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The challenge of contributing to policy making in primary care: the gendered experiences and strategies of nurses.

机译：促进初级保健政策制定的挑战：护士的性别体验和策略。

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This paper explores nurses' experiences as members of primary care organisations set up to develop and commission health services for local communities. Nurses, alongside GPs and other health professionals, were given a place on the governing bodies (boards) of Local Health Groups - a move widely welcomed by the nursing profession as long overdue recognition of the important contribution nurses and nursing could bring to the policy arena. Nurse board members faced a number of challenges in their attempts to contribute to and influence local health policy. This ethnographic study (which involved non-participant observation of 33 board meetings and interviews with 29 board members including nurses) suggests that medical authority and control, and hierarchical power relations between doctors and nurses on the board, were seen by nurses as significant obstacles to their participation in this new policy arena. In response to their perceived lack of power and subordinate status, nurses employed a number of strategies to negotiate their participation as board members - these included 'getting it right', 'achieving the right balance', 'self-presentation' and 'unassertiveness'. These strategies reflected and reproduced gendered identities and relations of power and raise important questions regarding the influence of nurses and nursing within policy making.
机译：本文探讨了护士作为基层医疗组织成员的经验，这些组织是为当地社区开发和委托医疗服务而建立的。护士与全科医生和其他卫生专业人员一起在地方卫生团体的理事机构（董事会）中占有一席之地。此举受到了护理界的广泛欢迎，因为人们早就应该承认护士和护理对政策领域的重要贡献。 。护士委员会成员在努力促进和影响当地卫生政策方面面临许多挑战。这项人种学研究（涉及对33次董事会会议的非参与者观察和对包括护士在内的29名董事会成员的访谈）表明，护士将医疗权威和控制权以及董事会中医生与护士之间的等级权力关系视为阻碍其发展的重大障碍。他们参与这个新的政策领域。针对他们认为缺乏权力和下属地位的情况，护士采用了许多策略来谈判其作为董事会成员的参与-其中包括“做到正确”，“实现正确的平衡”，“自我表现”和“放荡”。 。这些策略反映并再现了性别认同和权力关系，并提出了有关护士和护士在政策制定过程中的影响的重要问题。

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