Professionals in Bureaucracies: Autonomy vs. Integration

Abstract

The intent of the Banff Conference is to bring nurses from the areas of service and education together to examine some of their major conflicts, compatibilities, and common problems in relation to their ultimate aim of improving the nursing care of patients. On the premises, first, that the roots of many of our problems lie in the larger phenomenon of professionals working in bureaucracies, and second, that we can more ably examine the relationships of practitioners and educators if we keep such dynamics in mind, I should like to focus upon the tendency of large-scale organizations to try to integrate the professionals into their goal structures, and the tendency of professionals to behave as autonomous individuals and groups, regardless of the particular aims of the bureaucracies in which they work. Throughout, attention will then be given to nursing service/nursing education implications. Many negative words are associated with the term bureaucracy, among them: red tape, depersonalization, rigidity, rules, regulations (1), and to a considerable degree, these negative associations are well deserved, as very often it seems that bureaucracies function and develop impeti of their own without regard to the goals to which they are purportedly committed (2). I remember one story told by Peter Drucker, pertaining to the Second World War, in which the R.A.F. bombed a very important German factory. The factory was designed like a wheel. The administrative tower was in the center of the wheel and the munition plants were located in "spokes" radiating out from it. While the R.A.F. managed to knock out all the munitions plants, the administrative tower remained undamaged. Apparently it