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Professional Segmentation as a Barrier to Reform in Turkish Nursing
Zuleyha Inceoz1,2, David Hughes1
1Swansea University School of Health & Social Care, Swansea, UK.
Nursing Inquiry
|August 2, 2026
Summary
Segmentation within Turkish nursing hinders modernization efforts. Addressing internal divisions among nurses, rather than solely focusing on external reforms, offers the most promising path for advancing nurse management in Türkiye.
Area of Science:
- Healthcare Management
- Nursing Studies
- Public Administration
Background:
- Türkiye's healthcare system underwent significant transformation post-millennium with New Public Management (NPM)-style reforms.
- These reforms impacted financing and performance management but had limited effect on nursing management.
- Entrenched medical power and civil service culture posed obstacles, alongside internal nursing workforce divisions.
Purpose of the Study:
- To investigate the factors impeding the modernization of nurse management in Türkiye.
- To identify the specific divisions and orientations within the Turkish nursing workforce.
- To propose strategies for advancing nurse management by addressing internal nursing dynamics.
Main Methods:
- Qualitative study involving hospital nurses in Türkiye.
- Identification of distinct nurse orientations and their perspectives on innovation.
- Analysis of the impact of Western discourses on professionalization and leadership.
Main Results:
- Four distinct orientations were identified among hospital nurses: bureaucratic modernizers, professional modernizers, traditionalists, and pragmatists.
- Modernization plans faced resistance from traditionalists and pragmatists, with internal disagreements among modernizers.
- Limited interdisciplinary work, absence of hybrid roles, and restricted movement into executive positions were observed.
- Nurse managers focused on continuing education, evidence-based practice, and guideline development for limited autonomy.
Conclusions:
- Internal segmentation and differing orientations within the nursing workforce are significant barriers to modernizing nurse management in Türkiye.
- Addressing these internal tensions is crucial for progress, given the political challenges of reforming medical power and civil service structures.
- Future advancements in nurse management may depend on fostering greater cohesion and shared vision within the nursing profession itself.
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