Abstract

The evolution of academic credentials is not only a technical process, but also a social one. Whereas the technical process involves skill development for the increasing technologisation and sophistication of work, the social process comprises phenomena such as power struggles and status construction. Exploring the interplay between doctors and nurses, this article analyses what ideologies, institutions and devices lie beneath patterns of powers affecting healthcare organisations in Chile, examining the extent to which academic credentials are used, on the one hand, to question established patterns of power and, on the other hand, to wield power, reshaping in the process internal logics of stratification by class and ethnicity. Drawing upon ethnographic data, the authors argue that the transformation of the nursing curriculum coupled with ongoing state reform has led to a more open attitude towards power collectively, a process intertwined with the development of a series of alliances and the performance of negotiating abilities resulting in the gradual access to high-ranking positions. This may well reflect a move from a technical component of credentials to a more symbolic component, shaping cultural expectations of capabilities and a new code of power.