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Leading From the Frontline: Changes in Nursing

It’s a profession commonly associated with saintly levels of patience, but for nurses, the last few years have been testing times. Amid the cumulative stress and burnout of COVID-19 shared by healthcare workers of all stripes, nurses continue to face outmoded misconceptions surrounding their profession and their role within the sector.

 

Public attitudes towards nurses tend to be positive, yet their job is often misunderstood: while the role of doctors is comparatively straightforward, nurses are multitaskers, making it more difficult  to discern precisely what their job entails. While this often leaves room for misinterpretation (and unhelpful stereotypes), it could also mean room for growth.

Redefining The Profession

Professional development opportunities such as DNP nurse executive programs suggest a push for nurses to undertake more leadership positions, something former CEO of the American Nurses Association Marla Weston supports.

 

In an interview last spring, Weston argued that while nurses possessed untapped potential to enact positive change across the healthcare system, this would entail stronger professional governance and a more collaborative approach towards tackling pervasive systemic challenges.

Great Nurses

The historical schism between doctors and nurses is one such challenge. For all its surrealism, the early 2000’s comedy series Scrubs drew on the real life experiences of health professionals and could be surprisingly on point regarding such matters. In one episode, nurse Carla Espinoza admonishes protagonist and trainee doctor JD over his superior attitude towards nurses.

 

“You’re a good nurse,” he says, attempting to placate her.

 

 “I’m a great nurse,” she retorts. “You patronizing ass.”

 

It’s indicative of what Leonard Stein referred to in 1967 as the “doctor-nurse” game, where nurses were essentially there to bolster the ego of doctors while undertaking care duties. Behind every great doctor was a great nurse - but by 1990 Stein discovered nurses had grown tired of playing the game and were seeking their own professional fulfillment.

The Nightingale Effect

The view of nursing as “a woman’s profession” belies the fact that many early nurses were men until sanitary reforms instigated by Florence Nightingale led to schools barring them from acquiring nursing credentials on the basis that male hands were too rough to “dress wounded limbs”.

 

For all Nightingales’ accolades as a pioneer in the nursing profession, her (frequently misogynistic- and racist) approaches also contributed to the entrenched gendering of medical roles and the level of prestige and respect associated with them.

A Way Forward

Despite being a supporter of suffrage, Nightingale was very much a product of the patriarchal status quo, whose principles on what constitutes “important” work are still seen today. Women in STEM are historically undervalued, undermined and underpaid;  those in “care professions” (comprising ¾ of the health and long term care workforce) even more so.

 

At a deeper level, this speaks to the gendering (and devaluing) of supposedly “feminine” skills required by nurses such as empathy and kindness, to the point where men attempting to enter the profession (or to use Scrubs’ own very outmoded parlance, “murses”) continue to face discrimination for associating themselves with a stereotypically “female” job.

 

The way forward appears to be something Melissa Kalensky calls “flattening the hierarchy” so all healthcare providers are equally respected and valued. In turn this would offer much-needed interprofessional support to the professional development of nurses, whose compassion and care is needed more than ever.

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