Why ‘only’ women nurses?
by Dr Hilary Causer
We have been asked why our research focuses solely on women nurses.
Firstly, let me clarify that when we talk about women in the context of our research, we are referring to anyone who identifies as a woman. This definition has been developed in collaboration with nurses who have experience of suicidality, and we will use it when recruiting nurse participants into our studies.
We made the decision to focus specifically on women nurses for a range of reasons:
In response to the statistics regarding suicide rates by women nurses
Because women’s and men’s experiences of being a nurse are different
Because suicide is a gendered experience and there is a notable lack of research that specifically explores women’s experiences.
Because historically, women’s experiences and distress are more likely to be understood as medical problems.
Solutions and interventions to address women’s distress and suicidality have been individualised. This suggests that women are seen as being responsible for their own problems, whereas the root cause may lie in the ways that society and the workplace are organised.
In this blog I will focus on the first three.
Women nurses have a heightened rate of dying by suicide
This project came to fruition in response to the heightened rate of suicide among women nurses who have a 23% greater risk of dying by suicide than women in other professions. This statistic is echoed in other western countries such as Australia and the USA. However, male nurses, health care assistants, or midwives do not demonstrate a similarly heightened rate.
“women nurses have a 23% greater risk of dying by suicide than women in other professions”
Whilst the statistics tell us ‘what’ is happening, we don’t currently understand ‘why’ it is happening. Therefore, we are undertaking five distinct studies, using qualitative and mixed research methods, that focus on the experiences of women nurses. Our research findings will not only add to current knowledge, but also identify necessary changes to the working lives and environments of women nurses to address this longstanding anomaly.
Gendered experiences of being a nurse
Research tells us that there are distinct differences in the experience of being a nurse according to gender. Almost 90% of UK nurses are women, thus nursing is a female majority profession. Despite this, women nurses are less likely to progress to senior roles than male nurses and are paid less on average than male nurses.
They are also more likely than their male counterparts to experience discrimination, bullying, and harassment at work and are significantly more likely to experience gender-based violence inside the workplace and intimate partner violence, a known risk factor for suicide outside the workplace. Women health staff, including nurses, were also more likely to experience anxiety, depression, and sleep disorders after working through the Covid-19 pandemic. A recent report on suicide in female nurses in England states that of nurses who were in contact with mental health services 18% percent reported problems at work compared with 6% of women in other occupations.
“Almost 90% of UK nurses are women”
For some women nurses these gendered experiences occur at the intersection with other factors, which further complicate their experiences. For instance, 40% of the NHS workforce, and 60% in social care, are workers from the global majority, many of whom gained their nursing qualifications before migrating to work in the UK. Nurses who identify as Black are disproportionately referred to the nursing regulator.
It is clear, that while the experiences of male nurses are valid and important, they will not helpfully contribute toward growing our understanding of what is happening for women nurses.
Gendered experiences of suicide and gendered suicide research
There are also gendered differences in suicidal experience. The most significant being that nearly three quarters of all people who die by suicide are men. Paradoxically, incidents of self-harm and suicidal thoughts and attempts are more frequent for women. The means by which people die by suicide also differ between men and women, as do the most likely age at which people die by suicide.
These differences have shaped the research agenda. Specifically, as most deaths by suicide are men, research has focused on seeking to understand risk factors and preventative factors that pertain to men. This has resulted in a dearth of research into women’s suicide in any cohort.
“suicide research has focussed on risk factors and preventative factors that pertain to men”
This is problematic as it means that certain contexts or life events which are specific to women remain unexplored. These include the care burden and the ‘second shift’; menstruation, pregnancy/infertility and menopause; dominance of patriarchal messaging and systems in society and workplaces; sexual and domestic violence and coercive control; violence in the workplace; and experiences of working in female majority professions.
Our research, by focusing on women nurses, will provide novel and valuable evidence that will grow our collective understanding about how suicide might be experienced differently for women.
Our answer to your question
We have given a great deal of consideration to the design of the studies within this project, including consulting with nurses and our project stakeholders. Our answer to your question, ‘why only women nurses?’, is, because they face greater risk of dying by suicide, and have distinctly different experiences to men nurses, and because women’s experiences around suicide are currently under-researched and poorly understood.
To learn more about the approach that we will be taking in our research, and the feminist and critical arguments that underpin our approach, take a look at our previous blog post by our Principal Investigator Dr Ruth Riley.