The conflict between 'new nursing' and 'scientific management' as perceived by surgical nurses

Nursing on surgical wards is a major area of employment for nurses, but the literature is sparse in relation to this group. Dramatic alterations in surgical care have occurred over the past few years, including the introduction of day surgery on a major scale, increased technical equipment and faster 'throughput' of patients. This has led to Nicholas Fox describing 'a conveyor belt of surgery'. These changes are occurring alongside major evolution within the nursing profession. Nurses are encouraged to give holistic, individualized care in what has been termed the 'new nursing' movement. This study addresses the problem of how nurses resolve these two conflicting discourses. Following an initial phase of participant observation, 10 registered surgical nurses were interviewed using the techniques of career biography, critical incident analysis and informal interviews. Different interpretations by the key members of the 'new nursing' discourse have been identified. These have been termed the professional project discourse, the modernist discourse, and the traditionalist discourse. Various strategies are adopted by nurses to reduce cognitive dissonance caused by the two conflicting discourses. The most commonly used being rationalization about the need for emotional labour.