Title

In the public interest: Autonomy and resistance to methods of standardising nurses' advice and practices from a health call centre in Perth, Western Australia

Document Type

Journal Article

Publisher

Blackwell Publishing

Faculty

Business and Public Management

School

Justice and Business Law

RAS ID

2958

Comments

This article was originally published as: Larsen, A. C. (2005). In the public interest: Autonomy and resistance to methods of standardising nurses’ advice and practices from a health call centre in Perth, Western Australia. Nursing Inquiry, 12(2), 135-143. Original article available here

Abstract

The history of nursing is replete with examples of nurses battling for autonomy over their education, knowledge and work practices. The latest battleground is HealthDirect, Australia's first medial call centre, where nurses are required to meet externally imposed clinical standards while satisfying legal and financial obligations. These objectives are arguably achieved when nurses assess callers’ health problems via computerised algorithms that determine an appropriate plan of action. That way, nurses’ subjective responses to callers are ruled out. To ensure nurses comply with the standard processes, calls are monitored randomly and surreptitiously in formal and informal ways. This paper explores how nurses respond to standard procedures and surveillance, in order to argue that nurses’ input partially drives reform processes. Nurses continue to seek autonomy over the advice they give and how their work is evaluated but are constrained by structural power relations.

DOI

10.1111/j.1440-1800.2005.00265.x

 

Link to publisher version (DOI)

10.1111/j.1440-1800.2005.00265.x