Nursing and the Sociological Imagination
Is nursing a product of capitalism? I am going to explore the history of nursing and the sociological aspects of the profession’s role in society. I will cover the three components of capitalism: Rationalization, Alienation, and Exploitation. I will examine the possible effects capitalism has on my profession as well. I will evaluate the possibility that my profession has, in fact, been affected by social rationalization, alienation, or exploitation?
Rationalization can be defined as “to apply the principles of scientific management to (something, such as an industry or its operations) for a desired result (such as increased efficiency)”. This concept can be used to explain the history of nursing and its evolution. In the late eighteenth century care of the sick was limited to family and close friends. The only deviance from that was during periods of epidemics that spread throughout a region. It was not until the early nineteenth century and the start of the Civil War that modern nursing began its evolution. To say that modern day nursing is a product of rationalization is justifiable. We as a society replaced the traditional care of our sick with the urbanizational need of facilities and staff to provide care while we continued on with our daily lives and work duties.
Fortunately, alienation is not an issue I have been subjected to more than a few times during my adult years. “They area alienated from the production work itself, which is entirely directed by someone else, highly specific in nature, repetitive, and creatively unrewarding. Further, it is work that they do only because they need the wage for survival.” I have worked for companies that utilized the “warm body” concept to fill vacancies. Skill and motivation were not large contributors to my hiring.
I was employed by a large retail chain. I was hired to do a job that had minimal need for critical thinking or problem-solving skills. I could work an eight-hour shift and feel as though I had not utilized my brain beyond what was needed for the physical repetition required to perform my job. However, as a nurse, I must rely on those skills daily. Each patient is unique. Although several patients my share the same diagnoses, they require different plans of care. As a nurse, I must be aware of the minute details that can alter the direction of care the patient needs or is willing to adhere to. If it were like those positions controlled by alienation, we could quite possibly see a rise in the number of deaths resulting from uncontrolled chronic diseases.
According to Marx, all men and women were exploited to some extent unless they belonged to the small number of capitalists. Anyone that did not control production, shipment, or supplement of resources for each of those could be exploited for their labor-power. Also, in most cases the working men/women are responsible for keeping the capitalist’s pockets full and then some. Surplus value. Probably the most easily understood form of exploitation. Left over profit after maintenance, supply replenishment, labor and production costs. I had to really focus on this concept and pick it apart to see that even nurses are exploited for profit.
For example, I see a patient in office wanting to get their annual flu vaccine. This encounter does not require supervision by a physician. I spend approximately five minutes with the patient obtaining vitals and giving the shot. My time and labor are billed at $18.40 per minute, while I am only earning $0.30 per minute. Once the clinic replenishes the cost of supplies, the vaccine itself and other operating costs, it pockets the remainder. Undoubtedly, this number in exponentially greater than the other. I don’t feel oppressed on a daily basis, but I will now be more mindful of my production of surplus value for my current and future employers. Regardless of my personal objections to this issue, this concept has been in place for centuries, and will likely continue for several more.
Personal trouble or public issue? Personal trouble is limited to a problem affecting just the individual. Public issues are just that. Issues affecting the public as a whole. In an article on infed.org, an example using unemployment simplifies the concept for the reader. “When, in a city of 100,000, only one man is unemployed, that is his personal trouble, and for its relief we properly look to the character of the man, his skills, and his immediate opportunities. But when in a nation of 50 million employees, 15 million men are unemployed, that is an issue, and we may not hope to find its solution within the range of opportunities open to any one individual.”
The exploitation of my skill and value within the capitalistic business structure providing me with employment is that of a public issue according to C. Wright Mills. I am not an isolated incidence of exploitation. It is the way my employer maintains its socioeconomical status. It vastly differs from that of a private practice. One would think that the larger company would yield higher wages because of the larger value surplus availability. However, in private practices, employees in general are still viewed as individuals not as moving parts of the machine. In return, I have found that private practices offer higher wages, with respect to the needs of the individual. They are also more likely to see the effects of alienation and exploitation on their employees. Unlike the larger management companies behind medical groups and hospitals.
I don’t feel less valuable after studying this area of social theory. I believe it is a necessity at the present time that allows our economy and governmental structure to continue forward. I am not going to predict the communist comeback or takeover. I believe it will happen if and when the country needs it most. I am not sure how it will my career either. I believe the needs of the sick and ill will be there regardless of capitalism or communism. The availability of services seems to be more equal under the communist umbrella, but again, I cannot say with certainty. Until then, I will continue on in my career providing the best care I can to all those in need regardless of my new understanding of social theory.