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CARCINOMA DE MAMA

5. TRATAMIENTO DEL CARCINOMA DE MAMA

6.3 ESTUDIOS ALEATORIZADOS QUE COMPARAN QUIMIOTERAPIA NEOADYUVANTE Y ADYUVANTE

As hybrid professional public managers, DCSs are continuously negotiating their identity in complex, ambiguous organisational domains. As leaders, they balance their own identity work and struggle, with concern and responsibility for others who are trying to establish how to operate in a multi-agency, multi-disciplinary context. While there are different forms of practice and accumulated professional resources across these areas and workers, one of the more stable features in children’s services is that there is at least a broadly shared child-centred values base acting as a common point of reference. The importance of personal and professional values was discussed in Chapter Seven in relation to DCSs’ notions of identity expression and their stabilising influence; often seen to act as a ‘touchstone’ when faced with challenges and uncertainty.

In Chapters Two and Seven discussion focused on how leadership discourses, qualities frameworks and normative leadership models for DCSs - such as those produced by NCSCSL and the Virtual Staff College, can be seen as identity-targeting (Gagnon & Collinson, 2014), prescribing not only what a perfectly-constituted, high-performing, effective DCS should look and behave like, but in the Systems Leadership Model (2013), even suggesting there should be ‘ways of thinking’ and ‘ways of feeling’. Gagnon and Collinson argue that in the desire to encourage congruence with qualities and behaviours deemed necessary for the successful leader:

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Leadership development programmes and discursive practices seek to align participants’ identities and behaviours with the construction of a particular ideal leader. (Gagnon & Collinson, 2014, p.646)

Being subject to prevailing institutional and organisational leadership discourses and practices has implications for identity construction (Kenny et al., 2011; Thomas, 2009) as individuals engage in processes to make sense of their professional selves. What is interesting about some of the prevailing discourse and dominant models – as is the case according to Noordegraaf (2007, p.777) for many “rushing to professionalise themselves” – is that DCSs themselves are involved in creating, substantiating and embodying significant elements of these discursive tools. The Virtual Staff College is the ‘training arm’ of the Association of Directors of Children’s Services (ADCS) and is the main provider of leadership development, also acting as a professional resource and commissioner for research and a virtual site for professional knowledge accumulation and transfer. Sam describes the early establishment of the Association:

There were all sorts of tensions about which model to go for with the formation of the ADCS. In the end, although the old association of education directors and association of social services directors were merged, the ethos and philosophy of working has been more along social services and of course that influences the professional ideology. (Sam)

The idea of the ADCS was to create a professional membership body, focused on support for those in the DCS role and others in senior leadership roles in children’s services. Part of that support involved leadership development, but there was also an effort to set up regional support structures which mirrored the administrative regional organisation created by Government structures. It is the regional networks which most participants spoke of as a site of meaning-making in relation to their social identity (Hogg and Kipling, 2001) as a DCS. Chapter Nine explores this in more detail, as participants described either finding salience in the group, or the opposite - and actually feeling alienated and “not belonging”. This is important for identity work and struggle because self-definition in a social group context is based on how belonging to a particular social category is perceived. Chandra in particular struggled to find a ‘fit’ in the regional meetings:

It becomes more isolating the more senior you become, and being a DCS - the only one in that position in the whole authority - can leave you feeling vulnerable.

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You look to your leadership network for support. I really don’t feel like I fit in. (Chandra)

Sam acknowledged that there were particular dynamics at work in the group:

As a regional group of DCS, we’ve talked about the really different cultures our professional backgrounds bring. Some people seem more secure than others in their identity, their levels of confidence. With any professional grouping, you get that support, that strength and peer. There is a bit of a hierarchy in the wider regional group. You have to find your place, and that takes time. (Sam)

While most participants appeared fairly secure in their role identity as a DCS (Stryker & Burke, 2000; Thoits, 1991), expressing complementary and symbiotic connection to their work in children’s services, and often emphasising salience in the level of commitment they felt for the enactment of this professional self, collective efforts to organise a fluid discourse of occupational control felt more difficult to capture in identity narrative. Although Nat offered an example of how DCSs were mobilising themselves in the turbulent political and economic environment they are operating in.

In the group, our common thread is we are focused on children – on getting the best possible services in each of our areas. What we tend to do when we all meet up is place children at the centre of business ‘talk’, and as key stakeholders: I really think this reminds us all that we’re in the business of children. (Nat)

Nat’s observation was particularly insightful because DCSs frequently used this phrase ‘in the business of children’ during the narrative interviews. This could be explained as ‘languaging’, a way of colonising discourse by the professional social group of DCSs, which can offer salience and identity affirmation. Brown et al. describe this process as “seeking to appropriate and enact realities” (2015, p.265); part of sense-making acts of interpretation and actively employed in identity work to generate a common language.

It will be interesting to see how much may change in the professional group as some of the members move on (or are moved on as the case is all too often for DCSs - with one in three DCSs leaving the role either voluntarily or through dismissal, Wiggins, 2014). The first generation of DCSs were often former Directors of Education according to Alex, as they were quite powerfully positioned in local authority management hierarchies, so often stepped into the role as it was created from 2005 onwards, but

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quite quickly more and more former Social Care Directors were appointed as there was a significant gap in knowledge to deal with the statutory requirement for safeguarding children. This may explain why, according to Sam, the national membership body ADCS, was formed more “along social services professional ideology”. Alex believes that the balance is changing again:

I think the balance is shifting as a new breed of DCSs has emerged. There has been a softening, a coming together. New DCSs coming through have spent time in integrated children’s services and often grown up as an Assistant Director [of those services]. They have that different understanding. They have a language that cuts across because they are not steeped in just education, or just children’s social work. (Alex)

For now, the current DCSs are individually and in most cases, collectively, interpreting and generating a professional discourse for themselves for the present, and this is partly achieved by focusing on a positive narrative of the future where they articulate an intention to make a difference to children in the DCS role. In engaging in ‘prospective sense-making’ (Brown et al., 2014; Corley & Gioia, 2011), attempts are continually made to find identity salience and to cope with what most saw as the peculiar challenges, fragility, risk and joys of the role.

8.4 Chapter Summary and Conclusion

This chapter explored participants’ expressions of hybrid professional identity and notions of professionalism (section 8.2), reflecting on how participants often moved quite comfortably across a continuum between early career occupational learning, training and values-base, and their current identity constructs as a senior public services leader. As hybrid public leaders what it means to ‘be professional’ was seen to be defined and revised in new ways of working; especially in relation to learning how to control expertise in the ambiguous, multi-faceted organisational domain of children’s services. The second theme in part two of this chapter (section 8.3) examined influences of organisational or institutional discourses of control, and occupational discourse created and sustained by the DCSs themselves. Both were illuminative in offering new insights into how DCSs construct, revise and enact their leader identity.

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The next chapter examines some of the important emotional dimensions of what has been described as ‘the lonely posting’ of a DCS leader. Strong themes emerged from the data concerning the emotion work and emotional labour enacted in the role. These are organised around three central themes: Emotion, Resilience and (In)Security.

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9. THE LONELY POSTING: EMOTION, RESILIENCE AND