Hospital Social Workers' Boundary Work in Paediatric Acute Wards-Competitive or Collaborative?

Abstract

Recent research suggests that the notion of boundary work can improve our understanding of interprofessional tension and collaboration in health care, yet hospital social workers (HSWs) have not received sufficient attention in this area. Using boundary work as a theoretical framework, this article investigates HSWs' boundary work in interactions with other health care professionals in paediatric acute wards. The data were based on in-depth interviews with nineteen HSWs at hospitals in Norway about their experiences with interprofessional collaboration. Based on their situated narratives, abductive analysis was performed, using the conceptually distinct but inter-related forms of competitive and collaborative boundary work that are grounded in Abbott's framework of jurisdiction. The findings demonstrate how HSWs construct, defend and extend boundaries to create distinctions between themselves and others, and how they sometimes adapt and downplay boundaries in order to achieve common goals and perform their work. As a facilitator of this process, the HSW might be viewed as a boundary subject. This, in turn, can result in optional and intentional ways for HSWs to carry out boundary work. There is reason to believe that, the less specific educational requirements and role guidelines, the more important these mechanisms become.