Russian and Soviet Health Care from an International Perspective by Susan Grant

Author:Susan Grant
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Conclusion

Until recently, most physicians in the United States and in most of Europe were white upper middle to upper class men, and most hospitals or hospital systems were led by men of the same demographics. Professional nursing (in opposition to non-professional lay nurses) in the United States and throughout most of Europe has historically been and still remains comprised mostly of white, lower middle to middle class women. These demographics created and sustained strong gendered power and class differentials in American medicine and institutions, and they served to gender the work and worth of health care and caring work, in particular.

Nurses in a largely male hierarchy in hospitals typically were not part of critical decision-making at the administrative level. Here, in the normative male and upper class-dominated world of physicians and trustees, nurses struggled to have a voice in areas of patient care that relied upon them for success. Until recently, few nurses, not even the Chief Nursing Officer of a health system, were part of the decision-making team of the institution, and when they were, they were typically the only nurse in the room.

Gender sets up borders that define hierarchies of power and authority structures. We tend to forget that gender is an unstable category. When it is rendered as a binary, man–woman construct, we are also reflecting dominant power structures. Unwrapping gender is a journey historians of nursing must take. Gender can shape ways in which society determines how its resources, such as health care and its workforce, are structured and provided. But, gender is rarely the only or even the most important factor to consider when writing the history of nursing, but intersectionality is hard to accomplish. At its best, it uncovers connections and identities previously seen as natural and on the surface, all inclusive. We begin to see nurses who were previously hidden and whose impact was taken for granted or homogenized and de-identified. On the other hand, intersectionality could also cause us to lose, as historian Kathy Piess notes, women’s and nurses’ “inclusion in the main currents of historical writing.” 43 As our cases show, gender is just one piece of the power differential in the history of nursing. By drawing attention to nursing as a way to explicate larger historical constructs, such as gender, and by enticing historians of all types to see nursing as an important historic group, we keep gender and nursing as part of the broader historical narrative.

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