Has Feminism Abandoned Nurses?

Nurses Activism

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Waitresses, sex workers, mothers, child care workers....all are included in the welcoming arms of a feminist ethos that values the work of women in society. Women in historically male occupations such as lawyers, physicians, business managers, and such are allowed entry, too.

But not nurses. Why?

Misogynistic stereotypes of dumb nurse-sexpots abound in Halloween costumes , television , and even in

. It's pretty plain that the profession takes its hits for being female-dominated, intimate, and, in many ways, downright unpleasant . The work of nurses is the traditional work of women: personal, caring, and intellectual simultaneously, without a great deal of prestige or recognition. Nursing embodies precisely the sort of roles that should fire up feminists' advocacy engines.

Yet feminist media do not feature articles about support and empowerment of nurses, the largest group of health care providers. A search of feministing.com, for one, revealed a smattering of articles, mostly about lay midwives (who are not nurses) and breastfeeding. My subscriptions to B*tch and Ms. do nothing to make me feel included in feminism as a professional. As an artist, a woman, a wife, a reader, a listener of music and a daughter - yes. But nothing about life as a nurse.

Nurses' workplace horrors rival those of the most mistreated workers anywhere. We face high rates of work-related injury, suboptimal staffing and mandatory overtime (in addition to the less-avoidable weekend, night and holiday shifts and exposure to hazardous body fluids and chemicals). If feminists supported the 2.6 million registered nurses in the United States, would it remain a dirty secret that 69 - 85% of nurses report having experienced sexual harrassment (mostly by physicians) on the job? (see Valente, 2004).

Nurses are, in many ways, the solution to health care reform. Why aren't feminist organizations telling the public that, for example, better funding for educating advanced practice nurses (APRN) to provide primary care would save health care dollars? APRN students in Seattle undertook a media campaign when the University of Washington increased their tuition to equal that of medical students, but feminist magazines and websites missed the story entirely. No matter that nurses pay our own way through graduate school because of lack of federal funding. No matter that medical residencies receive 375 federal dollars for every 1 dollar spent on nursing residencies (despite the much greater numbers of nurses needed in health care and the 27% rate of one-year turnover among new nursing graduates.)

Even the willingly ignorant cannot help but hearing of the critical nursing shortage . Much of the shortage is attributed to nursing faculty shortages caused by persistently low faculty salaries. A graduate education in nursing does not bring with it proportional increases in compensation. Most nurses remain educated in 2-year community college programs because there is a lack of drive for better-educated professional nurses, even though research shows better patient and organizational outcomes when nurses have more education. Nursing' recent emphasis on doctoral education for advanced practice nurses was met with opposition from the medical community, who apparently consider highly educated nurses a threat.

So, in nursing we have an underfunded, under-appreciated caring profession that gets little recognition and encounters active opposition to efforts to advance our status. Ninety-three percent of us are women. We place ourselves in both physical and psychological danger to nurse. We swim upstream to advance our educations. We work strange hours, skipping meals and breaks because employers do not staff adequately. We are customarily called by our first names, but we call our physician colleagues "doctor." Resistance in the hierarchical systems that exist in health care settings is met by firings, harrassment, and legal action for nurses.

What about this makes the nursing profession worth ignoring to feminists? Are feminists, too, buying into the stereotype of nurse as feckless doctor-servant? Is the whole nursing mess so hard to manage intellectually and emotionally that even the brave and smart are afraid to enter? Or are nurses viewed as so complicit in our own oppression that feminism can hardly be bothered?

Whichever, it's time feminists started paying attention.

Valente, S. M., Bullough, V. (2004). Sexual harassment of nurses in the workplace, Journal of Nursing Care Quality, 19(3), 234-241.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Moogie, I really appreciate your thoughtful response to my questions and concerns. I know I am way out of my league here on the theory aspect of nursing.

First, my point about Marcus Welby wasn't to talk about the paternalistic aspect of the doctor image of the day, it was to point out that medicine doesn't have a uniform minimum entry point. A GP having not gone through a residency could perhaps be compared to an ADN. Yet the profession as a whole is respected by the public, and a GP is not excluded from the large physician lobbying groups. I didn't intend it to be a comparison of the doctor/nurse male/female relative roles, either. I agree that the role of the Nurse Practitioner is answering the need for a less hurried, more personal type of care, which is how I saw the Marcus Welby character. I seem to recall another TV series of the day, "Julia" which took on two entrenched stereotypes, and I love the stories of Sister Kinney and other decidedly un-handmaidenish nurses. They may have been few, but it is heartening to know that the trail-blazing started decades sooner than the modern American feminist movement.

I probably shouldn't have used the catch-all term Marcus Welby doctors. I do remember quite clearly that any veteran GP who would not or could not complete a Family Practice residency were instantly devalued by their colleagues. I saw it happen.

I think we are talking about at least three issues here at once. Minimum entry level education for nurses, gender-related occupations throughout history, traditional male/female relationships, and the two related biggies, what type of, (if any) unions should nurses have to address the relative deterioration in working conditions, pay and benefits for nurses.

Now, I am seeing nursing in the midst of a transformation that will probably, and hopefully catapult us out of the woman-nurse/man-doctor dichotomy. I have been amazed at the trending diversity of people entering this profession. It isn't only males entering nursing, if I may be so blunt as to say, stereotypes other than gender are also falling away, and that will only serve to advance all of us and hopefully eradicate in time the dual fronts nursing has had to fight.

Thanks again for your reply and the book suggestions!

Specializes in Gerontology, nursing education.
Moogie, I really appreciate your thoughtful response to my questions and concerns. I know I am way out of my league here on the theory aspect of nursing.

First, my point about Marcus Welby wasn't to talk about the paternalistic aspect of the doctor image of the day, it was to point out that medicine doesn't have a uniform minimum entry point. A GP having not gone through a residency could perhaps be compared to an ADN. Yet the profession as a whole is respected by the public, and a GP is not excluded from the large physician lobbying groups. I didn't intend it to be a comparison of the doctor/nurse male/female relative roles, either. I agree that the role of the Nurse Practitioner is answering the need for a less hurried, more personal type of care, which is how I saw the Marcus Welby character. I seem to recall another TV series of the day, "Julia" which took on two entrenched stereotypes, and I love the stories of Sister Kinney and other decidedly un-handmaidenish nurses. They may have been few, but it is heartening to know that the trail-blazing started decades sooner than the modern American feminist movement.

I probably shouldn't have used the catch-all term Marcus Welby doctors. I do remember quite clearly that any veteran GP who would not or could not complete a Family Practice residency were instantly devalued by their colleagues. I saw it happen.

I think we are talking about at least three issues here at once. Minimum entry level education for nurses, gender-related occupations throughout history, traditional male/female relationships, and the two related biggies, what type of, (if any) unions should nurses have to address the relative deterioration in working conditions, pay and benefits for nurses.

Now, I am seeing nursing in the midst of a transformation that will probably, and hopefully catapult us out of the woman-nurse/man-doctor dichotomy. I have been amazed at the trending diversity of people entering this profession. It isn't only males entering nursing, if I may be so blunt as to say, stereotypes other than gender are also falling away, and that will only serve to advance all of us and hopefully eradicate in time the dual fronts nursing has had to fight.

Thanks again for your reply and the book suggestions!

You are most welcome! I really appreciate your thoughtful response and willingness to engage in discussion. One reason I love AllNurses is that I love seeing things from the perspective of others and feel so encouraged that we do treat each other with respect here.

I think you are absolutely correct when you say that when we're going in three different directions in this thread. I see the male/female dichotomy as inherent to feminism and blazing trails for human self-actualization in that we can be free from traditional roles. I think what is discomforting to some feminists is that nursing is still seen as a traditional female role---and there are some feminists who can't get their minds around the fact that some women might CHOOSE a traditional role. To me, true liberation is allowing people to be who they want to be and if they want traditional roles, in the family or the workplace, that decision should be respected. I consider myself to be a feminist but I chose to be a SAHM for several years and definitely felt a lack of respect for my decision from acquaintances who chose to work outside the home and who judged me as being brain-dead for wanting to stay home with my kids. I certainly did not judge them for their choices so I felt very disrespected when they belittled my choice. So maybe similarly, there are ardent feminists who dismiss nursing as a career choice because they can't understand why a woman might chose such a role.

I have also met feminists who don't like the presence of men in nursing because, as one once told me, "they take all the positions of power". I have a fundamental problem with that attitude because if women are free to have career choices, so too should men. I am glad to see more men in nursing because they offer a different perspective and are breaking the stereotype of nursing as "woman's work". I agree completely with your statement that diversity in nursing and breaking down these stereotypes will help us all.

Maybe the issues of unionization and entry to practice are not central here---though I would hope that getting some sort of agreement in those two issues would lead to more cohesiveness in nursing and more respect for nursing. In terms of unionization, it seems that in so many cases, nurses are powerless against a system that can fire someone at will. Looking at these boards and the stories of nurses who have been mistreated by their employers, it is clear that we are not respected by administration and that we're seen as expendable. It bothers me to think that a human being is considered to be an expendable resource. Someone once told me that nursing is not a separate charge in the hospital bill---we're considered to be part of the "room charge". Good grief. That has to change and maybe unionization is necessary to get management to be more open to the needs of nursing.

Right now, of course, this whole management disrespecting nursing thing has gotten way out of control because of the recession. Some employers are using the recession as an excuse to fire experienced, more expensive workers and others are using it as justification to not hire new nurses. We are losing the new grads of the last couple of years because of the shortsightedness of the bean counters who make decisions about nursing without knowing a thing about nursing. Will unions help? I don't know if they will change things but I do know we can't go on as we are, with management having the power and the nurses being viewed as a resource somewhat less important than the furniture in patient rooms.

Re: the entry to practice, I guess I see it as another issue of respect because as it currently stands, the multiple practice levels pit us against each other as we each strive to defend our choices. When I was a new AD grad, I saw that many diploma grads didn't think much of ADNs and thought even less of BSNs. When I got my BSN, I saw how some ADNs resented BSNs (yes, even among my AD classmates there were hard feelings toward those of us who chose to go back to school.) I've seen RNs view LPNs and CNAs with disrespect bordering on contempt and the LPNs and CNAs, in turn, feeling resentful of the RNs. We have wasted so much time and entire generations of nurses spinning our wheels over entry to practice. Either let's do it and not argue about it for the next 45 years or let's fuggedaboutit and learn to live with the consequences of multiple entry levels (such as a lack of respect and understanding from the pubic and other health professionals). Either way we have to move on and quit wasting our energies. I just don't see how nursing can progress as a real profession, though, until we get real about nursing education and quit starting up all these new ADN and LPN programs---particularly when employers in hospitals are hiring fewer of these grads because of wanting magnet status and such. To me, it's irresponsible of these schools to be promising the moon and stars to prospective students when these are the new grads who are having the most trouble finding employment. In my area, there's a proprietary school that is running an ad for its LPN program and quoting statistics that the demand for nurses is expected to rise 600% in the next few years---while the local hospital is seeking magnet status and quietly not hiring LPNs or ADNs. Oh, yeah, and tuition for this school is around $30,000 for an LPN program. angry-smiley-054.gif Meanwhile, budget cuts in state schools are eliminating the entry-level BSN program at a local college. To me, this is so bassackwards because the BSN grads stand a chance of getting jobs in the local hospital whereas the LPN grads who spent $30,000 on their education are going to find themselves relegated to LTC hell (and in this area, there are pretty hellish LTC facilities.) :banghead:

Anyway, I once spoke with a lobbyist for a state nursing organization who said that the legislators in that particular state had very low opinions of nurses and thought of us as a bunch of disorganized, bitter, infighting women (yes, in spite of men in the profession) and they admitted to this lobbyist that their negative perception of nurses made them less open to concerns expressed by nurses. I honestly believe that getting our stuff together regarding the entry to practice issue might help us to be more cohesive and give us the professional legitimacy we need to get things done and not get left behind in terms of deciding health policy---and the future of our profession.

Thank you again, nursel56, for a great discussion!

Oh wow I think I'm going to love nursing because I always thought inside a little box...Example: Dr=male and RN=female... My mother is a RN and never thought that males could be nurses or should i say respected in that field! Really how I look at things now is its a new dawn and a new day and I think everyone can do WHATEVER they set their mind to. So yea sexism is out there but so is racism and every other "ism" known to the human race. We may not be able to change people and their outlooks on things but we dont have to give it any energy either.

First, my point about Marcus Welby wasn't to talk about the paternalistic aspect of the doctor image of the day, it was to point out that medicine doesn't have a uniform minimum entry point. A GP having not gone through a residency could perhaps be compared to an ADN.

But medicine does have a "uniform minimum entry point" -- every physician in the US, whatever other residency or other degree(s) s/he may have completed, has completed an undergraduate degree and four years of medical school. They get licensed as an MD when they finish medical school -- the residency may be a necessity in terms of the public's and hospitals' expectations, but it's not a requirement for licensure or practice. They are eligible for licensure as MDs when they finish med school, before they do any residenc(ies), and any additional education they complete doesn't affect or change their MD license.

Comparing a med school grad with no further education/residency/fellowship to an ADN grad is probably a v. good comparison. V. few physicians would even consider going into practice with "just" medical school, but there's nothing legally stopping them from doing it -- it is the minimum level of education required to practice as a physician, just as the ADN is the minimum level of education required to practice as an RN. Yet, the majority of US RNs are happy to practice their entire careers with just the bare minimum of nursing education, and don't see additional education as being of sufficient value to justify an investment of time or money. Is it any surprise that society doesn't take us seriously as professionals, when we (as a group) appear to not take ourselves v. seriously as professionals?

Specializes in peds, vent, home health, private duty.

But you can't compare the CBest to the Nclex.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I agree with you both Moogie and Elkpark about the LPN/LVN situation. I'm not familiar enough with the ADN programs to comment, though. When I went through LVN school in the mid-seventies, we were still being hired in acute care hospitals at numbers rivalling RNs. My first three years of nursing were at Children's Hospital of Los Angeles where I worked for a year and a half on a unit of 0-18 monthers, and another year and a half floating to all the units. Floating wasn't my choice but the experience was great!

We didn't hang IV meds, usually the interns on the floor started the IVs, and later they created an IV team comprised of LVNs!! I catch flack from people sometimes when I tell them that the chances of working someplace like Children's or other large acute care hospitals as an LPN/LVN are pretty slim. From where I sit, there are very few jobs like that left! Honestly, unless someone wants to work in an LTC, or needs to be out makiing money very quickly, it is far better to become an RN.

Like you Moogie, I left nursing to be a SAHM for a while and moved to Colorado for 10 years. I returned in 2004. I didn't experience a gradual change. I left. I came back. The differences to me are really disturbing. There has been deterioration in pay and benefits adjusted for inflation and cost of living. There is a deterioration, I think, in the respect given to nurses by both hospital administrators and the public. The whole "customer service" trend in particular makes me see red! I honestly think this causes the public to view nurses as less-than professionals. When a nurse is forced to say, through an uncomfortable grimace, a pre-written catch-phrase- what would the average person think? Probably that their nurse is either servile or crazy. Gold sticky stars on badges for extra good service? I think I'd rather have Nurse Ratched as my nurse thank-you-very-much.

I've talked before on this forum about my experience when the unions attempted to organize our hospital. It was pretty heated. Lots at stake on all sides. The reason the union lost, was that the hospital management could truthfully say that their wages, benefits and retirement plans rivalled those offered by the unions. Management stressed their committment to the nursing staff and they followed through.

I don't know why or how, or who is to blame, but I feel now that compact is broken. I feel for the new grads now. You are right. I don't feel the schools have been honest as to what the reality of the job market will be, and they continue to entice and pump more and more people with less than the BSN into the system.

I enjoy these thought provoking discussions, too. Gives me a chance to clarify my own thoughts (to the extent that is possible :) )

I think the problem is less with nursing and more with the downturn in the feminist movement. The feminist movement since the seventies has moved away from a mass based movement towards a lobbying body trying to raise the glass ceiling. The feminist movement is dominated by the perspectives of wealthy women and their allies. Nursing issues are deeply embedded in gender and our class. Taking on class issues comes into conflict for many in the feminist movement. We need to reinvent the struggle against sexism and exploitation. We need to build a movement of working class women and men who can challenge hierarchy in the workplace through direct action.

Although economic status has been addressed in reference to the feminist movement of the '70's, no one has addressed where nurses come from on the economic ladder-especially when comparing nurses to teachers. Nurses in the past usually were considered "blue collar" (or, pink collar, if you prefer). My parents, both teachers, were horrified by and refused to allow my oldest sister to be a social worker-which was a step or two above a nurse in the social ladder. Most teachers have not only had more education, but tend to come from middle-income and higher-income families. Many nurses come from economically disadvantaged backgrounds and are just grateful to have a job that pays for food, clothing and shelter. This is encouraged by a welfare system that subsdizes the economically disadvantage woman (maybe men, too-I don't know) into a two-year nursing program so that she can support herself and her family. A woman who has worked one or more minimum-wage jobs to support her family isn't inclined to make waves-she just wants a job. She can't afford to be a feminist.

Teaching was an acceptable way for a middle-class woman to make a living in the mid-1900's, especially if she did not marry. Some of thse women had home backgrounds that valued education, intellectual discussion, and social placement. They quickly learned from fathers and brothers that the way to keep their place was to organize and to communicate their dissatisfaction with the media.

While I support a 4-year degree as a starting point for nursing, I believe the present four-year degree is not adequate for a nurse, either. There needs to be more business and more science in the coursework. The BSN needs to be more than a glorified ADN, with schools pandering to the need for a higher degree by allowing coursework that doesn't really add skills for the employer.

The ANA no longer speaks for the bedside nurse; they long ago abandoned both women and the bedside nurse in favor of the Nurse Practitioner. As for men in nursing-I'm all for it, as long as they can do the job. And Brian (A brand new nurse)-thanks for that raise I got after 10 years of nursing so that I made as much as you did on your first day of work. I appreciated the irony and the raise.

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