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Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance

Zuleyha Inceoz, David Hughes

Sociology of Health & Illness, Volume: 48, Issue: 4, Start page: e70194

Swansea University Author: David Hughes

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DOI (Published version): 10.1111/1467-9566.70196

Abstract

Nursing work in several Western countries has been affected by evolving discourses of managerialism and professionalism. Interdisciplinary working has given nurses more prominence in high-level teams and created hybrid management roles that have affected understandings of professionalism. Such chang...

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Published in: Sociology of Health & Illness
ISSN: 0141-9889 1467-9566
Published: UK Wiley 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71813
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spelling 2026-05-06T14:44:14.5893308 v2 71813 2026-04-27 Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2026-04-27 Nursing work in several Western countries has been affected by evolving discourses of managerialism and professionalism. Interdisciplinary working has given nurses more prominence in high-level teams and created hybrid management roles that have affected understandings of professionalism. Such changes generally followed broader new public management (NPM) reforms that shifted power from senior doctors to executive managers. Yet, although there is an extensive literature on the global spread of NPM reforms, less is known about the influence of associated discourses concerning nurse management and professionalism. This paper addresses that gap by presenting qualitative data on the evolving situation of hospital nursing in Türkiye, a country that implemented NPM-type reforms in the early 2000s. Based on 40 in-depth interviews completed in 2021/22, it describes the uneven impact of these reforms on medicine and nursing, the continuing reality of medical dominance and the development of a professionalising project among Turkish hospital nurses that avoids directly challenging medical power. This emphasises continuing professional education, practice guideline development and a curtailed form of teamwork away from doctors. Nurses exercised greatest autonomy in specialised wards, intensive care units and emergency departments, where a stable staff group could operate at a distance from oversight by senior doctors. Journal Article Sociology of Health & Illness 48 4 e70194 Wiley UK 0141-9889 1467-9566 Nursing management, Turkiye, Professionalism, healthcare reform, medical dominance 6 5 2026 2026-05-06 10.1111/1467-9566.70196 https://onlinelibrary.wiley.com/doi/pdf/10.1111/1467-9566.70196#accessDenialLayout Published Gold Open Access COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) Swansea University 2026-05-06T14:44:14.5893308 2026-04-27T15:19:07.0684288 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Zuleyha Inceoz 1 David Hughes 2 71813__36668__0e9834d85d564ca2aa2b72c884039c61.pdf Sociology Health Illness - 2026 - Inceoz - Cocooning Nurse Autonomy in T rkiye Navigating a Path to Professionalism That.pdf 2026-05-06T14:29:18.2205653 Output 460190 application/pdf Version of Record true false English
title Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
spellingShingle Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
David Hughes
title_short Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
title_full Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
title_fullStr Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
title_full_unstemmed Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
title_sort Cocooning nurse autonomy in Türkiye: navigating a path to professionalism that does not challenge medical dominance
author_id_str_mv f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author David Hughes
author2 Zuleyha Inceoz
David Hughes
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container_title Sociology of Health & Illness
container_volume 48
container_issue 4
container_start_page e70194
publishDate 2026
institution Swansea University
issn 0141-9889
1467-9566
doi_str_mv 10.1111/1467-9566.70196
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
url https://onlinelibrary.wiley.com/doi/pdf/10.1111/1467-9566.70196#accessDenialLayout
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description Nursing work in several Western countries has been affected by evolving discourses of managerialism and professionalism. Interdisciplinary working has given nurses more prominence in high-level teams and created hybrid management roles that have affected understandings of professionalism. Such changes generally followed broader new public management (NPM) reforms that shifted power from senior doctors to executive managers. Yet, although there is an extensive literature on the global spread of NPM reforms, less is known about the influence of associated discourses concerning nurse management and professionalism. This paper addresses that gap by presenting qualitative data on the evolving situation of hospital nursing in Türkiye, a country that implemented NPM-type reforms in the early 2000s. Based on 40 in-depth interviews completed in 2021/22, it describes the uneven impact of these reforms on medicine and nursing, the continuing reality of medical dominance and the development of a professionalising project among Turkish hospital nurses that avoids directly challenging medical power. This emphasises continuing professional education, practice guideline development and a curtailed form of teamwork away from doctors. Nurses exercised greatest autonomy in specialised wards, intensive care units and emergency departments, where a stable staff group could operate at a distance from oversight by senior doctors.
published_date 2026-05-06T06:30:14Z
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