The Contraction of Social Work
This chapter describes the contraction of social work as intrinsic to understanding the story of nursing's expansion. The Forest Grove Elder Services' mandate of coordination and comprehensive management seemed like the perfect setting to showcase social work's expertise. Moreover, the Grove was mandated to hire social workers—a rarity in outpatient health care. Despite its having all the right organizational conditions, the doors of legitimacy never seemed to open for social work. Exploring how this occurred provides an opportunity to consider the relationship between nursing's professional gains and social work's losses. The chapter then shows how the logics and structural conditions that legitimate nursing's expansion are related to those that justified social work's contraction. Physician absence is undoubtedly a necessary condition for nursing's expansion; however, it is not a sufficient one. One must also understand how the NPs' incorporation of social and organizational problems into the clinic came to make more sense than having them resolved within social work.