The impact of intersectionality on nursing leadership, empowerment and culture: A case study exploring nurses and managers’ perceptions in an acute care hospital in Aotearoa, New Zealand

Abstract

Aim: This study determines whether the culture within an acute care hospital empowers 'all' nurses to be leaders by exploring intersectionality and nursing leadership in the context of the social environment.Background: Nurses practice leadership in their day-to-day activities as clinical leaders alongside traditional roles of management and leadership. However, some nurses do not acknowledge nursing work as leadership activity, nor is it seen so by others where hierarchical leadership approaches remain prevalent. Social constructs of gender and race are barriers to accessing formal leadership positions for some, while dominant power structures such as class diminish the value of bedside nursing work.Unexplored is the impact of the intersection of these and other social identities on nurses being leaders.Design: An embedded case study design.Methods: Thirty-one participants participated in semi-structured interviews. Four levels of analysis including inductive and deductive approaches were applied to the data. The research complied with COREQ guidelines for reporting qualitative research. Results:This study shows nurses do not identify themselves as leaders without an associated title and the pathway to leadership varies depending on intersecting social constructions. Conclusion:The impact of the organisational structures and the experience of navigating intersecting social constructions on nurses being leaders goes unseen, privileging some while disadvantaging others.

Barriers and facilitators in providing care for patients with a migration background

“…Barriers on the level of the care organisation and its management point out that there is a lack of leadership and guidance towards culturally sensitive care and a lack of organisational policy towards culturally sensitive care when patient and healthcare professionalfrom different ethnic-cultural backgrounds-interact with each other. Although research has proven that the role of the care organisation and the management is very important to support the healthcare professionals in daily care practice and to strengthen structural changes (Aspinall et al, 2021;McClimens et al, 2014), our study shows that there is little support from the employer or the manager, and the responsibility to find flexible solutions or to think out of the box lies with the individual healthcare provider. Markey et al (2012) claims the whiteness of the care institutions goes unnoticed as the prevailing framework, which plays an important role in the deceleration of structural changes.…”

Intersectionality and nursing leadership: An integrative review

“…Aspinall et al (2021) investigating intersectionality and nursing leadership describes how nurses did not acknowledge themselves as clinical leaders neither as a professional cadre were they recognised as so by other health professionals who ignored them in multidisciplinary meetings and during ward rounds unless they held a manager's title. English fluency was associated with perceptions of levels of competence and impeded career progression in several studies (Aspinall et al, 2021; Isaac, 2020; Semu, 2020). Experiences unearthed in Semu's study P.8 led them to a disconcerting description of nursing, stating, ‘The nursing profession has become the new ghetto for immigrant women of colour’.…”

An integrative literature review and critical reflection on nurses' agency

“…In line with the reflections above, the results of the literature review show that there is a need for researchers to engage themselves with theoretical frameworks to address the issue of nurses' agency. The theoretical lenses of critical realism as used by Goodman ( 2017 ) and Williams et al ( 2016 ) have shown their value in highlighting the multiple ways in which agency is harnessed by nurses to confront forms of domination (Aspinall et al, 2019 , 2021 ; Schiller, 2016 ). However, critical theory lenses have been the ones that have made the most forceful contributions toward nurses' emancipation (Chulach & Gagnon, 2016 ; McMillan & Perron, 2020 , 2021 ; Paloniemi & Collin, 2012 ; Perron, 2013 ).…”