Content area
Full text
Abstract
Aim To explore the extent to which nurses are willing to challenge doctors' practice in everyday situations in an acute NHS hospital.
Method Qualitative data were collected using in-depth interviews with 12 nurses in an acute NHS hospital in England.
Findings Participants believed that they challenged doctors' practice and acted as patients' advocates. However, data revealed that nurses questioned doctors' practice only under specific circumstances. Nurses would not challenge doctors if they perceived that this would result in conflict or stress, if they were afraid of the doctor or feared reprisal.
Conclusion Nurses are discouraged from challenging doctors' practice by the structural inequality arising from the gender division of labour and doctors' expert knowledge and status (medical dominance) in the workplace.
Keywords
Gender issues, nurse-doctor relationship, occupational hierarchy
These keywords are based on subject headings from the British Nursing Index. All articles are been subject to external double-blind peer review and checked for plagiarism using automated software. For author and research article guidelines visit the Nursing Standard home page at www.nursing-standard.co.uk. For related articles visit our online archive and search using the keywords.
THE GENDER DIVISION of labour is characterised by the employment of women in parr-time, semi-skilled or unskilled roles and men in positions of supervision or management with greater career opportunities. This 'gendered hierarchy' emphasises male domination and marginalisation of women in society (Radtke and Stam 1994). Nursing is a predominantly female occupation and, although there are increasing numbers of female doctors, 60% of registered doctors are male (General Medical Council 20 1 0). This division of labour may place nurses in a subordinate position to doctors.
The public inquiry into the high mortality rate of infants undergoing cardiac surgery at Bristol Royal Infirmary between 1984 and 1995, found that the occupational hierarchy made it difficult for nurses to voice their concerns (Department of Health (DH) 200 1 ). There was also a failure to develop effective multidisciplinary teams and poor communication was evident in the paediatric cardiac surgical service. Following publication of the report of the public inquiry (DH 200 J ), NHS organisations were expected to implement measures to develop a culture of openness about mistakes, where patients and staff work in partnership and patient safety is prioritised (DH...