Professional legitimacy claims in the multidisciplinary workplace: the case of heart failure care

Abstract

The pattern of occupations engaged in the care of patients has grown steadily more complex, and is characterised by the creation of new occupations, additional specialisation within existing occupations, and extensions to existing occupational roles. This paper presents empirical data from a study of professionals working with heart failure patients in the English National Health Service, focusing on the discourses employed by nurses and by three different specialties within medicine to legitimise their occupational boundaries. We identify four themes that characterise such discourses, specialised expertise, competence, organisational efficiency and patient-centredness, though these are deployed to different degrees by the different professions. The findings point to a theory of 'occupational legitimation talk' in which newer occupations utilise a wider set of legitimacy claims as a means of strengthening their role and credibility within an increasingly complex and fluid healthcare environment.