Leadership roles still not there for women despite females dominating nursing profession

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In Australia, the nursing profession remains dominated by women. But new research has revealed women are still struggling to land leadership roles in the healthcare sector, despite having significant experience and training.


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According the government, there are around 450,000 registered nurses and midwives employed across Australia.

Nursing and midwifery is the largest clinical workforce in the country.

Kate Hyett is the Executive Lead at Everyday Independence, an organisation that delivers support to NDIS-funded children, teenagers, adults and their families.

She's been a registered nurse for 37 years now.

She says one of the key career challenges women nurses face is the lack of female role models in senior positions within the healthcare industry.

"So, looking towards role models was always a challenge, particularly if you wanted to look outside a public hospital and in the private sector. The other thing was probably the lack of really senior nurses in other positions within the hospital system and outside the hospital system, so usually - not always but usually - a female Director of Nursing, not always, by any stretch of the imagination. But that was about it. So if you looked at other areas within a hospital, or outside hospitals, you didn't see many other nurses in senior leadership positions."

According to the World Health Organisation, nearly 70 per cent of the global healthcare workforce is women, and 89 per cent are nurses.

Yet only 25 per cent of senior healthcare roles are filled by women.

New research released from Monash University has revealed that healthcare systems and organisations generally limit women nurses in skill acquisition, motivation and opportunities in healthcare leadership.

This is due to inequitable policies, practices and bias.

Professor Helena Teede is a professor of women's health at Monash University and author of this new study.

She says women nurses face a multitude of barriers to obtaining senior leadership positions in healthcare.

"Because we often perceive, and it's men and women, perceive nursing as that feminine, caring role which we don't see as being compatible with leadership, there's an extra layer of barrier. And the other thing is that the nursing workforce has the other intersectional barriers. For example, many of them have migrated to Australia, have different cultural backgrounds, and so they are not only disadvantaged because they are women but they're also disadvantaged because they're nurses and because many of them have additional intersectional barriers."

For Ms Hyett, who has held multiple senior leadership positions in her career, another key workforce issue is that women nurses lack the self-confidence to strive for leadership roles from when they start out.

"I think that, there are a lot of nurses who don't necessarily view themselves as leaders or future leaders. They start as health professionals and then if they want to move into leadership there's an identity shift that needs to be managed. So really being a leader is more than being a skilled nurse - it's also having the ability to work through the additional studies, to seek out the mentoring that's required, to look towards other senior female nurses in leadership positions."

Kylie Ward is the Chief Executive Officer of the Australian College of Nursing.

She says the linear career pathway for registered nurses is also limiting in that it discourages women from developing cross-disciplinary skills in the health industry.

"For registered nurses, it's quite linear in terms of the acute setting, where you would see an acting or a team leader and go into management and director roles and once you leave a ward or a unit, you're managing over several sites. But there's not as many articulated career pathways in primary and community health. And the challenge for nurses in their drive to want to do better is that if you wanted to stay close to being in the clinical setting, you almost have to choose whether you're going to do education or management or academia, and that's a challenge in and of itself."

Ms Hyett says developing a richer career pathway for nurses should begin at the undergraduate level to instil in young female nurses that they can and should become leaders.

"It starts as a student, so I think there's an opportunity for the undergraduate bachelor of nursing and midwifery courses to start inserting some leadership training within that undergraduate degree, just so that the seed is planted. There's no point in just identifying female nurses and putting them into leadership positions, it's got to be more than that. They've got to have the scaffolding around them to perform in those positions and to gain confidence and become confident and competent in those leadership roles."

According to Professor Teede, it's not just up to one nurse or leader to change individually.

She says the solution lies in system-wide policy and culture change across the healthcare sector.

"Focusing on broader scale education and valuing of nursing as a profession. Recognising that these are very highly-trained, highly professional individuals, who are often with a Masters or usually a PhD. They're often clinical nurse specialists and we, I think, currently under-recognise and definitely undervalue the contribution that our nurses are increasingly making to our healthcare workforce. And we will do that at our peril because they're going to have to be a critical part of any sustainable workforce moving forward."


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