On the Interplay between Boundary Work and Organizational Context

There is a growing interest in deepening our understanding of variations in professionals’ boundary work. How healthcare professionals work to change or maintain power and practice domains is embedded in their efforts to collaborate across organizational and professional boundaries. Drawing on a comparative interview study from the Danish eldercare sector, we explore how nurses and care workers in two different organizational contexts articulate their boundary work strategies. Our findings illustrate ways in which organizational context may influence boundary work. In one organizational context, nurses and care workers worked from separate functional units and had limited opportunities for interactions to collaborate and build trust across professional boundaries. This was linked to competitive boundary work strategies. In the other organizational context, nurses and care workers worked together in integrated units, providing opportunities to build trustful relationships and familiarity with each other. This was linked to collaborative boundary work strategies. Furthermore, we found that boundary work was not only influenced by the organizational context but also influenced the organizational context in return. The nurses in the functional units defended and created new boundaries that hindered engagement in collaborative-oriented strategies. Our study contributes by demonstrating how elements of the organizational context can influence boundary work through relational aspects, while boundary work, in turn, can influence the organizational context. This suggests an interplay between organizational context and boundary work that resembles a reciprocal relationship, potentially differing from previous assumptions in the boundary work literature. This interplay may help us better understand variations in professionals’ boundary work.