Investigation of gender balance in leaders of nursing and directions for mediation to influence policy
Authors: Emma Balkin [1], Jayme Tauzer [2], Lamprini Maria Xiarchi [3]
[1] Aalborg University
[2] Birmingham City University
[3] University of Borås
Executive Summary
In the European Region, 57% of the health workforce are nurses; about 84% of all nurses are female, yet only 25% of leadership positions are held by women. This report investigates gendered patterns of leadership participation in nursing across eight nations: Denmark, Germany, Greece, Norway, Poland, Spain, Sweden and The United Kingdom.
Findings support that despite socioeconomic, cultural, and historical differences between nations, gender persists as a determining factor in advancement to nursing leadership. This report highlights the prevalence of cultural norms around gender that shape the nursing field, such as:
- A set of culturally constructed values that women are naturally more suitable for roles of caring and bodywork, while men are better fit for tasks of leadership and decision-making. This culturally-constructed value promotes a gendered divide in roles within the nursing field.
- Gendered prejudices deter men from performing care or bodywork.
- A persistent gendering of the health professions, where nursing is considered feminine, or “women’s work” and medicine male, despite large numbers of women now entering medicine. This gendering process promotes inequality between professions and the devaluation of care work within the health care sector. Cure, traditionally associated with masculinity, is valued over care, a traditionally female domain.
- Structural issues which have been discussed in other professions are also relevant to the field of nursing, such as the double shift – where women are expected to provide informal care inside of the home while also working outside the home – prohibits women from advancing in their careers. Meanwhile, men are expected to work overtime and to advance more rapidly in order to financially support their families.
What this report reveals is the need for further investigation in the field of gender (in)equality in nursing leadership. There is a substantial amount of work still to be done to uncover the complexities and regional specificities of this problem. In this report we highlight some points of articulation and avenues for further research and development.
Drawing from recently published figures and statistical data on nursing and gender across the EU, Norway and the UK, and supported by a sociocultural analysis of the gender norms that underlie existing workforce statistics in nursing, this cross-national investigation supports the following key recommendations:
At the European Level:
- Conducting qualitative analysis to identify gender-related barriers in transition to leadership roles in nursing at a transnational level.
- Collaboration of governments with gender equality organizations and nursing organizations at a Europe-wide scale.
- Integrating international workforce data, allowing for comparable cross-national comparisons on gender and leadership in the nursing workforce.
At the National Level:
- Investing in inclusivity campaigns on a national level.
- Governmental commitment to gender equality policies.
- Investing in national surveys to gather data on the gender distribution in nursing leadership
- Increasing remuneration to attract and retain highly qualified nurses of all genders.
At an Institutional Level:
- Investing in fostering appropriate work environments for all genders.
- Promoting horizontal leadership practices, beyond management-based leadership.
- Enhancing nurses’ autonomy and interdisciplinarity within care systems.
- Change structures, not people.
This has been an executive summary of our key findings and recommendations.
To download the full report please click here.
BMC Health Services Research has published:
Gendered experiences of providing informal care for older people: a systematic review and thematic synthesis
Authors: Ioanna Zygouri[1], Fiona Cowdell[2], Avraam Ploumis[3], Mary Gouva[4], Stefanos Mantzoukas[5]
[1] Department of Medicine, Faculty of Medicine, University of Ioannina, University Campus, P.O. Box: 1186, Zip: 451 10 Ioannina, Greece
[2] School of Nursing and Midwifery, Birmingham City University, Birmingham, UK.
[3] Department of Medicine, Faculty of Medicine, University of Ioannina, University Campus, P.O. Box: 1186, Zip: 451 10, Ioannina, Greece
[4] Department of Nursing, University of Ioannina, Ioannina, Greece
[5] Department of Nursing, University of Ioannina, Ioannina, Greece
Abstract
Background and purpose: The caregiving’s impact on informal carers’ quality of life and gender-based stereotypes make older individuals’ informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers’ experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020.
Design and methods: The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework.
Results: This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers’ experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers’ healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers’ negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men’s and women’s mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role.
Conclusion and implications: Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people’s care.
Keywords: Informal carers, Family care, Gender, Qualitative research methods
You can read the whole article here: https://doi.org/10.1186/s12913-021-06736-2
