What is it about?

Nurses often shy away from asking awkward questions about the professional relationship between themselves and doctors. Orthopaedic nurses tend to be self-sacrificing (altruistic) in their attempts to satisfy the needs of their patients and doctors. This article attempts to explain and enlighten, to enable change towards better and more just interactions between nurse and doctor. It is recognized that the reality of these relationships has both positive and negative aspects and to draw out the issues general- izations and over simplifications have often been made in what follows.

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Why is it important?

Alongside recent Health Service reform, has come the call for developing a climate of further collaboration, cooperation, team building and multi- professional working. The facilitation of such a climate demands that an ethos of egalitarian (democratic) working relationships and equal partnerships prevail. Whereas this should be the case, it appears that it is not – particularly between the professional groupings of medicine and nursing. Recent research serves to remind nurses of the continuing trend, whereby the medical profession still exercises a dis-proportionate degree of power and dominance over the nursing profession (Gair & Hartery 2001). It could be argued, on the basis of anecdotal evidence that this certainly continues to be the case for much of orthopaedic nursing. The issue of medical hegemony (dominance) appears to be as prevalent as ever and the maintenance of subsequent divisions, caused by unequal power relationships, seems to be as strong as ever.

Perspectives

Privileged groups always have a vested interest in maintaining the status quo to protect their advantages. Male dominated medicine, for example, thus has a vested interest in continuing the disadvantaging of female dominated nursing. To address this nurses must make themselves unpopular and difficult to live with and challenge taken for granted assumptions and familiar beliefs. Why, for example, should nurses accept the current dominant ‘scientific approach’ to their work? Nurses care for people as individuals, with all their idiosyncrasies, not anonymous bodies within specified categories of diagnoses. Our work needs to acknowledge subjectivity and the environment in which care is carried out. No one else will stand up for orthopaedic nurses and nursing unless we start to take the hard route and fight for what we believe in.

Dr Dean Whitehead
Flinders University

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This page is a summary of: The issue of medical dominance (hegemony), Journal of Orthopaedic Nursing, August 2001, Elsevier, DOI: 10.1054/joon.2001.0167.
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