“Female nurses: Professional identity in question how female nurses perceive their professional identity through their relationships with physicians”

Abstract Background: Nurses and physicians are longtime complementary professions in the hospital setting, prominent in patient care. The hierarchic relationship between them, by gender and professional status, results in various conflicts. Over the years, the balance of power between the two has shifted: nursing has undergone great development in the professional aspects, while the number of female physicians has increased. The influence of these changes on the nurse’s professional identity and interactions with other medical professionals was studied. Objective: The current study aims to understand how professional identity and the gender of physicians affect the relationship between female nurses and physicians. Design: Female nurses underwent qualitative, semi-structured interviews and responded to hypothetical scenarios describing their interactions with male and female physicians. Setting and participants: Twenty female nurses with at least one year of experience from seven internal medicine departments in a major public hospital in central Israel participated in the study. Methods: Semi-structured in-depth interviews were carried out, including descriptions of conflicts with physicians, and nurses’ responses to hypothetical scenarios with male and female physicians. Explicit and implicit statements as well as anecdotes were analyzed. Results: Nurses tended to define their professional identity in relation to physicians, presenting a united front against the so-called “other,” a distinct “us versus them” divide. They appeared to perceive themselves as superior to physicians, competing with them over their professional importance and prestige. They utilized aggressive and manipulative strategies as means of resolving conflicts with physicians. This was more pronounced with female physicians, who received little to no respect from nurses, and were judged by gender stereotypes, and only gained recognition if they proved themselves worthy of it. Apparently, physicians, and female ones, in particular, shape the professional identity of the nurse through a struggle over influence, authority and public prestige. By so doing, nurses simultaneously undermine and preserve the existing nurse-physician hierarchy. Conclusion: Nursing in hospitals is focused on the structuring professional identity, alongside competition with the female physician over influence, authority and public prestige, which simultaneously undermines and preserves the existing hierarchy. Thus, the nurses’ professional identity is influenced by their interaction with and gender of medical physicians.