The Vocabulary of Complaints: Nursing, Professionalism and Job Context

Abstract

A large body of research has fully documented the contradictions and problems of nursing with special reference to the job context of nursing activities in bureaucratic hospital organisations. In this discussion, the notion of a'vocabulary of motives' is developed as an explanatory framework for the analysis of nursing complaints about their job context. These vocabularies are illustrated by qualitative data from interviews with nurses in South Australia. There are a variety of structural and cultural factors which produce dissatisfaction with nursing as an occupation and these structures give the context for the development of a complaint system which functions as an occupational sub-culture. The function of complaints is to bind nurses together as an occupational community in opposition to superiors within the hospital system and also against the patients as a demanding group of inmates. The notion of a vocabulary of complaint is developed from the work of C. Wright Mills who produced an innovative analysis of motives as a form of language. Although Mills' work has been subject to important criticism, his approach to language as a form of social interaction can be developed to provide an insight into the frustrations of nursing as an occupation. This discussion is, therefore, a contribution to the sociology of occupations with special reference to nursing but the intention is to provide a framework which could be employed for the study of a variety of health-related occupations. The primary argument of the first section of this paper is that the frustrations of nursing are over-determined by a range of structural and ideological features which conspire to limit the professional autonomy of the nurse at the bedside and the focus of the vocabulary of complaint is this lack of work-context autonomy with respect to the patient under the general surveillance of the medical profession. The doctor/nurse relationship is in this respect a primary illustration of medical dominance.