By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor
Back in the late 60s, when I was trying to figure out what I wanted to be when I grew up, one particular piece of advice kept popping up: “Become a nurse. That way, if anything happens to your husband, you’ll be able to get a job and support your family.”
This month we celebrate National Women’s History Month. The theme is Women’s Education–Women’s Empowerment. I think back to that advice and how it captures the journeys of both nursing and women over the last 45 years.
That one piece of advice reflected so many beliefs of the time. The husband (and there should be a husband for any self-respecting woman) is the breadwinner. A woman doesn’t really want to work and shouldn’t work; her role is to take care of husband and home. She doesn’t need the fulfillment of a career—only the ability to pay the bills if she suddenly finds herself alone.
Nursing was the safety net job. Not something to pursue for its own sake—for the intellectual, emotional, and financial rewards it could offer. Women who did pursue it found themselves earning their own paycheck—but still subjugated, the handmaiden to the physician.
Thankfully, that has changed. Women pursue all kinds of careers and are surpassing men in numbers of higher education graduates. Few people would still argue that the woman’s place is in the home, and girls are encouraged to grow up to pursue their own dreams and be successful in their own right. Despite this progress, we still have a long way to travel for true gender equality. Boardrooms and legislative bodies are still disproportionately filled with men. Women still earn only 77% of what men do, a difference that has improved a mere six percent in 20 years.
Nursing has followed a similar trajectory. It is no longer a safety net occupation and nurses are no longer viewed as the handmaiden to the physician. Nursing school application numbers are way up, with many applying as second degree students after pursuing other careers. There is greater recognition of the high level of knowledge and skill nursing requires. We have our own scientific body of knowledge and we control and monitor our own practice. We are involved in life-changing research and interventions across the globe and our impact on quality of care and patient outcomes is well established.
Yet, despite recent progress (for example, see Shawn Kennedy’s blog post about Lt. General Patricia Horoho, the new Army Surgeon General), we are still underrepresented in boardrooms and executive positions of health care organizations and institutions. Our image still suffers from sexism and outdated perceptions of what nurses actually do. And we earn less than other health care professionals even when we have similar levels of education and responsibility (check out nursing faculty salaries compared to those of physician faculty).
The history of women and the history of nursing have always been intertwined, and may always be, even with the number of men who are nurses. The two groups’ struggles against oppression run parallel. Despite the scientific and technical nature of our work, nurses continue to deal with the legacy of—as Reverby stated so succinctly in Ordered to Care: The Dilemma of American Nursing, 1850–1945—their “order to care in a society that refuses to value caring.”
Women struggle with a similar dilemma. They are still the primary caretakers at home of children, and now aging parents as well, even while pursuing careers and accomplishments outside the home. And they are still facing critical judgments about it, from themselves and others.
Both groups are ambivalent about this concept of caring, sometimes bristling under the connotation of softness or the suggestion that it is a substitute for intellectual prowess. As if the two cannot coexist in the same profession or in the same person! At other times we embrace the characterization of nursing as “caring”—it is what differentiates us, the essence of nursing, the art. Will there be a time when the value of caring can be acknowledged and celebrated? When it is not seen as a feminine quality? Or, even better, when it is and that is not a bad thing?
National Women’s History Month honors six women who forged a path and created opportunities for women of all ethnicities. Nursing shares this legacy as well. Take a moment to think about the women in nursing who forged a path for all of us. Who will you honor this month?
Thank you for this great post in honor of International Women’s Day. Globally, I’m witnessing more nurses taking their place and being their authentic intelligent competent selves with no apologies. They are confident and prepared as they challenge the status quo. Let’s all work together and keep pushing the “pre-fabricated’ glass ceiling (decorated with smoke and mirrors) until we reach equity in pay, positions of authority and power as women and health care professionals.
I often think of the Wizard of Oz when Dorothy and her pals finally get to meet the Wizard and Toto pulls back the curtain. Surprise! Not the all-powerful, all knowing giant they were afraid to face. Every time we pull back the curtain we allow the truth to be let out. When we practice fully being ourselves in all our roles in life no one gets hurt. As a matter of fact, everyone does better.