Jette Ernst

From theoretical concept to organizational tool for public sector improvement: Janus-faced social capital in a hospital department

Purpose The purpose of this paper is to examine, first, how social capital was crafted and transformed from a theoretical concept to an organizational tool for public sector improvement that was adopted by a Danish region and implemented in all regional hospitals. Second, the paper examines the application of social capital in one of these hospitals and, further, in a department of the hospital with the purpose of showing how it was applied by the managerial levels and responded to by the nurses of the department. Design/methodology/approach A Bourdieusian ethnographic approach was used for understanding the local and subjective understandings of social capital as well as the wider context in which the new tool was crafted. Findings Social capital as a tool for organizational improvement was constructed in a gray zone between science and consultancy. The paper demonstrates that the application of social capital in practice is connected with paradoxes because the concept is inherently ambiguous and Janus-faced in that its official representation is “soft” and voluntary with a working environment focus yet, it envelopes concealed steering intentions. These contrary working features of the concept produce a pressure on the department management and the nurses. Originality/value The explanatory critical framework combined with the ethnographic approach is a useful approach for theorizing and understanding social capital as an example of the emergence and consequences of new managerial tools in public organizations.

Merger as field transformation: Nurses’ positioning and metaphoric journeys

ABSTRACT The integration perspective on culture that has its base in the intellectual tradition of functionalism seems to be institutionalized in the literature on healthcare mergers. In our analysis of a merger between two hospital departments, we approach culture from a different perspective, when we analyse the merger as a cultural practice developing in the intersection between Bourdieusian habitus, field and capital. We believe this framework facilitates deeper insights into the complexities of these processes. We show how the metaphors and stories told by the two groups of merging nurses are used as cultural resources in the nurses’ battles to establish distinctive group identities and positions in the new setting. Our results demonstrate that the difficulties of the merger can be explained by the field’s unsuccessful attempt at re-defining the capital that structures the work place, rather than in commonplace explanations of cultural clashes or inflexible employee attitudes.

Between change and reproduction: Profession, practice and organizational space in a hospital department

Purpose The purpose of this paper is to examine the role of organizational space in attempts at practice redesign and innovation that involve a break with the traditional professional boundaries in a recently established Danish hospital department. Design/methodology/approach Organizational ethnography combined with Bourdieusian theorization. The data used for this paper are derived from 13 months of ethnographic fieldwork. The author performed participant and meeting observations combined with interviews and the reading of internal and external documents. Findings Despite the department’s attempts at pursuing practice redesign and innovation by breaking with the institutionalized professional boundaries as well as role hierarchies, and emphasizing collaboration between nurses and doctors, the paper demonstrates how the attempts at change meet invisible impediments in practice and how organizational space plays an important yet, overlooked part in reproducing field tradition. Originality/value By virtue of Bourdieusian theorization in combination with organizational ethnography, the paper contributes with unique insights into a seldom studied part of hospital organization, which is how organizational space, rather than being a backdrop for organizational life, is constructed and used by professionals whose habitus renders this space an active component in delimiting professional work as well as the scope of change.