Doctoral Degrees (Nursing and Midwifery)

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Browsing Doctoral Degrees (Nursing and Midwifery) by Author "Van der Heever, Mariana"

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    A framework to facilitate the appointment of women nurses of colour to leadership positions in hospitals
    (Stellenbosch : Stellenbosch University, 2018-12) Van der Heever, Mariana; Van der Merwe, A. S.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    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.