Supplier behaviour and public contracting in the English agency nursing market.

The worldwide expansion in the use of private firms to deliver public services and infrastructure has promoted a substantial literature on public sector contract and relationship management. This literature is currently dominated by the notion that supplier relationships should be based upon trust. Less prominent are more sceptical approaches that emphasize the need to assiduously manage potential supplier exploitation and opportunism. This article addresses this imbalance by focusing upon the recent experience of the English National Health Service (NHS) in its dealings with its nursing agencies. Between 1997 and 2001, the NHS was subjected to considerable exploitation and opportunism. This forced managers to adopt a supply strategy based upon an assiduous use of e-auctions, framework agreements and quality audits. The article assesses the effectiveness of this strategy and reflects upon whether a more defensive approach to contract and relationship management offers a viable alternative to one based upon trust.

Bottom lines: the influence of government funding on 20th century district nursing practice in Australia.

AIMS AND OBJECTIVES: To investigate the impact of past government policy and legislation on the practice of district nursing in Australia. BACKGROUND: Nurses have historically been politically passive and have not engaged in the political processes of policy development. However, legislation can have profound impacts on the daily work of nurses as demonstrated in this paper. DESIGN: Historical analysis. METHODS: The archival records of six district nursing services in Australia were analysed within the political, social and economic context of the 20th century, with particular focus on the 1950s and 1970s. RESULTS: Two pieces of Federal legislation passed in 1956 and 1973, respectively, had critical effects on the work of district nurses. Both resulted in significant expansion of district nursing in Australia; neither was formulated with input from district nursing services. However, together these acts shifted district nursing from being a voluntary, charity based activity to one that was greatly controlled by government. CONCLUSIONS: Greater government funding allowed district nursing to expand beyond the capacity possible when funding was locally based, but with government funding came other restrictions related to accountability processes and expectations regarding services provided, and these had profound effects on nursing practice, including excess workloads to the point of unsafe practice. RELEVANCE TO CLINICAL PRACTICE: Nurses need to engage with the political processes associated with government policy formulation and implementation if they are to avoid placing themselves and their clients in vulnerable situations as a result of government decisions.

Marketing the municipal model: the London County Council Nursing Service recruitment strategies 1930-45.

Municipally administered, with its origins in the Poor Laws, the LCC Nursing Service could be said to have been a Cinderella Service in comparison with the prestigious London voluntary hospitals. This paper analyses the recruitment strategies of the London County Council Nursing Service within the context of the overall national situation during the 1930s and the Second World War. These can be categorised as cosmetic, reactive, innovative and pragmatic. An astute nursing leadership could use the resources of a large municipal authority to challenge the voluntary hospitals in the nursing labour market in the area of acute hospital care. The image of the acute hospitals could be favourably projected; however, local as well as national difficulty persisted in the recruitment of candidates to Cinderella services such as tuberculosis sanatoria.

Working conditions and duties of nurses in Byzantium.

From the beginning of the Christian Era, nurses in Byzantium were female and belonged to the Church. These women were called deaconesses and received no payment. Later on, there were professional nurses; the men were called hypourgoi and the women hypourgisses. Their main duties were: Psychological support of patients, everyday care of patients' bodily needs and elementary comfort, cleaning of patients and providing them with proper food, the administration of medicines according to a doctor's instructions, supervising wards when the physicians were not present, the performance of enemas, cuppings and bloodletting, the main therapeutic means used at that time, the placing of patients on the operating table and the performance of minor operations. In the present study details are also given about woking hours and the nourishment and payment of nurses.

The great divide.

In November 1937, a group of masked nurses marched through London's streets, carrying placards proclaiming their demand for improved pay and conditions. The campaign they and like-minded nurses fought was to have far reaching consequences. Trade unionism was established elsewhere in nursing, but this was to be an important first step in breaking down the hegemony of the professional associations in general nursing as well as the service's dominant culture of subordination and loyalty to a mythic but compelling vocational ideal.

Nursing's divided loyalties: an historical case study.

Using the historical version of the case study method, this research explored an example of turn-of-the-century nurses' conflicted loyalties. One training school alumnae association was examined to demonstrate that nurses acted out simultaneous loyalty to competing entities: individual graduates attributes vs. associational eligibility requirements; member vs. institutions' needs; and local vs. national nursing concerns. As a result of these divided loyalties, the nurses did not meet the alumnae organizational goals they set for themselves.