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McMaster University
Health, Aging and Society
Elena Neiterman

Chapter 13: Nurses and Midwives in the Charging Health-Care System Nursing – The Historical Context: -refer to page 327 Nursing Today – Issues of Sexism, Managerial Ideology, Hospital Organization, and Cutbacks: -Sexism:  Doctors have usually been men and nurses have usually been women  Both historically and today, nursing refers both to a mother’s action in suckling or breastfeeding her baby and to the act of caring for the sick  Since the earliest nurses were nuns, nurses have long been called sisters  The few men who train or are educated to e nurses usually end up moving up the administrative ladder  This sexism in ideology is reflected in differences in pay, authority, responsibility, prestige and working conditions between men and women  Physicians have the advantage over nurses in all of these respects  Most nurses work shifts but the working conditions are problematic -Managerial Ideology in Hospitals:  Managerial ideology assumes that it is the job of managers to run organizations as efficiently as possible so as to provide adequate service at minimal cost -Bureaucratic hospital organization:  Opportunity consists of the available career expectations, ambitions and goals, and the probability of reaching these  Opportunities for nurses are lacking and the only way to get more is to work the way up the ladder  Power is the capacity to mobilize resources -cutbacks:  Cutbacks represent a grave threat to the public nature of the health-care sector and have had significant effects on hospitals  According to Potter et al. (2003), as hours of nursing for the patient increase: the level of patient pain decreases, the patient’s perceptions of self-care and health status increases and the patient’s post-discharge satisfaction increases  A recent study done by McGillis Hall and Kiesners, has documented that nurses are currently experiencing a great deal of job strain as a result of many factors especially overwork, understaffing and excessive overtime  72% of nurses say they do not feel safe from assault at work Nursing as a Profession: -the shift to university training:  Nurses with a degree in nursing and additional training to a level at least parallel with a master’s degree have been working as independent practitioners in many Western countries for many decades  Nurses are being encouraged through education to engage in critical thinking, independent decision-making, research, and leadership -taking over the work of the physician:  Nurses have taken over
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