ILPC 2027

 In recent years, Norwegian hospitals have undergone numerous changes, whereof many relate to the incorporation of information technology, eg decision support software and medical algorithms used to perform medical triages (Russel, Trusson & De, 2016). In consequence, work processes related to professional’s work became increasingly standardised and thereby delimit professional’s job discretion. Overall, these changes appear to imply a shift toward “organisational professionalism” (Evetts, 2011), ie professionalism as a means of practitioner / employee control where organisational objectives regulate professionals work.

The aim of this paper is to present the consequences of technology and organisational standards on physicians and registered nurses work in a Norwegian hospital.

Our findings build on data from a case study of a Norwegian hospital by utilising a mixed method approach. Data compilation occurred before and after the relocation of employees into a new hospital constructed to utilise information technology and technological equipment, ie the fall of 2015 and 2016. At both times, we completed a cross-sectional study among employees engaged in the provision of health services and an ethnographic study at two wards in the hospital.

Preliminary analyses of data from the cross-sectional studies reveal that the majority of employees are satisfied with their workplace. Nevertheless, there was a significant negative correlation between job satisfaction and a perception of control through technology and standards. In addition, analyses indicate differences across employees’ perception of technology and standards on their work. Registered nurses were more likely to agree that technology and standards control their job than physicians.

Moreover, a majority of registered nurses disagreed on that technology open up for an increase in contact with patients, thereby supporting findings from the ethnographic studies.

The findings from participant observations and interviews reveal that technology and standards increasingly intertwine with professionals’ work, although in different ways. Registered nurses find themselves captured by standards and felt a time consuming effect of technology, obstructing them from having contact with patients. Technology, thereby, structured the work of registered nurses in accordance with organisational objectives.

Physicians, however, obtained more access to information needed in their job and increased control over registered nurses through an increase in standards based on medical algorithms, since physicians are entitled to justify any deviation from standardised procedures.

Overall, our findings indicate a shift toward organisational professionalism in hospitals by restructuring work processes in accordance with technology based on the medical paradigm. Consequently, professions deviating this paradigm appear comprehensively more influenced by technology and standards.