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.