Cocooning Nurse Autonomy in Türkiye: Navigating a Path to Professionalism That Does Not Challenge Medical Dominance

Nursing work in several Western countries has been affected by evolving discourses of managerialism and professionalism. Interdisciplinary working has given nurses more prominence in high-level teams and created hybrid management roles that have affected understandings of professionalism. Such changes generally followed broader new public management (NPM) reforms that shifted power from senior doctors to executive managers. Yet, although there is an extensive literature on the global spread of NPM reforms, less is known about the influence of associated discourses concerning nurse management and professionalism. This paper addresses that gap by presenting qualitative data on the evolving situation of hospital nursing in Türkiye, a country that implemented NPM-type reforms in the early 2000s. Based on 40 in-depth interviews completed in 2021/22, it describes the uneven impact of these reforms on medicine and nursing, the continuing reality of medical dominance and the development of a professionalising project among Turkish hospital nurses that avoids directly challenging medical power. This emphasises continuing professional education, practice guideline development and a curtailed form of teamwork away from doctors. Nurses exercised greatest autonomy in specialised wards, intensive care units and emergency departments, where a stable staff group could operate at a distance from oversight by senior doctors.