Interprofessional Conflict and Repair: A Study of Boundary Work in the Hospital

Abstract

This article is about boundary work and the accomplishment of work among various groups claiming professional status at the bedside in the hospital. The author analyzes qualitative data from 110 in-depth interviews and participant observation with physicians, nurses, respiratory therapists, social workers, and occupational, physical, and speech therapists. The findings show how work roles, and hence occupational boundaries, are flexible and malleable. Practitioners usually cross these boundaries within reason, and thus boundary work engenders ironic dualities; it generates both conflict and cooperation, questioning and affirmation, and that is why most reasonable work role transgressions do not fundamentally undermine the social order of the hospital. Boundary work provides insights on the dynamic nature of professionalism as the outcome of a negotiated order that reveals itself at the ideological and behavioral levels. Understanding how and why boundary work is done also has policy implications at the workplace and health care service levels.