Knowledge, technology and nursing: The case of NHS Direct
研究了英国NHS Direct护士电话咨询热线中，护士如何在实际工作中灵活运用标准化医疗软件，揭示了管理层的抽象理性与护士的实践理性之间的张力。
NHS Direct is a relatively new, nurse-based, 24-hour health advice line run as part of the UK’s National Health Service (NHS). The service delivers health advice remotely via the telephone. A central aspect of the service is the attempt to provide a standard level of health advice regardless of time, space or the background of the nurse. At the heart of this attempt is an innovative health software called CLINICAL ASSESSMENT SYSTEM (CAS). Using a number of qualitative methods, this article highlights how the interaction between the nursing staff and this technology is key to the service. The technology is based on management’s attempt to standardize and control the caller-nurse relationship. Thus the software can be seen as part of an abstract rationality, whereas how it is deployed by nurses is based on a practical rationality that places practice and experience first and sees the technology and protocols as tools.