Stop, Collaborate and Listen: Nursing, Power and Gender in Interprofessional Collaboration

Patti Leake is no stranger to the intricate working relationships between members of the healthcare sector.

Trained as a midwife, Leake’s interactions with patients, physicians, nurses and other allied health professionals sparked a curiosity turned graduate research topic focusing on the nature of interprofessional collaboration between nurses and physicians.  Now, a recent pharmaceutical sciences MSc graduate, her thesis offers incredible insight on the interprofessional hierarchy prevalent in the healthcare sector.

Titled Nursing, Power and Gender in Interprofessional Collaboration, Leake provides an in-depth analysis of top-cited articles discussing collaboration between nurses and physicians, questioning how each article reflects professional struggles, hierarchies and gendered positions.

Invisible Gender & Hierarchy

Leake’s analysis presents two common themes among her research base, the rarity of considering gender as necessary to exploring collaboration, and how interprofessional hierarchies are reinforced by gendered professions.

Leake’s findings suggest that gender easily slips from view in writing on the subject of interprofessional collaboration, citing that 58% of her article base lacked any direct mention of gender.  Although, cited works in many of the articles analyzed cover the topic of gender extensively, Leake found that authors made the decision to leave it out.

“Now that medicine is nearly gender balanced, it may be that a discussion of gender in interprofessional collaboration is no longer relevant, but I do believe that this assumption ignores the fact that nursing is still a gendered workforce” states Leake.  “I think that the role of nurses and physicians need to be acknowledged as gendered positions, regardless of whether a male or female holds them.”

Most notably, her work highlights the hierarchical nature of the healthcare landscape, suggesting that the distribution of power between physicians and nurses is reinforced by physicians.

“While the literature demonstrates that physicians ascribe the role of ‘handmaiden’ to nurses, it is interesting to see that nurses, aware of the hierarchy, often ‘play the game’ or make recommendations seem as if they are at the request of the physician.  It is how nurses access power” says Leake.

The Challenge

In her thesis, Leake suggests that when issues of power are ignored, collaboration is unlikely to succeed.  While the goal of interprofessional collaboration is to provide diverse professional opinions, it appears that gendered positions within interprofessional hierarchies have perpetuated a power displacement that makes this difficult to achieve.

“I believe it is important for researchers studying interprofessional collaboration to take a step back and look for patterns in gendered behaviour. I think this can really open up the discourse, and provide a much more detailed understanding of the power at play”.