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The challenge of contributing to policy making in primary care: The gendered experiences and strategies of nurses

Hughes, Alison



This paper explores nurses' experiences as members of primary care organisations set up to develop and commission health services for local communities. Nurses, alongside GPs and other health professionals, were given a place on the governing bodies (boards) of Local Health Groups - a move widely welcomed by the nursing profession as long overdue recognition of the important contribution nurses and nursing could bring to the policy arena. Nurse board members faced a number of challenges in their attempts to contribute to and influence local health policy. This ethnographic study (which involved non-participant observation of 33 board meetings and interviews with 29 board members including nurses) suggests that medical authority and control, and hierarchical power relations between doctors and nurses on the board, were seen by nurses as significant obstacles to their participation in this new policy arena. In response to their perceived lack of power and subordinate status, nurses employed a number of strategies to negotiate their participation as board members - these included 'getting it right', 'achieving the right balance', 'self-presentation' and 'unassertiveness'. These strategies reflected and reproduced gendered identities and relations of power and raise important questions regarding the influence of nurses and nursing within policy making. © 2010 The Author. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.


Hughes, A. (2010). The challenge of contributing to policy making in primary care: The gendered experiences and strategies of nurses. Sociology of Health and Illness, 32(7), 977-992.

Journal Article Type Article
Publication Date Nov 1, 2010
Journal Sociology of Health and Illness
Print ISSN 0141-9889
Electronic ISSN 1467-9566
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 32
Issue 7
Pages 977-992
Keywords gender, local health group, doctor/nurse relationships, policy, nurses, nursing identity, ethnography
Public URL
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