Identity as Wrapping Up – controversies at a hospice
Niels Christian Mossfeldt Nickelsen
Abstract
The aim of this paper is to provide an understanding of cross-professional collaboration and to develop a notion of professional
identity based in practice. The background of the paper is science and technology studies and more precisely actor network theory.
The method used: The empirical analysis is based on an ethnographic study in a hospice and focuses on conceptualizing the different
orderings and controversies of the cross-professional collaboration. The observations focus on how the professions identify each
other, and how certain controversies lead to specific wrapping up. This is analyzed in close relation to the making of a report
concerning the cross-professional collaboration. Findings are that “Identity as wrapping up” points to the way in which certain actors,
by other actors, are maneuvered into certain pockets in a network. Identity as wrapping up is emphasized as a way of participating,
which is closely connected to the intention to control the relation towards the other. Thus identity as wrapping up is argued to be a
strategy to optimize the situation of one’s own profession. Conclusion: This articulation of identity contributes to the actor network
literature as well as to nursing in three ways, firstly by emphasizing and conceptualizing that professional identity is negotiated;
secondly by taking a closer look at how the enrollment of a profession into a network takes place; thirdly by illustrating the strategic
positioning this comprises.
Identity, wrapping up, cross-professional collaboration, actor network theory, focusgroup interviews, nursing, hospice
1
Summary Statements
What is already known about this topic:
 Public health institutions comprise partly coupled, highly autonomous professional groups
that live in parallel worlds. Organizing is often based on form filling and detailed time
scheduling.

It is a professionally conditioned ethos that configure the participation of the professionals
and identify other professionals in certain ways.
What this paper adds:
 The paper discusses a particular kind of identification “wrapping up” By the maneuver of
positioning the other outside the core-set they are constructed as limited legitimate.

Wrapping up embrace a particular kind of participation, which is interweaved with the
intention and aim to control the other as well as optimize one’s own situation.
Implications for practice:
 The paper offers a vocabulary to analyze the specific and local negotiations and folding of a
number of different semiotic orderings i.e. professions.

The paper demonstrates that identity in a network is negotiated and that professions are
enrolled into a particular position and that this enrolment is strategic and politically
motivated.
2
Identity as Wrapping Up – controversies at a hospice
Introduction
This paper investigates cross-professional collaboration by taking a closer look at the meeting
among different professional practices at a hospice. A hospice is an institution in which cancer
patients spend the terminal phase of their lives. The paper is based on the assumption that this
intimate circumstance has particular effects for nurses, physiotherapists, medical doctors,
theologians, psychologists and others. In the paper I explore how the institutional ramifications
related to the singular profession is defined and negotiated and as such structure professional
identities.
Theoretically the study is based in science and technology studies (STS) and particularly in the
perhaps most ground breaking perspective within this frame: namely, actor network theory (Latour,
2005). In its early form actor network theory carries out symmetrical analyses and studies how facts
are constructed among scientists and are particularly concerned with the way certain actors obtain
spokesman ship (Latour, 1991; Latour, 1987; Callon & Latour, 1981; Callon, 1986; Latour og
Woolgar, 1979). A later and modified form, so-called ”post-ANT”, is interested in multiplicity and
translations among a number of simultaneous orderings (Nickelsen, 2008; Law & Moser, 2003;
Law, 2002,) as well as in the production of marginalization as well as connections among different
aspects of this multiplicity (Mol, 2002; Leigh Star, 1991).
The theoretical contribution is the delineation of a concept of identity, which articulates identity as a
particular sort of enrolment. This basic idea of the paper draws on Michaels (1996) notion of
”envelopment”, which I unpack later. The empirical observations and analysis of the paper is
3
concerned with controversies in relation to the production of a report about cross-professional
collaboration in the studied institution. The main argument is that professional identities are
performed through mutual “wrapping up”. The study is based on an ethnographic study in 20082009 at Hospice Flowerfield1 (HF).
Analytical strategy
Cross-professional collaboration as partial connection
Inspired by organizational sociology Vinge & Knudsen (2002) argue that health institutions
comprise partly coupled professions. On that ground, they maintain; generally managerial efforts in
healthcare institutions may very well be seen as detached from the assembly line-like organizing of
nursing. Organizing of nursing is often based on form filling and detailed time scheduling. On one
side this points to the possibility that cross-professional collaboration is difficult to control. On the
other side this points to the possibility that it is difficult to take part of due to ongoing negotiations
of boundaries and power struggle among professions.
The notion “cross-professional collaboration” has to do with collaboration across professional
boundaries. A number of notions are closely related for instance “multi-professionalism”, which is
typically used in health care (Ansari, Russell and Willis, 2003); “parallel professionalism” which is
typically used in teaching contexts (EMU, 2008) and “cross-organizational processes”, which is
used in consulting (Casparij, 2002; Morsing & Kristensen, 2001; Morsing & Nickelsen, 1999).
These notions articulate the yields in focusing on common tasks rather than particular professional
angles. Thus the perspective on cross-professional collaboration of this paper is grounded in an
intention to focus on multiple dimension of a working community. The point is to elucidate how
”Hospice Flowerfield” is a fake name. It is an important premise for the precarious discussion of mutual identification
that the institution as well as all participants stay anonymous.
1
4
professions conceived as semiotic and material orderings (Law, 1994) fold into each other and as
such define each other, the patients and the institution.
Network, contraction and multiple orderings
In 1986 the French philosopher and anthropologist Bruno Latour published the paper Drawing
things together. In this paper he argues that material inscriptions such as figures, texts and graphs
constitute non-human actants, which have pivotal effects in relation to maintaining certain orderings
and as such non-human actants are actively co-constructing reality (Latour, 1986). In this paper I
draw on this argument and try to get an understanding of exactly, which actants draw themselves
together in relation to palliative treatment. Thus, identification as well as cross-professional
collaboration must be seen as effects of certain contractions of networks. This discursive
perspective may appear surprising since actor network theory is exactly interested in the way in
which certain actants2 are successful in defining networks for others and maneuver humans as well
as objects into certain wished for positions in these networks. The point is that these maneuvers’
make it possible to realize the ambitions of the network constructor and produce “black boxes”
(Latour, 1999a; Callon, 1986; Latour, 1987). It may be argued that actor network theory
simultaneously instantiates a discursive perspective and an actor-based perspective. This relates to
the Machiavelli inspired conceptualization of power struggles articulated as “controversies”
between strong and less strong programmes (Latour, 1999a; 1991). In the study of crossprofessional collaboration in HF it is interesting to explore the multiple identifications, which the
meeting of a number of professional networks embraces as well as the material constituents, which
stabilize these identifications. At this moment it is suitable to draw on earlier mentioned ”post-
2
The notion actant is used to signify active entities, which in principle may be either human or non-human. The
differentiation between actants and actors are outside the project of this paper. In brief actors are actants, which have
been successful in circulating other actants in a network. See for instance Callon (1991), where he discusses
intermediaries or see Czarniawska & Hernes (2005, 8).
5
ANT”, where the interest circles around multiplicity, marginalization and translations among a
number of simultaneous orderings (Law & Moser, 2003; Law, 2002; Latour, 1999b).
Loaded networks
“Network” in actor network theory is not a thing lying out there waiting to be described. Rather the
notion of network gives attention to movements or moments of translation (Callon, 1986) and the
amount of energy the observer is able to put into the descriptions (Latour, 2005, 128-131). Thus
network may be seen as the traces left by the observer (ibid, 217). If this is contemplated in
connection with the Machiavelli inspired idea of agony, it appears that the researcher does not
simply unveil reality. Rather he/she enacts it in a partial way. Observation and description are in
other words always loaded. This is an important argument for careful consideration and
explicitation of what kind of assumptions the researcher unfolds in the field. Informed by poststructuralist feminists in actor network theory it is considered a virtue to extrapolate the presence of
the researcher (Harraway, 1991). Law (1994, 4) for instance emphasizes that he tells stories about
his own participation in the fields he studies and make explicit connections between his own
university department and the organizations he studies.
Wrapping up ”the other”
Michael (1996) proposes as earlier mentioned the notion ”envelopment”, which I unpack and
rearticulate as wrapping up in order to theorize ramification of flexible identities based on
controversies among actants in networks. In Michaels definition envelopment is a matter of
constructing the adversary in a controversy in certain ways and thus to be capable putting oneself
forward as well as controlling the relation to the other by showing certain aspects and hiding other
aspects. This notion obviously draws on Goffmann (1959). Envelopment is moreover based on
6
Collins notion ”core set” (1985, 142 in Michael, 1996). The notion of core set points to those
groups that are regarded as legitimate opponents in a specific controversy - it points to a kind of
delineation of who is part of a debate and who is outside. Michael (1996) demonstrates
convincingly how animal experiment and vivisection researchers identify opponents by delimiting
narrow categories and thus demarcates the debate they are part of with particular adversaries.
Radical groups which want to prevent cruelty to animals are for instance “demonized” and are thus
completely excluded from the debate (not core set). Others are categorized by the label ”antirationalists” or ”lack of expertise”. In emotionally oriented debates the animal experiment
researchers only participate, if they are capable beforehand to categorize their opponents as
”rational emotional”. The interesting point is that the adversaries are identified in relation to
categories (wrapping ups) in order to decide who are the legitimate opponents (the core set); who
are limited legitimate opponents and who are illegitimate opponents (not core set). Michaels’
argument is that this is a kind of control strategy used in connection with media appearance. What I
find interesting is the way in which a number of actors are maneuvered into certain positions in the
network. They are locked into positions where only a limited number of actions and
counterarguments can be made. This leads to a definition of the concept of identity articulated in
this paper. The notion identities as wrapping up in a network is meant to contribute to and to make
the notion of enrollment in actor network theory more precise. Thus, wrapping up identities in a
network articulates particular maneuvers, which are enacted mutually by a number of actors with
the intention to enroll others in intended ways, to marginalize, as well as to do strategic positioning.
The point is that actors try to maneuver other actors into certain pockets. By attributing certain
capabilities to others and define positions to them, those who wrap others up, obtain influence and
control. Inasmuch this wrapping up is part of controversies among professions their purpose is to
7
make other professions illegitimate and to strengthen one’s own profession. In this subtle way
ramifications among professions are negotiated and power and assets are potentially produced.
Empirical observations - Hospice Flowerfield
Meeting the field
HF is a well-run and well-reputed institution. There are 12 beds and 35 employees of which most
are nurses. The institution endeavors to offer qualified care and alleviation to incurable ill patients.
The through-going principle for palliation is to do it cross-professionally and with the subjective
pain of the dying person in focus. The value statement of the institution hold:
”The management sees it as its task to ensure that nursing and treatment are carried out
based in a cross-professional and total consideration of the patient and his/hers family and
based in as little professional division as possible…..palliation and treatment are done in a
way where all patient encounters are documented and evaluated by the cross-professional
personnel team”
The empirical investigation was started when the hospice manager invited me to participate for five
days in team seminars. Later the board decided to start a project on cross-professional interaction.
At HF a tradition of nurse management has emerged. Earlier managers and nurses have explicitly
been fighting for the right to lead the institution. This has lead to the fact that today there is a
heedful interaction among professions and high ambitions about cross-professional collaboration
have, as mentioned, been written into the value statement. The empirical observations that this
paper is based upon comprise the following focus group interviews, participant observation and
discussions of observations in the field.
The observation of the daily practice in the institution in connection with which I followed a
number of professionals for a day, documented cross-collaboration with a high degree of integration
among professions. This took place at conferences as well as via ad hoc around the patient beds etc.
8
In the focus groups interviews some critical articulations of the cross-professional collaboration was
articulated. It was an explicit aim in relation to the focus group interviews to understand more of
ideals and realities in relation to the cross-professional collaboration. I supposed, and rightly so, that
ideal was generally consistent with the mentioned articulations in the value statement. But the
rhetorically produced realities appeared to be far from the ideals. Those realities were generally
articulated like this: The nurses have a broad span of responsibilities and find themselves in close
and often emotionally demanding contacts with the patients and their relatives, whereas the
theologian, the medical doctor, the psychologist, the physiotherapists and the music therapist all
have relatively narrow assignments and they act in relation to a large number of patients. For this
reason they do not come close to the singular patient and their relatives. While the nurses express
frustration the other professionals seem to be content.
Cross professional controversies – why are the conferences messy?
The following four-five pages are to be read as documentation for how professional identities are
negotiated. The nurses appeal for “appreciation, respect and support” from the management. Some
nurses hold they are ”reprimanded, if they haven’t got the answer when they are asked something at
the conference”. A number of nurses maintain that morning and afternoon conferences are messy.
This leads to the fact that, ”you often waste your time, even though you are very busy”. This is
expanded by the statement that the management provides an experience ”of being unprepared, even
though this is not the case”; as well as ”to offer privileges to the cross-professionals” i.e. nonnurses. Generally the nurses find that the hospice management provides an inconvenient
”individualization culture”, where motives that are not your own are attributed to you.
Discussion of first report draft
9
After the focus group interviews and observation were carried out the researcher presented a first
draft of the report on cross-professional collaboration. This draft is taken up at a so-called
inspiration group meeting, which is a meeting where representatives from all professions meet.
Whereas the nurses find the draft interesting others seem to be less engaged. The management finds
the first draft ”problematic”. The hospice manager is absent, but has sent a letter, which is handed
over to the researcher during the meeting. The letter explains that the hospice manager is critical
towards report-draft and he proposes a number of changes. The deputy manager proposes another
focusgroup interview with the same nurses. She maintains that the focusgroup interviews do not
sufficiently elucidate the cross-professional collaboration. Rather, she emphasizes, the focusgroup
interviews underscore critical relations between the nurses and the management. Constructive
proposals are lacking.
Later the nurses inform that they are willing to go give one more interview. As soon as the hospice
manager is back he and the deputy manager discusses the agreement they have made with the
researcher. This written document emphasizes as one out of several questions that the crossprofessional collaboration project is to put light on ”How is leadership carried out in the
institution?”. The point I want to draw attention to here is the fact that the management is not able
to make them self invisible. Just before the second focusgroup interview the deputy manager calls
the researcher to tell, that the strategy has changed and the interview has been abandoned. He
invites the researcher to a meeting where the progression of this research project is to be discussed.
Criticism of first draft of the report
At the meeting the hospice management maintains that the report ought to clarify the often only
hinted examples, which the interviewed nurses take up. This should be done in order to bring the
10
hospice management to understand, which are the situations referred to, ”otherwise this is not
useful”. The researcher denies because the respondents have been promised to stay anonymous.
Then the report-draft is categorized as ”problemfocused” by the hospice management and it is
argued that the researcher, rather than pointing to possibilities, looks for problems. The
management asks for an explicitation of the researchers assumptions. Undoubtedly the managers
are worried that the researcher is becoming an ally with the frank nurses. I will return to this point.
Moreover the statements of the nurses are met with astonishment. The management has just carried
out performance review with all nurses ”and nothing of all this was mentioned”. The managers
decide that ”the other side” is missing i.e. constructive perspectives on cross-professional
opportunities. They decide to invite four new nurses for a focusgroup interview. Moreover the
hospice management proposes a so-called volunteer-coordinator should help the researcher to keep
on the interview track and lead the focusgroup in a “positive direction”.
Who gives the patient a glass of water?
In this new focusgroup interview the management is not mentioned and it is unclear what kind of
instruction the participants are given. The nurses are resigned; they lack energy and don’t have
much to say. A rude criticism of the participation of the physiotherapists is then raised; they call
them “passive” and”uncollaborative”. The physiotherapists don’t enter the patients’ room before 9
in the morning and the physiotherapists never make coffee for the conferences. The physiotherapists
keep up the attitude that the patients ought to be satisfied, clean and have something to drink before
they can have physiotherapeutic treatment. The participants offer compromising narratives such as;
the physiotherapist use the emergency call in order to tell a nurse, that one particular patient is
thirsty and need a glass of water. This leads to the fact that the nurses are unnecessarily disturbed.
Suddenly a nurse explains that she can’t stand the work relation with the physiotherapists and she
11
emphasizes, that this is very difficult to share with the physiotherapists. As part of participant
observation I witnessed the way the nurses react to “passivity”. In a specific situation a
physiotherapist is asked in a strict tone to find out to whom a wheelchair belongs. In another
instance the nurse simply agrees with the patient about a particular physiotherapeutic treatment and
instructs the physiotherapists what to do. Not surprisingly this creates frustration and the
physiotherapists emphasize that this leads to mistakes and treatment errors.
Overgroup and undergroup
At a later inspiration group meeting the third report-draft is discussed. A certain passage is taken up,
which articulates the formal organization of cross-professionalism as an “overgroup” versus some
“undergroups”. This articulation is common among nurses and refers to the existence in the
institution of four nursing teams i.e. mono professional teams versus a so-called ”crossprofessional team”, in which all non-nurses take part. The report-draft queries this organization and
constructs it like this: Every year the cross-professional team spends three days at a fashionable
seaside hotel, while the nursing teams are offered a work day in combination with a dinner at a
near- by restaurant. A nurse confirms she sees this as problematic. Then the hospice manager raises
his index finger, points to the nurse and maintains that her view is “too narrow”. He explains that
the stay at the seaside hotel is important for the coordination of activities across professions. After
this meeting I talk with the manager. He thinks the nurses are emotional. They ought to be proud of
their discipline as well as the central role in the palliative effort, rather some of them are envious, he
states. The hospice manager refers to the continuous appeal for appreciation and articulates this as
“lack of maturity”.
Analysis – identity as wrapping up
12
I am aware that this presentation appears critical toward the management. That is not my intention. I
am convinced that the management does a good job. The empirical sequences of events document
the way the professions wrap up each other. The wrapping up of the report and the researcher as
”problemfocused” may be seen as an effective identification, which draws legitimacy out of the
report. When somebody is ”problemfocused”, they see problems and thus according to the hospice
management they don’t see what is important; possibilities. This may be the way the hospice
management endeavors to wrap up the researcher and thus maintains appreciation of the
management of the institution. ”What are the assumptions you bring with you?” the hospice
manager asks the researcher. The importance of this question is emphasized by the analytical
strategy of this paper. The answer is that the package is not simply brought with him rather it is
produced during the sequences of event as well as during this writing. The researcher develops a
kind of sympathy for the nurses because he also experiences this kind of identification; “not to be
prepared well enough even though this is not the case”. The hospice manager critically “drills” into
exactly which observations a given conclusion refers to; nothing can be discretional. The argument
I am making here is that wrapping up is a sort of enrollment, which elucidates that the hospice
management disagrees with the report; secondly because it draws attention to the ambition to tear
the analytical strategy apart and reveal the report as “half a truth”. During the meeting with the
hospice management I became aware that this wrapping up of the researcher is in resonance with
the sort of wrapping up the nurses protest, when they explain “you feel humiliated”. Thus the
researcher is placed outside the core-set because he “sees problems”. This is strengthened when the
manager proposes that the volunteer coordinator should help the researcher to lead the interview in
order to describe “the other half”. This is close to what a nurse points to when she states ”you are
talked to as somebody who are not capable of the contact with the relatives”. If somebody is
convincingly identified as problemfocused this person will hereafter be seen as problemfocused!
13
This is the case for nurses too. They are placed outside the core set. If you are wrapped up as
somebody who pleads for appreciation, what comes from you will be contemplated as appreciationpleading and thus have limited legitimacy?
This point back to Michael’s vivisection researchers, who defend themselves against animal welfare
groups by acting strategically. The wrapping up in HF may just as well be contemplated as elements
in a mutual political positioning, which has to do with obtaining control in relation to others by
presenting others in a certain front stage set-up (Goffmann, 1959). More or less the same is repeated
at the inspiration group meeting. The articulation of an ”overgroup and some undergroups” in the
report and the confirmation by a nurse as well as the pointing index finger of the hospice manager
and his uttering that ”it is too narrow to see it that way” becomes a positioning of the nurse outside
the core set. This wrapping up categorize the opponent in the controversy as ”immature”, ”envious”
and ”emotional”. If the opponent is identified successfully, then it is not so important to listen to the
opponent - and wrapping up is documented to be an effective enrollment strategy.
Mutual wrapping up as tensions and agony
As is often the case in actor network analyses the management is positioned centrally. But the
strategic wrapping up of the opponent takes multiple directions (Leigh Star, 1991). The
transformation of the network, which can be observed during the interview with the four new
nurses, is particularly illustrative. The collaboration with the physiotherapists is identified to be
very problematic. In this interview this is an interesting shift in relation to the last focusgroup
interview with nurses, where it was first and foremost the hospice management, which was
identified as a difficult collaboration partner. Whilst the academics are more or less left in peace,
the physiotherapists are continuously criticized. The nurses regret that the other professions must be
14
persuaded to participate actively in the alleviation of patients. They wonder why other professions
do not act more ”responsible”, ”enterprisingly” and as ”a driving force”. The physiotherapists for
instance are identified as “provocative”. Whilst the physiotherapists are a part of the so-called
cross-professional group (the uppergroup), the nurses are involved in all basic palliative care of the
deadly sick patients; personal hygiene, service in relation to food and drinking, medication;
conversations as well as cleaning. The tension in this relation, I argue, is made obvious by way of
the material constituents. The physiotherapists have their own office with a desk, a computer and
massage couch. They participate in the cross-professional group and offer treatment to the patients
based in professional discretion. In opposition; the nurse are forced to run around with the feces
tray, the service tray, and medication pump. The wrapping up of the physiotherapists as “passive”
possibly has the effect, to strip and disarm and perhaps even harass the exclusive and not very
powerful physiotherapists.
Thus the nurses clearly wrap up the hospice management as well the physiotherapists in substantial
ways and place them outside the core set. This is articulated only behind closed doors. I see this as
documentation for the existence of a remarkable tension. This is not a tension that they are able to
take up at conferences. This is the case in spite of the fact that the afternoon conferences have been
designed to take care of pressing issues. I spite of the fact that the management is criticized for lack
of structuring they argue that they intend to continue to keep clear the afternoon conferences for
issues, which occupy the professionals. The tension among professionals seems to indicate that the
sharing of pressing issues is pivotal, but also that this opportunity is not yet yielded fully. This may
be seen as a consequence of the fact that the nurses place the management as well as the
physiotherapists outside the core set.
15
Tensions as difference in rhythms
Since a number of parameters point to a well-managed institution, the institution for instance has a
very good reputation in the local environment and the patients and relatives claim to be satisfied
during and as well as after the stay; I find it paradoxical that strong controversies are articulated in
the focusgroup interviews. The tensions among nurses and physiotherapists may be observed in
practice as difference work rhythms. The nurses are busy and they have difficulties in being ready
for the afternoon conferences. They also have difficulties in finishing when the work day ends.
They spend a lot of time reacting on alarms and questions from patients and relatives. In opposition
the other professions keep the freedom to plan their work-schedule. My argument is that tensions
has to do with the fact that nurses carry out the basic, time consuming alleviation work, whereas
other professions contribute with a narrower professional profile.
Criticism of the developed notion of identity
In this paper I have developed a notion of identity inspired by Latour and Michael; ”identity as
wrapping up”. The degree to which those wrapped up identify themselves with exactly this kind of
identification is not part of the analysis. It may be argued that this notion appear to be close to
discourse analysis (Harre, 2004) and perhaps even closer to discourse analysis than to sociology of
associations. The point is that language rather than practice, actual condition and materiality are the
analytical starting point. Critically, the notion may be said to point to cross-professional
collaboration as this is experienced – not enacted. This means that the analysis does not so much
relate to the heterogeneous practice of care. In Latourian terminology this becomes sociology of the
social, which is not predominantly interested in following associations among human and nonhuman actants. Exactly this point is put forward by Michael. He argues it is an asset that
envelopment as an analytical tool is apt to carry out actor network analyses based on an interview
16
material (1996, 102). In this study it is predominantly the focusgroup interviews that constitute the
empirical basis. This is the case in spite of the fact that the analysis take up a number of material
constituents observed in practice. Within an actor network theoretical frame these are coconstitutive and have stabilizing effects in relation to the wrapping up identified. The feces tray, for
instance, strengthen the wrapping up of nurses as undergroup; just as office and couch stabilizes the
wrapping up of physiotherapists as overgroup.
Conclusion
Public health institutions comprise autonomous professional network. It is maintained that it is
professionally conditioned ethuses that configure the participation of the professional entity (Hein,
2007; Kragh Jespersen, 2004). These ponder points to the question of how professionals identify
other professions and thus define mutual engagements. This paper explores how identities are
constructed at a hospice in Denmark. The theoretical contribution is a notion of identity, which at
the same time draws on and contributes to actor network theory. ”Identity as wrapping up”
elucidates the way particular actors by way of other actors are maneuvered into pockets in the
network, where action possibilities and arguments are narrowed in. Wrapping up embrace a
particular kind of participation, which is interweaved with the intention and aim to control the other
as well as optimize one’s own situation. By the maneuver of positioning the other outside the coreset they are constructed as illegitimate. Identity as wrapping up is thus apt at analyzing the concrete,
specific and local negotiation of a number of different orderings and ramifications i.e. professions.
The empirical observations has to do with the way professionals identify one another in
controversies and how these controversies lead to particular wrapping up while working on a report
on cross-professional collaboration. The management is wrapped up as ”non-appreciative” and
”unstructured”, which leads to the fact that the researcher and the report are wrapped up as
17
”problemfocused”. The physiotherapists are wrapped up as “passive” and the nurses are wrapped
up as “emotional” and ”immature”. The argument is that wrapping up points to tensions among
professional groups, which may also be observed in different settings in public health and which
connect to embedded traditions for professional autonomy (Nickelsen 2010). In the studied
institution the observed wrapping up reflects different work rhythms, competences as well as
unfolding of agony and marginalization. Wrapping up may be seen as translations among
professions, which has also to do with the interesting and paradoxical observation that nursing is a
most powerful profession, but at the same time the nurses define themselves as the undergroup.
The notion identity as wrapping up contributes to the literature on actor network theory in the
following three ways. Firstly by emphasizing and conceptualizing, that identity is negotiated and
may very well be analyzed as an outcome of heterogeneous contractions in a network; secondly by
offering nuances and put light on how the enrollment of a profession in a network takes place; and
thirdly by illustrating the strategic positioning, which this comprise by defining multiple positions
in networks based in particular interests and agendas as well as in agony and wishes to control.
18
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