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Multiple Segregation in Nursing Careers: Causes and Consequences

Multiple Segregation in Nursing Careers: Causes and Consequences. WES Conference 2004, UMIST Sarah Wise Research Associate Employment Research Institute. Segregation and Nursing Careers. Vertical Segregation

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Multiple Segregation in Nursing Careers: Causes and Consequences

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  1. Multiple Segregation in Nursing Careers:Causes and Consequences WES Conference 2004, UMIST Sarah Wise Research Associate Employment Research Institute

  2. Segregation and Nursing Careers Vertical Segregation • 40% of qualified nurses and midwives in NHS Scotland work part-time (ISD 2004) but... • Part-time nurses have been found to be under-represented in higher clinical grades (G grade and above) • Part-time work and career breaks have been found associated with slower progression up the clinical grades • Men have been found to be over-represented in higher nursing grades and spend less time getting there • Davies (1995); Lane (2000); Whittock et al. (2002) Horizontal Segregation • 90% of qualified nurses and midwives in NHS Scotland are women (ISD 2004) • However, there has been little research on horizontal segregation and patterns of employment within nursing

  3. Work-life Balance and Careers in NHS Nursing and Midwifery Coverage • Qualified nursing and midwifery staff (RN and RM) in a large, acute Trust in NHS Scotland (2 adult hospitals, 1 paediatric hospital, 2 acute elderly hospitals) 3,700 qualified nurses and midwives Funding & Partners • Scottish ESF Objective 3 Programme (part-funded) • Napier University, the Trust and RCN Scotland Objectives of Research Project • To examine availability, accessibility and implementation of work-life balance policies and practices in NHS nursing and midwifery; • To examine the role of working hours and shift work in work-life balance; • To examine the relationship between the utilisation of policies and career development and progression; • To examine the relationship between work-life balance and retention; • To identify best practice and recommend areas for improvement.

  4. Field Work Selection of case study areas - 12 in total 64 interviews – grades D to I 3679 distributed 1084 returned – 29% response rate Data Job details – type of workplace and responsibilities Perceptions of workplace support for career development and work-life balance Availability, usage and operation of flexible working and leave policies Working hours and preferences Retention issues Communication and involvement Detailed workforce demographics Methodology

  5. Profile of Part-timers • 33%(n=354) of respondents worked part-time • 2% (n=26) had always worked part-time • 55% (n=586) had always worked full-time • 43% (n=463) had worked a mixture of part-time and full-time • 98% of part-timers were women • 60% of parents of dependent children, 28% of those with adult care responsibilities only and 16% of those with no care responsibilities worked part-time • 73% of respondents whose youngest child was under 5 years old worked part-time falling to 35% of those whose youngest child was aged 16-17 years (CHI-SQUARE SIG = 0.000) • The most common form of work-care strategy was fairly ‘traditional’ - 38% of all parents were mothers working part-time taking primary responsibility for the care of dependent children

  6. Support for Career Development • Part-timers were disadvantaged in some areas: • A lower proportion of part-timers had an HE degree (partly age-dependent) • A lower proportion had been granted study leave in the last year (43% compared to 60% of full-timers) (CHI-SQUARE SIG = 0.000) • 26% of part-timers compared to 38% of full-timers agreed with the statement “There are plenty of career opportunities for someone like me” (CHI-SQUARE SIG = 0.001) • However, similar proportions of part-timers as full-timers: • thought their line manager was supportive of their professional development • had undertaken post-registration courses (in addition to PREPP) • had been involved in research and practice development in the last year

  7. Vertical Segregation of Part-timers? Proportion working part-time / full-time at each clinical grade (%) • Highest proportion at E grade (experienced staff nurse) • Lowest proportion at H/I grade (senior line manager) • Low levels at D grade because of high numbers of young entrants from education CHI-SQUARE SIG = 0.002

  8. Vertical Segregation of Part-timers? Distribution of full-timers and part-timers across the grades • 53% of part-timers were E grades compared to 39% of full-timers • 21% of full-timers were G grade or above compared to 16% of part-timers (CHI-SQUARE SIG = 0.052) • Part-timers were under-represented in higher grades but not substantially so CHI-SQUARE SIG = 0.002

  9. Part-time Work and the “Experience” Gap Average years since first registering less career break • Part-timers older than full-timers (41 yrs compared to 36 yrs) (Mann-Whitney SIG = 0.000) • Part-timers, on average, more “experienced” than full-timers (16.5 yrs compared to 11.7 yrs) (Mann-Whitney SIG = 0.000) • D to F grade part-timers had worked significantly longer than full-timers • Reversal at G grade - an indication of changing attitudes?

  10. Part-time Work in Senior Grades Availability Opportunities there but not universal. No organisational policy or guidance. Attitudes of senior line managers important (H/I grades). “Job share is difficult for ward managers [G grades] - you have to find a like minded person with the same goals and aspirations. Job share is frowned upon at this level.” (G grade nurse) Do-ability Jobs at G grade and above entailed high levels of responsibility, stress and often long working hours as both clinical and managerial roles have expanded. “If I can’t get my job done coming in at 7.30 everyday, how will I get it done coming in at nine?” (G grade nurse)

  11. Gender, Part-time Work and Progression Average years since first registering less career break - always worked full-time only • Men and women were evenly distributed through the clinical grades • When part-time working is controlled for, men did not progress more quickly through the grades • Men were less likely to take study leave and to think the line manager was supportive of their career development

  12. Horizontal Segregation of Part-timers Respondents working part-time / full-time by workplace • Popular clinical areas low in part-time working • Areas with ‘regular hours’ high in part-time working • Medicine for the Elderly – unpopular area with acute recruitment and retention problems • Segregation by age, experience and care responsibilities CHI-SQUARE SIG = 0.000

  13. Discussion • The profile of part-time nurses was fairly traditional. • Part-timers were disadvantaged in access to support for career development (e.g.study leave), but not in all areas (e.g. line manager support). • Compared to previous studies, vertical segregation of part-timers was much less pronounced although there was an “experience gap” at grades D to F. • There were greater opportunities to combine part-time work with progression into senior roles than in the past but barriers still existed. • Male nurses were not over-represented in higher grades and when part-time working is controlled for, did not progress more quickly. However as long as part-time working is gendered, male nurses will have an advantage. • Part-time working was less common in the popular clinical areas. Why? • What are the implications for service provision that the nursing workforce is segregated by age, experience and care responsibilities?

  14. Work-life Balance and Careers in NHS Nursing and Midwifery. For more project information and downloads go to: http://www.napier.ac.uk/depts/eri/research/esf or contact: s.wise@napier.ac.uk

  15. References Davies, C. (1995) Gender and the Professional Predicament of Nursing. Open University Press: Buckingham ISD (2004) NHS Scotland workforce statistics for March 2004. Available online http://www.isdscotland.org Lane, N. (2000) ‘The Low Status of Female Part-Time NHS Nurses: A Bed-Pan Ceiling’, Gender Work and Organisation, Vol. 7 No. 4, p 269 – 281 Whittock, M., Edwards, C., McLaren, S. and Robinson, O. (2002) ‘’The tender trap’: gender, part-time nursing and the effects of ‘family-friendly’ policies on career advancement’, Sociology of Health and Illness, Vol.24 No. 3, pp. 305 – 326

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