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Week 10 - Nursing Profession.docx

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Rhona Shaw

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• Nursing Profession • nursing is – A gendered occupational ghetto for women – Is subordinated to the medical profession • nurses make up approx. 2/3’s of all medical care­givers – Approximately 90% of all workers in nursing are women nd – 2  female concentrated occupation is clerical work • small but growing number of men now working as nurses, however are over­represented in: – psychiatry – critical care – emergency – administration • Development of the Practice of Nursing • early nursing a private affair • usually performed by unpaid family member or paid family helper – Was part of the domestic economy – Linked to women’s roles as care­takers, nurturers – early founder of professional nursing (1860) – Florence Nightingale – stated that  “every woman is a nurse”  • Argued that women should not aspire to be doctors – Because nursing meshed with women’s “natural” abilities  • Development of Nursing • Nightingale envisioned genteel nurses – running hospitals as domestic managers – but who were to be completely supportive of & subordinate to the docs • Doctors were analogous to male heads of household • nurses were expected to be – Deferential, nurturing and submissive – while at same time taking an active role in patient’s care • study (1960’s) Doctor – nurse game – found series of strategies used by nurses to communicate their recommendations to docs  – but w/out appearing to do so • Development of Nursing • also found strategies used by docs asking for nurses recommendations w/out appearing to do so – (we will discuss this during week 11 – next week) • although recent studies show nurses to be more assertive than before 1960s: – Changes in doctor­nurse relationship occurred more in nurses behaviour than doctors – Emphasis on womanly qualities remains an ideological hindrance to professional  recognition  – this lead nurses to seek a distinctive way of relating to patients • Are expected to care – do emotion work • this in contrast to impersonality of biomedical model – 4 Approaches to Critical Research on Nursing Work • 1. Patriarchal/sexist nature of work – And the nurses’ location within medical labor force • 2. Impact of managerial evolution in nursing practice • 3. impact of hospital bureaucracy on – the working lives of nurses – & on patient outcomes • 4. impact of cutbacks on nos. of nurses • & safety & quality of nursing work • we will look at approaches 1 & 2 • Patriarchy/Sexism • sexism systemic in medical work place – Organizational structures based on gender hierarchy • There is a gendered division of labour • until recently (1970s), docs have traditionally have been male – & nurses female – Sexuality of male nurses suspect – except if in more masculine domains (involved physicality) • the role of the nurse is closely connected to – Cultural ideas, values and beliefs about the nature of women – & women’s social roles • to care physically & emotionally for others • Patriarchy/Sexism • From the very beginning nurses were to be subservient to doctors • a powerful ideology existed that nursing was a calling – only a certain type of woman was suited to work as a nurse – Nursing one of a few respectable occupations for women – seen as an appropriate preparation for marriage – did not challenge cultural norms of women’s work • Also powerful is the notion that the ability to provide caring nursing is innate – it cannot be taught or learned  – this idea remains today – only certain personality types make good nurses • Patriarchy/Sexism • thus various aspects of a woman’s character important to good nursing care & should include the  traits of: – selflessness – Devotion to others – Obedience to those in authority • entrance requirements of nursing schools included an interview in which these characteristics  were evaluated – To be a nurse a woman had to be successful at being a woman – A woman’s moral character was always under scrutiny  – there could be no sex scandals • student­nurses were expelled from school, nurses fired – curfews & strict hemlines were enforced – however, image of sexy nurse popular • Patriarchy/Sexism • however, women not w/out power ­ worked around these issues  – Used their feminine “wiles” to their advantage when dealing with male doctors and  administrators – some used their femininity/sexuality & charms – others used deference  – however,  “It all ended with pantsuits.” (1970s) • systemic sexism also noted in the behaviours & relships between nurses & docs & is reflected in: – Significant differences in pay – authority – responsibility – Prestige of occupation – & working conditions • Patriarchy/Sexism • docs have an advantage over nurses in all respects – Even if doctors are incorrect in their diagnosis or treatment, nurses are not allowed to  correct them – this seen as insubordination • Impact of Managerial Work • Majority of nurses work in hospitals • majority do shift work – work hours are rigid rather than flexible – work either 8hr or 12hr shifts • Are limits to what kind of work nurses can do – types of procedures – taking blood, blood pressure – work is repetitious & time consuming – decision making powers limited – doctors determine • Historically nurses were paid low wages (1971­1987) – pay raises failed to keep apace of cost of living – starting salary for RN in hospital setting $50,000 • ceiling is around $80,000 – is less for non­hospital nurses ­ $42,000 ($21.75/hr) • Impact of Managerial Work • Work environments are also dang
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