Managerialism and professional strategies: a case from nurses in Portugal

Abstract

There have been profound changes in the Portuguese national health system (NHS), instigated under the influence of managerialism and the new public management (NPM) "philosophy". These changes have been in line with what has happened in other developed countries. At the beginning of the new century, important reforms that emphasised the efficient use of scarce resources were implemented. The objective of this study is to understand how nurses are adapting to a more managerial environment, one in which economic rationalism and market-driven initiatives are the key principles behind the health reforms. A qualitative study was developed, based on semi-structured interviews with 83 nurses with managerial duties in ten hospitals in Portugal. All interviews were tape-recorded and each interviewee's discourses were subjected to content analysis. Data analysis led to the conclusion that under the new logic of the market and managerialism, these professionals have tried to (re)define their professionalisation route by emphasising the importance of care but also by trying to incorporate management as their dominant role in the social division of work. In reconfiguring their notion of professionalism, nurses were incorporating new practices in their day-to-day activities. This empirical study confirms that professionalism can also be conceptualised as a technology of self-control being able to discipline professionals at the micro level. This research is an empirical study based on the effects of managerialism on nurses with managerial duties in Portugal. This study contributes to a better understanding of the complex process of the professionalisation of nurses in a context of institutional change.