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 Ante-Intra-Postpartum, Post Gyne.

Please don't think I am trying to turn this into a ASN/BSN debate.

When a person can become a nurse with only a 2yr degree it is not hard to see why the general public would not look at nursing in regards to "professionalism" as much as say a female Lawyer or Doctor. I think having a BSN as an entry level to nursing is a way to start. No offense to those with an ASN degree, I know we all worked hard for our degrees no matter which level of education, but nursing is probably the last degree you can do anything with at the associates level. In most studies even a Bachelors degree is starting to become the bottom of the barrel.

Specializes in ICU, trauma, gerontology, wounds.

Even granting you the points you wrote about, working conditions and compensation for nursing are wayyy above average. Have you worked in any other field before you became a nurse?

If you count jewelry store retail, office clerk at a medical group practice, and cocktail waitress, yes. I fully agree that compensation for nurses is good; it's working conditions that still trouble me.

Specializes in ICU, trauma, gerontology, wounds.

Like another male poster on this thread, while I do appreciate the historical context that nursing has been female dominated for the last 100 years and change, I see these present day issues as nursing issues, not female nurse issues, and I think most men in nursing would like a seat at the table in any discussion focused on righting these wrongs. Don't count us out.

I admire men in nursing. I think a man who studies nursing has to be pretty darn secure to put up with the ignorant jerks who call them "male nurses" (as if that is something different from "nurse"), not to mention the much worse assumptions about sexuality and masculinity that are SO wrong in many ways. Thank you for being a nurse, too. I don't mean to exclude men in any way from the battles that nurses are fighting in the 21st century. I am a fan of diversity in all its forms.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
Every time "Dirty Jobs" comes on tv, I say aloud, "Why don't you try being a nurse? No job is dirtier."

Have you ever noticed that all the jobs shown are men's jobs? Where are the women who clean public restrooms? How about child care workers who deal in snot? Women's dirt is REALLY dirty - men's dirt is oil and soil and grime, which doesn't conjure up the same "yuck factor." And isn't actually dangerous to the worker.

As an avid fan of "Dirty Jobs with Mike Rowe" (I include his name because he created the show, and largely in reverence of his dad and blue collar workers in general) the job of a nurse and/or nurse's aide has been suggested many times. I believe the reason they will not do it, is that the "dirty" or "gross" part is related to people, not worms, bat guano, raw sewage, etc. The most entertaining female dirty job he did was the girl who caught water snakes in Lake (Erie?) :)anyway. . . all that slightly off my point which is. . .

Thank you for your thoughtful response to my question about the nursing shortage. I did consider that you would probably make that point prior to my original post, that perhaps it's all related to the recession, but it seems to me (completely anecdotal/subjective I admit) that I have worked through recessions of the 70s, the 80s, left in 90s, and now. I just don't remember prior recessions causing the widespread misery we are seeing now in the field of nursing , and as I recall, at least in the large urban area I am from, hospitals at that time still had the full-page ads and sign-on bonusses. Ah, well, that is for the statisticians to figure out I guess.

A common complaint I am reading is that many new grads feel they have been hung out to dry by their schools. I don't mean necessarily that they are responsible for a student not researching the job market prior to choosing nursing as a career, but that with the extremely dire situation, a new grad who is unemployed for 6mo to a year after graduating because there are no jobs available, even with some moving to a different state, they become ineligible for many hospital's new grad programs because they are "stale" (their word) through no fault of their own. What are they supposed to do in a situation like that? I realize nothing good happens by waving the magic wand, but I am hearing schools giving the grads a shrug and a cold shoulder. It would just be really great if they could come up with extension programs or refreshers to keep their eligibilty for these programs they'd dearly love to be in.

Teresa, sorry for bending your ear and going somewhat off your topic of feminists ignoring nursing. I agree with you wholeheartedly that nursing would look so very different than it does now if we had assumed ourselves to be, and insisted that others view us as, independent practictioners.

I think that perception would be very hard to change. What we can change though, as I think about far more than I used to, is collective bargaining. When I worked at a large LA hospital in the 70s, the unions attempted to organize us, and ultimately were rejected by employee vote. I believe we would have a very different outcome now. If nurses could truly unite, that is. Back then unions were splintered and worked at cross-purposes, which resulted in very little being accomplished. Thanks again for your interesting posts.:up:

Specializes in Nursing Professional Development.

Like another male poster on this thread, while I do appreciate the historical context that nursing has been female dominated for the last 100 years and change, I see these present day issues as nursing issues, not female nurse issues, and I think most men in nursing would like a seat at the table in any discussion focused on righting these wrongs. Don't count us out.

I would never "count you out" or exclude you from the conversation. That male perspective is important.

My point has been that ... just as we should not exclude the male perspective, we should also not exclude the gender-related roots of many of the current issues.

Specializes in burn unit, ER, ICU-CCU, Education, LTC.

Teresag CNS said, "I fully agree that compensation for nurses is good; it's working conditions that still trouble me".

I disagree that compensation for nurses is good. The starting salary is similar to the starting salary of a teacher. But look down the road at the salaries and benefits teachers have at 10 and 20 years and compare it with that of nurses who managed to survive that long. There is a huge difference.

But then, most teachers have unions to represent them.

Teresag CNS said, "I fully agree that compensation for nurses is good; it's working conditions that still trouble me".

I disagree that compensation for nurses is good. The starting salary is similar to the starting salary of a teacher. But look down the road at the salaries and benefits teachers have at 10 and 20 years and compare it with that of nurses who managed to survive that long. There is a huge difference.

But then, most teachers have unions to represent them.

And teachers also have a higher minimum level of education to enter the field ...

Specializes in burn unit, ER, ICU-CCU, Education, LTC.
And teachers also have a higher minimum level of education to enter the field ...

I don't understand your point. What does that have to do with the fact that 10 and 20 years down the road, teachers make much higher salaries and have much better benefits than nurses who have been employed that long. And, teachers were smart enough to organize a long time ago.

I don't understand your point. What does that have to do with the fact that 10 and 20 years down the road, teachers make much higher salaries and have much better benefits than nurses who have been employed that long. And, teachers were smart enough to organize a long time ago.

While I would also like to see a lot more union representation in nursing and that is clearly a factor in teachers' compensation, I don't think one can ignore the fact that the majority of US RNs are ADN-prepared and stay that way (no further formal education) throughout their careers. My point was that teachers not only have a significantly higher level of union representative, they also have a signficantly higher level of education across the board. That seems like an important difference to me, but I'm sure there are plenty who feel differently.

Specializes in Gerontology, nursing education.
While I would also like to see a lot more union representation in nursing and that is clearly a factor in teachers' compensation, I don't think one can ignore the fact that the majority of US RNs are ADN-prepared and stay that way (no further formal education) throughout their careers. My point was that teachers not only have a significantly higher level of union representative, they also have a signficantly higher level of education across the board. That seems like an important difference to me, but I'm sure there are plenty who feel differently.

I didn't want to get into the entry to practice debate but it frustrates me that the ANA first endorsed the bachelor's degree as the MINIMUM educational preparation for professional nursing back in 1964 and we STILL have multiple entry levels for registered nursing. I have tremendous respect for ADN and diploma grads but as I see other health care professions move ahead with practice doctorates to become pharmacists and occupational and physical therapists, it frustrates me that nursing cannot get its act together and decide on ONE basic level for entry to practice. I agree completely with elkpark in that this lack of a standardized entry to practice level is keeping nursing on a different level from other disciplines and that it, like it or not, costs us respect.

Nursing is always going to lumber along as a quasi-profession in the eyes of other health care disciplines until we can get our act together and finally decide that we are going to move toward the BSN as the minimum entry to practice level for registered nurses with the ADN as the entry to practice level for technical nurses. I don't say that to alienate anyone who has an ADN or is an LPN as I believe those who are currently licensed as RNs and LPNs should be grandfathered (grandmothered?) in and given the opportunity to advance their education if they desire. But it is utterly ridiculous that nursing has flatused around about this for over forty-five years and we still have gotten NOWHERE.

As much as I dislike the term "pink collar" or other terms that have described "women's" work, I believe that nursing's lack of consistency on creating and STICKING TO one level of entry for practice has cost us, as a profession, respect from other health care disciplines as well as from the general public. And yes, I think we would be more respected by feminists as well. That's why they refer to us as "pink collar" or worse.

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

Unions historically have focussed on rank-and-file employees without advanced degrees. In fact, I think the unions representing those occupations have more power than the much smaller, elitist, DC lobbying unions just below union exempt salaried management employees.

Sorry for sounding cranky. There's nothing wrong with minimum education requirements, but I do not believe that is the reason nurses have an ineffective collective bargaining structure.

Elkpark- don't teachers get automatic pay increases for each advanced degree? Don't they get other incentives, such as better pension plans and job security? If nurses had those incentives, perhaps there would be a higher percentage of nurses with ADNs continuing on.

Moogie- couldn't a new MD practice legally once he or she has graduated from medical school? No one ever seems to do that, but are they banned from membership in the AMA or other physician "unions"? I well remember when the Family Practice board specialty was created, the old Marcus Welby doctors had their prestige ripped away if they were too old or didn't want to go back to school.

Specializes in Gerontology, nursing education.

Sorry for sounding cranky. There's nothing wrong with minimum education requirements, but I do not believe that is the reason nurses have an ineffective collective bargaining structure.

Moogie- couldn't a new MD practice legally once he or she has graduated from medical school? No one ever seems to do that, but are they banned from membership in the AMA or other physician "unions"? I well remember when the Family Practice board specialty was created, the old Marcus Welby doctors had their prestige ripped away if they were too old or didn't want to go back to school.

Medicine has changed since the days of "Marcus Welby", which is, of course, a fictionalization of the paternalistic medical system in which "Father Knew Best". (Interesting that the same actor who portrayed the archetypal father figure in the TV show Father Knows Best went on to portray the archetypal paternalistic physician, aka Marcus Welby...) But do keep in mind that medicine, was, at that time, extremely paternalistic with the notion of the physician being the all-knowing, wise father who made the decisions (who knew best....) and the nurse acting as the mother figure, the one who did the day-to-day work of taking care of the children/patients. Patients were stripped of their autonomy, expected to be passive and compliant with physician "orders". Nurses, too, were expected to be submissive, never question the doctor's authority, always carry out orders dutifully and without complaining.

Would you really want to return to those days? I wouldn't.

Yes, MDs can legally practice out of medical school, but would you really want to go to a physician who hasn't done a residency? Would you want to trust someone who has no board certification, who hangs out a shingle the day he/she graduates from med school? Now you may wish to blow a hole in my argument by pointing out that nurse practitioners are not currently required to complete residencies. Frankly, I think they should do residencies---if not in general practice, certainly in any specialty. I also think that the DNP for nurse practitioners is long overdue and that nurse practitioners need the additional didactic education as well as more clinical hours.

The odd thing is---if you want the type of personalized care that was glorified during the heyday of the "Marcus Welby" stereotype, you're more likely to get it from an advanced practice nurse than a physician. (BTW, in most states, nurse practitioners cannot hang a shingle and go into business straight out of school---most need to practice and/or dispense medications under the direction of a physician. Same with PA's. You don't see PA's in independent practice. But I am getting off track here...)

My point is---the educational model for nursing has been a hodge-podge of quick fixes and short-term fixes that are applied to address cyclical shortages. The ADN, for example, was viewed as a temporary fix when first conceived because of the shortage of nurses in the immediate post-World War II era. Mildred Montag proposed the idea as her doctoral dissertation, which was published in 1951. Montag herself never envisioned the ADN as a career path for professional nursing and, in fact, saw the role as being an assistant of sorts to the baccalaureate-prepared professional RN. Here's a link if you are interested: http://www.workingnurse.com/articles/Mildred-Montag-Visionary-of-the-Associate-Degree

I actually have a published copy of Montag's original work. Fascinating read. I strongly suggest it to anyone who is interested in nursing history, to learn where we have been so we can chart where we are going.

At any rate, when we, as a profession, end up letting ourselves be controlled by those from outside our discipline, whether it is medicine, the proprietary schools out to make a quick buck on the nursing shortage, or the hospitals who are balancing their budgets on the backs of their nursing staffs----when we give up control, we give up our professional identity. Frankly, as a feminist since the 1970s, I see the whole issue of nursing's professional and personal identity being tied up in the struggle for women's rights. The struggle for women's rights is the struggle for nurses' rights but baby, we have got a long way yet to go!

My point regarding entry to practice is this---if we can't get our act together and keep on bickering about an issue that is over forty five years in the making---we squander and surrender our power and cannot expect to be taken seriously as professionals. We might as well hang it up, go back to the days of white pantyhose, caps, and capes and relegate ourselves to the pink ghetto forever. (Yeah, I went there. I hate that term but we only have ourselves to blame if we stay there forever.)

Do you want to make a difference in the profession? Join a professional organization. Get involved. If you don't like the direction in which we're going, take a stand and say something. Don't just sit there and stew. Do something.

Another couple of good reads: anything by Suzanne Gordon, especially From Silence to Voice and Code Green: Money-Driven Hospitals and the Dismantling of Nursing by Dana Beth Weinberg. Read these books and you will NOT want to remain complacent about any of these issues, from unionization to entry to practice, ever again.

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