Professional autonomy

A researcher who conducted a study on the experiences of informal carers of terminally ill patients had difficulty gaining access to participants. In many cases this was because nurses would not refer them to the researcher without the permission of a doctor.

The AIDS epidemic is a driving force in the external policy environment, stimulating large-scale changes in health care organizations. Visiting Nurse Associations (VNAs), gendered organizations with a hundred year tradition of caring work in communities, responded to governmental initiatives with structural and functional changes. A case study of the development of the AIDS Care Program of the Visiting Nurse Service of New York (VNSNY) offers a unique opportunity to explore the exercise of strategy as health policy is translated into organizational practice.