Depersonalization of Nurses in Conditions of a Bio-technologically Based Medicine

Medicinska sociologija je kao posebna disciplina sociologije najviše javnih i akademskih priznanja, te financijske i organizacijske potpore, priskrbila istraživanjem socijalnih i profesionalnih relacija koje se razvijaju u odnosima liječnika i pacijenta. Sredinom ovog stoljeća taj je odnos tumačen kao čisti interpersonalni odnos. Razvojem bazičnih prirodnih znanosti, fizike, bilogije i kemije, te tehnološkom aplikacijom tih spoznaja, odnos liječnika i pacijenta postaje višestruko posredovan. Profesionalna uloga medicinske sestre mijenja se u skladu s tim tendencijama i odlikuje se sve izraženijim procesima alijenacije i depersonalizacije. U članku se analiziraju: 1. procesi alijenacije sestara i depersonalizacije pacijenata u bolnicama koje se još uvijek ne odlikuju visokim stupnjem biotehnologijske zasnovanosti procesa liječenja; 2. Promjene koje nastaju u organizaciji zdravstvene prakse i karakteru medicinskog znanja usvajanjem novih znanja i tehnologija; 3. Potrebe za novim pristupima istraživanju odnosa medicinska sestra - pacijent, liječnik - pacijent, te medicinska sestra - liječnik, a u kontekstu subjektiviziranja tehnologije i objektivizacije zdravstvenog osoblja. Koristeći Seemanovu klasifikaciju različitih stupnjeva alijenacije medicinskih sestara u istraživanju se pokazuje da već u toku sedamdesetih godina medicinske sestre doživljavaju u procesu rada: 1. Rutinizaciju svakodnevnih zadataka; 2. Parcijalizaciju uvida u ukupnost procesa liječenja; 3. Ritualizaciju formaliziranih svakodnevnih radnji; 4. Izolaciju u odnosu na skupinu s kojom rade; Rezultat je tih procesa izražen gubitak socijalnog identiteta i profesionalne odgovornosti. Svi ti doživljaji karakteristični su za početnu fazu uvođenja visokih tehnologija u poslove koji se obavljaju sa ljudima. Zbog toga se može zaključiti da je današnji položaj liječnika u bio-tehnologiziranoj zdravstvenoj zaštiti anticipiran položajem medicinskih sestara. Obje profesionalne skupine doživljavaju promjenu socijalne pozicije od statusa subjekta medicinske prakse u status deperonaliziranih sredstava strojne ili kibernetičke obrade pacijenata. Ti procesi zahtijevaju od medicinske sociologije da promijeni i paradigmu na osnovi koje je analizirala odnos liječnika i pacijenta, i epistemu na osnovi koje je prihvaćala bio-medicinski model medicine.Medical sociology, as a special branch of sociology, has gained most of its public and academic acknowledgements, financial and organizational support, trough studies on social and professional relationships between physicians and their patients. In the middle of this century this relationship was interpreted as a pure interpersonal relationship. With the development of basic natural sciences, physics, biology and chemistry, as well as the technological application, of this notios the relationship physician-patient has become manifoldly interceded. The professional role of the nurse is changing in accordance with these tendencies and is characterized by growing processes of alienation and depersonalization. The article analyzes the following: 1. Processes of alienation and nurses and depersonalization of patients in hospitals which are still not characterized by a high degree of bio-technologically based process of treatment; 2. Changes that occur in the organization of health practice and in the character of medical knowledge by acquiring new knowledge and technologies; 3. needs for new approaches to studies on the relationship nurse-patient, physician-patient and nurse-physician and in the context of subjectivizing technology and objectivizing health personnel. Using Seeman’s classification of different degrees of alienation of nurses, the study has shown that already in the 70\u27s nurses experience in the process of work the following: 1. Everyday tasks become a routine 2. Formalized everyday work become a ritual 3. Isolation in relation to the group who they are working with. The result of these processes is the loss of social identity and professional responsibility. All these experiences are characteristic for the initial phase of introducing sophisticated technology into work which is performed with people. That is why it can be concluded that the present position of physicians in the bio-technologically based health care is anticipated by the position of nurses. Both professional groups experience changes of their social position from the status of the subject of medical practice to the status of depersonalized means of computer or cybernetic processing of patients. These processes require from medical sociology to change the paradigm on the basis of which it has analyzed the relationship physician-patient as well as the epistema on the basis of which it has accepted the bio-medical model of medicine