CHANGES IN MEDICINE, CHANGES IN NURSING: CAREER CONTINGENCIES AND THE MOVEMENT OF NURSES INTO CLINICAL TRIAL COORDINATION

This article considers the emergence of the career line of clinical trial coordination in the occupation of nursing and the ways in which some nurses move away from other areas of work and come to be affiliated with it. Our analysis builds on the work of Becker and Strauss, who argued that two dimensions of a career contingency are central in understanding the development of an occupational line : the local contingencies of movement in a career and the broader contingencies of occupational development. In our analysis of empirically based scholarship on clinical trials and biomedicine and interview data conducted with twenty-four nurse clinical trial coordinators, we found that the career contingency framework remains useful. However, we highlight broader social factors as central to the emergence of the occupational domain devoted to clinical trial coordination. In addition, we modify the career contingencies identified by Becker and Strauss to include "social enhancement," a contingency characterized by the elevated status associated with particular work practices and skills. Between 1930 and 1970 careers were a robust and lively topic of inquiry in the sociology of work, occupations, and professions. University of Chicago-trained "interactionists," students, and associates of Everett C. Hughes engaged in much of this work. Throughout this period scholars investigated and analyzed the careers of such traditional occupational workers as medical doctors (Bucher 1962; Hall 1948; Strauss et al. 1964), nurses (Davis and Olesen 1965), and teachers (Becker 1952), as well as attending to the experiences and careers of status groups, such as the physically handicapped (Goffman 1963), hospitalized patients (Davis 1963), dance musicians (Becker 1963), and inmates of mental asylums and other "total institutions" (Goffman 1961). * Direct all correspondence to: Mary-Rose Mueller, Department of Social and Behavioral Sciences, University of California at San Francisco, Box 0612, San Francisco, CA 94143-0850; e-mail: mrm@itsa.ucsf.edu. Sociological Perspectives, Volume 43, Number 4, pages S43-S57. Copyright © 2000 by Pacific Sociological Association. All rights reserved. Send requests for permission to reprint to: Rights and Permissions, University of California Press, Journals Division, 2000 Center St., Ste. 303, Berkeley, CA 94704-1223.