on to look for some core sense of profession that might properly underpin professionalism as an ideal. The difficulty this uncovers is that conceptions of profession and professionalism are not fixed – new versions of professionalism have emerged along with new expectations for health and social care practitioners. We track some of these changing conceptions, contrasting traditional conceptions of professionalism with some versions of ‘new professionalism’. In chapter 3, we seriously explore the idea that calls for professionalism are unrealistic – because changing social conditions and expectations make traditional conceptions of professionalism less relevant and because changing working conditions make the delivery of ‘new professionalism’ practically impossible, even laying aside question marks about its coherence as a version of professionalism. Whilst not accepting the thesis that professionalism is now a practical impossibility, we explore these issues to show just how challenging it is to formulate, practise and socially underpin forms of professionalism in the contemporary workplace.

In the remainder of the book, we set out to respond to these challenges. First, in chapter 4, we map out and illustrate a summary and ideal-type conception of professionalism – as the accomplished exercise of expertise-based social authority – that we think can stretch to serve current practice conditions and that embodies something both desirable and, at least to a degree, possible (albeit demanding) for many practitioners. This conception draws upon the discussions earlier in the book and, we suggest, is general enough to hold together different perspectives on, and versions of, professionalism but needs interpretation and application in contemporary conditions. We then set out to analyse and illustrate the dilemmas involved in both living out (chapter 5) and socially and institutionally supporting (chapter 6) this notion of professionalism. Our argument is that these dilemmas are inherent in professionalism – and that professionalism does not consist in identifying ‘what works’ so much as in being ready to question and debate what counts as working from case to case. These two chapters thus help to ‘fill out’ the general account of professionalism offered in chapter 4 for the conditions of contemporary health and social care. The account that emerges is of a ‘critically reflexive’ professionalism – a professionalism which is continuously negotiated with others and routinely combines relational as well as technical forms of expertise, which is ready to embrace critique and self-doubt, and which draws upon practitioners’ humanity and practical wisdom. This conception of professionalism also entails that practitioners will understand their work, and engage with it, with sensitivity towards broader debates about social and civic purposes. In chapter 7, the concluding chapter, we retell the story of the book by returning to the idea of individual practitioners, or at least their role models, as embodying admirable qualities. What kind of identities can and should practitioners aspire to and enact if they want to embody the ideals and virtues of professionalism in their working lives? Our intended audience here, as throughout the book, is practitioners who work in health and social care, but we imagine that the themes and topics we discuss will have many resonances for people working in other professional roles.

This book, in short, explores and reflects upon the complex and disputed territory of professionalism. We hope that it will stimulate readers’ own explorations and reflections; indeed, this is the primary aim of the book. Although we do offer arguments and observations of our own about the nature and importance of professional roles and professionalism, we are hoping that readers will approach the book not looking to take away ‘answers’ but rather to find material to think about. After all, we would suggest, professionalism entails being able to think things through and make judgements for oneself, albeit within frameworks of support provided by others.

Acknowledgements

We would like to thank all our colleagues in the Centre for Public Policy Research, King’s College, London for being wonderful people to work with and, more specifically, for many criss-crossing conversations relating to things discussed in this book which we have enjoyed over the years. We are also very grateful to Pat Mahony and Ian Hextall who co-organized an ESRC seminar series on professional identities and education with us which gave us the opportunity to think around the topic of professionalism. Huge thanks go to Vikki Entwistle and John Owens who provided very encouraging and constructive comments on an earlier draft of the book. Alan would also particularly like to thank the Health Foundation for funding which made the writing of this book possible and his colleagues there, including Adrian Sieff, Alf Collins and Nick Barber for support, stimulation and valuable feedback on ideas.

As before, it has been a pleasure to work with Polity Press. Emma Hutchinson and Pascal Porcheron have been patient, helpful and suitably challenging. We are grateful to them and also to the two anonymous reviewers whose comments, along with those from Vikki and John, were invaluable in helping us to complete the manuscript.

CHAPTER ONEHeroes and Anti-Heroes

Are health and social care professionals, and perhaps other professionals also, somehow special? This is a large – and deliberately vague – question which we will come back to from time to time. But we can begin to respond to it straight away.

There is a sense in which all professionals, including, for example, health professionals, are special because they are just different from one another and from ‘non-professionals’. That is, all professionals occupy specific and distinctive social roles – they participate in a division of labour between people and ‘specialize’ in various areas of work, tasks and goals. If someone collapses in an airport departure lounge – perhaps just fainting with exhaustion, perhaps because of something more serious – it makes sense that it is a doctor or a nurse, rather than an accountant or retail assistant, who rushes across to see what can be done. They are, generally speaking, more likely to have relevant knowledge and experience. They are, for this reason, also more likely to feel confident and comfortable offering this kind of help. In turn, this suggests another sense in which some professionals are arguably special. It is not just that most other bystanders would feel wary of the intrusion entailed by approaching the collapsed individual and their family members and, even more so, by crouching down on the ground, putting their faces in close and reaching out to touch them. It is also that some professionals have a distinctive kind of social licence to be able to ‘get up close and personal’, and so those on the receiving end of these attentions are also much more likely to feel comfortable and reassured if they know that it is a health or social care professional attending to them. These considerations about personal space and intimacy are relatively unique to the care professions. (There are some similarities in the hair and beauty sector, for example, but the corresponding licence is both more conditional and more restricted.) However, there are some analogous aspects to other professions. We may, for example, allow a lawyer or social worker to ‘invade’ the intimate details of our finances but would resist having these shared more widely.