A framework to facilitate the appointment of women nurses of colour to leadership positions in hospitals

Van der Heever, Mariana (2018-12)

Thesis (PhD)--Stellenbosch University, 2018.

Doctorate

ENGLISH SUMMARY : Background: Notwithstanding a 79% African majority and the implementation of the Employment Equity Act (EEA) in 1998, the employment equity reports of the Department of Health in the Western Cape and private health sector nationally in South Africa show under-representation of African and Coloured nurses in leadership positions. International and national literature indicate that the appointment of women to leadership positions tends to be influenced by issues related to race, class and gender. The purpose of the study was to develop a framework to facilitate the appointment of women nurses of colour to leadership positions in hospitals. The objectives were to:  Explore the influence of the EEA on the appointment of nurses in leadership positions  Explore the opinions of nurses regarding the influence of race, class and gender on the appointment of nurses in leadership positions  Explore the practices imbedded in the selection processes of nurses in leadership positions as experienced by those involved in the selection processes  Develop a race, class and gender sensitive framework to support nurses in their preparation for leadership positions Design: A concurrent mixed methods design was employed using a quantitative cross-sectional descriptive survey and qualitatively, interpretive phenomenology. The study was based on the philosophy of pragmatism. Population and setting: The study was conducted in the public and private health care sectors in the Western Cape and Gauteng provinces. Quantitative research: The survey was completed by n=573 professional nurses (return rate =83%). The researcher used a structured questionnaire with Likert scale and open-ended questions. Data was analysed with SPSS statistical software, version 24, and the assistance of a statistician. Inferences of the Likert scale questions showed that racial, gender and hierarchical relationships in the workplace had improved since the implementation of the EEA. However, inferences from the open-ended responses revealed the opposite. The findings demonstrated distrust in the promotion systems applied by the public and private health sector. Qualitative research: Interviews were conducted with 5 nurse leaders and another 40 interviews were conducted with people who had participated in the selection processes of nurses appointed to leadership positions: successful and unsuccessful candidates, human resource staff and the chairperson of selection committees e.g. nursing service managers. The researcher observed distinct efforts to accommodate the EEA during formal promotion processes. However, interview questions were sometimes revealed before the time and nepotism did occur. Other findings include stereotyping of the abilities of women of colour resulting in overt and covert racial discrimination. There were also distinct efforts to promote those similar to those who made the appointments e.g. males appointing other males. The influence of class on promotion varied from factors such as professional dress code and sound conduct to being able to converse in eloquent English and physical attractiveness. Findings confirmed the intersecting influence of race, class and gender to marginalize women of colour. Lastly, the framework was developed from the meta-inferences (the integrated inferences from the quantitative and qualitative findings) and focuses on improving the credibility of the promotion process, diversity training, succession-planning and the creation of healthy managerial structures.

AFRIKAANSE OPSOMMING : Agtergrond: Nieteenstaande ʼn 79% Swart Afrikaner meerderheid en die implementering van die Wet op Diensbillikheid van 1998, die diensbillikheidsverslae van die Departement van Gesondheid in die Weskaap en dié van die private gesondheidsorg-sektor nasionaal in Suid-Afrika toon swak verteenwoordiging van Swart Afrikaner en Kleurling verpleegkundiges in leierskapposisies. Internasionale- en nasionale literatuur toon dat die aanstelling van vroue in leierskap-posisies neig deur aspekte wat verband hou met ras, geslag en klas, beïnvloed te word. Die doel van die studie was om ʼn raamwerk te ontwikkel om die aanstelling van vroue van kleur in leierskapposisies in hospitale te fasiliteer. Die doelwitte was om die:  Invloed wat die Wet op Diensbillikheid het op die aanstelling van verpleegkundiges in leierskapposisies, te verken  Die sieninge van verpleegkundiges oor die invloed van ras, geslag en klas op die aanstelling van verpleegkundiges in leierskapposisies te verken  Die praktyke eie aan die selekteringsprosesse van verpleegkundiges in leierskapposisies, soos ervaar deur diegene betrokke in die selekteringsproses, te verken  ʼn Ras-, geslag- en klas-sensitiewe raamwerk te ontwikkel om verpleegkundiges in hul voorbereiding vir leierskapposisies te ondersteun Ontwerp: ʼn Samehangende gemengde ontwerp was aangewend deur van ʼn kwantitatiewe deursnit beskrywende opname en kwalitatiewe interpreterende fenomenologie benaderings gebruik te maak. Die studie was op die filosofie van pragmatisme gebaseer. Populasie en studie-omgewing: Die studie was in die openbare en private gesondheidsorg-sektore van die Weskaap en Gauteng provinsies uitgevoer. Kwantitatiewe navorsing: Die deursnit beskrywende opname was deur n=573 professionele verpleegsters voltooi (terugkoers =83%). Die navorser het ʼn gestruktureerde vraelys wat Likert- en oop-vrae bevat het, gebruik. Data was met SPSS statistiese sagteware, weergawe 24, en die bystand van ʼn statistikus geanaliseer. Die afleidings van die Likert-skaal vrae het getoon dat rasse-, geslag- en hiërargiese verhoudings in die werksplek sedert die implementering van die Wet op Diensbillikheid verbeter het. Die afleidings van die antwoorde op die oop vrae het egter die teenoorgestelde getoon. Die bevindinge het wantroue in die bevorderingsprosesse toegepas deur die openbare en private sektors getoon. Kwalitatiewe navorsing: Onderhoude was met 5 verpleegleiers en ook 40 persone wat deelgeneem het in die selektering proses van verpleegsters in leierskapposisies soos die suksesvolle en onsuksesvolle kandidate, menslike hulpbronpersoneel, en die voorsitter van selektering komitees, bv. verpleegbestuurders, gevoer. Die navorser het besondere pogings om die Wet op Diensbillikheid tydens formele bevorderingsprosesse te akkommodeer, waargeneem. Nieteenstaande was onderhoudsvrae soms voor die tyd uitgelek en nepotisme het plaasgevind. Ander bevindings behels stereotipering van die vermoëns van vroue van kleur wat tot openlike en subtiele rasse diskriminasie gelei het. Daar was ook besonderse pogings om diegene eenders tot hulle wat die aanstellings maak, te bevorder bv. mans bevorder ander mans. Die invloed van klas op bevordering het van ʼn professionele kleredragkode en goeie gedrag tot gespreksvoering in elegante Engels en fisiese aantreklikheid gevarieer. Die bevindinge het die oorvleuelende invloed van ras, klas en geslag om vroue van kleur te onderdruk, bevestig. Laastens, die raamwerk was uit die meta-afleidings (die geïntegreerde afleidings van die kwantitatiewe en kwalitatiewe bevindinge) ontwikkel en fokus op die verbetering van die kredietwaardigheid van die aanstellingsproses, diversiteitsopleiding, loopbaanbeplanning en die skepping van gesonde bestuurstrukture.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/105108
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