The Nursing Process as a Strategy for a (De-)Professionalization in Nursing: A Critical Analysis of the Transformation of Nursing in Germany in the 1970s and 1980s

The nursing process generally is understood as key element of professional nursing care in Germany. This study follows this argument back to the introduction of the nursing process in the 1970s and 1980s. At that time, the German healthcare system underwent dramatic changes and economic reorganization, which can be understood as the emergence of the neoliberal rationale in Germany. The argument of cost explosion was used to restructure hospitals into enterprises that were to operate based on the logic of the market. Its cybernetic logic made the nursing process an ideal instrument to restructure nursing care. Perspectives of governmentality and critical accounting reveal the nursing process as an accounting tool which has made nursing calculable. And while German nurses valued its potential for professionalization, the findings suggest that a newly constituted accountable nursing vocation can instead be considered as de-professionalizing.