Beyond occupational differences : the importance of cross-cutting demographics and dyadic toolkits for collaboration in a US hospital

Abstract

Scholars of work and occupations have long shown that asking members from different occupations to collaborate with one another is difficult because of differences in status, meanings, and expertise across occupational groups, but they have failed to consider how the demography of the setting affects cross-occupational collaboration. Our 12-month ethnographic study of two units in a US hospital demonstrates the importance of cross-cutting demographics and dyadic toolkits to cross-occupational collaboration. In this paper, we demonstrate that a social structure characterized by cross-cutting demographics between occupational groups (where occupational membership is uncorrelated with demographic group membership) can loosen the occupational identity and status order, thereby creating space for members of cross-occupational dyads (e.g., nurses and patient-care technicians) to draw on other shared social identities (e.g., shared race, age, immigration-status) in their interactions with one another. Drawing on a shared social identity at the dyad level provides members with alternative (nonoccupational) expertise, meanings, status rules, and emotional scripts that facilitate collaboration across occupational differences. These findings about cross-cutting demographics and dyadic toolkits have implications for research on cross-occupational collaboration and demography and intergroup relations.