Women's power in hospital‐based nursing: A critical qualitative study

Abstract

Aim To understand the factors that affect power in hospital‐based nursing and reveal how the female gender affects an individual's ability to feel empowered. Design Critical qualitative research design. Method Semi‐structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis. Results Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. These themes include supportive leaders, positive unit culture, successful advocacy, personal factors, societal gender roles and sexism. Conclusion Empowered nurses can revolutionize health care. The themes developed in this study will help nurse leaders and nurses alike increase nurses' ability to use their power and feel empowered in the workplace. Impact Nurse leaders should strive to be supportive of their nurses and build a positive work environment while also providing consistent consequences for sexist actions of staff. Nurses should take opportunities to advocate for their patients, be autonomous and build their knowledge base to improve empowerment. As nurse leaders and nurses alike work together to improve health care, nurse experience, patient and clinical outcomes will be improved. Patient or Public Contribution The nurses interviewed for this study contributed their experiences and insights during data collection. Some also contributed rigour to the data analysis process by participating in member checking.

A dimensional analysis of nursing unit culture

“…Aspects of this subdimension include regularity of communication on the unit (Astroth et al., 2013), communication styles used on the unit (Astroth et al., 2013), appropriate language to use with colleagues and patients/families (Yap et al., 2014), forms of communication (e.g. verbal or written, public or private) (Baggett et al., 2016), quality of communication (George et al., 2023; Hastings et al., 2016; Hopkinson & Wiegand, 2017; Quigley et al., 2023) and content of communication (Hopkinson & Wiegand, 2017). These patterns of communication common to a nursing unit are an important component of unit culture.…”

“…This subdimension refers to the collective mood of the unit, and in the included articles was generally referred to as on a spectrum from negative to positive. In some articles, emotional climate was discussed in relation to the overall mood of the unit at a given time (Astroth et al., 2013; Casida et al., 2012; George et al., 2023; Hastings et al., 2016; Lea & Cruickshank, 2007; Salmela et al., 2012), and while in others it was discussed in relation to the mood or feeling around a particular situation or practice (Garcia et al., 2021; Huang et al., 2010).…”

“…• Practice Norms (Astroth et al, 2013;Baggett et al, 2016;Chin et al, 2021;Currie et al, 2019;Douglas et al, 2014;Hastings et al, 2016;Hopkinson & Wiegand, 2017;Huang et al, 2010;Lea & Cruickshank, 2007;Livingston et al, 2020;McIntosh & MacMillan, 2009;Pepler et al, 2005;Salmela et al, 2012;Scott & Pollock, 2008;Shin et al, 2018;Søndergaard et al, 2017;Spence & Lau, 2006;Yap et al, 2014) • Prioritization (Baggett et al, 2016;Chin et al, 2021;Currie et al, 2019;Douglas et al, 2014;Livingston et al, 2020;Søndergaard et al, 2017) • Communication (Astroth et al, 2013;Baggett et al, 2016;George et al, 2023;Hastings et al, 2016;Hopkinson & Wiegand, 2017;Quigley et al, 2023;Yap et al, 2014) Shared beliefs (18)…”

“…• Support/Collaboration (Astroth et al, 2013;Douglas et al, 2014;George et al, 2023;Hastings et al, 2016;Huang et al, 2010;Jenkins et al, 2015;Jun et al, 2020;Lea & Cruickshank, 2007;Quigley et al, 2023;Salmela et al, 2012;Spence & Lau, 2006;Yap et al, 2014) • Emotional Climate (Astroth et al, 2013;Casida et al, 2012;Garcia et al, 2021;George et al, 2023;Hastings et al, 2016;Huang et al, 2010;Lea & Cruickshank, 2007;Salmela et al, 2012) Hierarchy (8)…”

“…Support and collaboration were a component of the atmosphere dimension in 12 articles. These articles referred to an atmosphere of colleague support (Astroth et al, 2013;Douglas et al, 2014;Jenkins et al, 2015), a sense of unity (Salmela et al, 2012), nursing and interdisciplinary collaboration (Hastings et al, 2016;Jun et al, 2020;Spence & Lau, 2006) and teamwork (Douglas et al, 2014;George et al, 2023;Hastings et al, 2016;Huang et al, 2010;Jun et al, 2020;Quigley et al, 2023;Yap et al, 2014). Inversely, some articles referred to bullying or horizontal nursing violence as an aspect of unit culture that did not exhibit support or collaboration (Lea & Cruickshank, 2007).…”