An epistemological study of the power of women as nurses : a phenomenological approach.

Abstract

Aim: The aim of the study was to do an epistemological analysis of the power of women as nurses working in one of the larger and more deprived regions of South Africa, namely KwaZulu-Natal. This research was based on the premises of the Standpoint theory. Concurrent to the collection of data, a literature review and a concept analysis of power, powerfulness, powerlessness and empowerment were done and incorporated where applicable in the final theoretical framework. Methodology: A phenomenological approach was used. This incorporated two to three in depth interviews with each participant, lasting an average of thirty minutes each, was used. Women, relating to the gender factor, as nurses were also marginalised in terms of class, as they belonged to the enrolled category of nurses, and race, being African. A fourth selection criterium was added to analyse the reality of locality, called rurality. The researcher applied the principle of theoretical saturation and a total number of nine women, who belonged to the enrolled category of nurses and who worked in a distinct rural health care setting, were interviewed. A second group consisting of five women enrolled nurses and working in an urban setting were interviewed, as were a third relatively contrasting group of four women registered nurses. All forty four interviews were audio taped and transcribed, and a qualitative software package called NUD*IST was used to identify and refine experiential themes. Findings: The relationship between power and rights was often layered in contradiction during the interviews and the participants portrayed a picture of being oppressed or marginalised and powerless. The women as nurses belonging to the enrolled category were alienated as women and as nurses in terms of being severed from the nursing profession and from the ruling gender of men, of being lost in an ever present routinization of activities, of being misused, maternalised and domesticated at home and at work. These phenomena were quantitatively more voiced by the rural group of women and these participants strongly emphasized the limiting influence of their prescribed scope of practice, the approach of the senior category of nurses and they conveyed a traditionalist and altruistic view of nursing and nurses. The women as registered nurses created their own freedom often away from their men as in divorce. They also sought for solutions concerning powerlessness in more global and distant terms, for example in relation to cultural practices. They communicated a sense of empowerment in terms of for example education, personal qualities and increased job satisfaction. Culture rather than race was emphasized as an essence of womens' oppression. An epistemological framework of the power of women as nurses developed by the researcher constructed the totality of empowerment in terms of fifteen transformational and hierarchial actions incorporating and adapting Dooyeweerd's theory of modalities and the surfaces of class (categorial divide), gender (the eternal carer), race (culture) and locality (rurality). These actions and reformulated concepts could be used for the development of specific strategies to facilitate the empowerment of individuals, groups and communities of women as nurses and nurses as women. Further collaborative research into the phenomenon of power, a reconceptualization of nursing education and levels of expertise and hierarchies within nursing were some of the suggestions for the way forward.