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Caring: A gendered concept
Women's Studies International Forum, Vol. 20, No. 4, pp. 529-536, 1997 Copyright © 1997 Elsevier Science Ltd Printed in the USA. All rights reserved 0277-5395/97 $17.00 + .00
Pergamon
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CARING: A GENDERED CONCEPT MARILYN POOLE School of Social Inquiry,Deakin University,221 Burwood Highway, Burwood, Victoria 3125, Australia DALLAS ISAACS Human CommunicationsUnit, Telstra Research Laboratories, 770 BlackburnRoad, Clayton, Victoria 3168, Australia
Synopsis - - The concept of caring has been explored in a variety of ways in both feminist academic literature and in the professional nursingjournals. In this study of first-year nursing students the focus was on why they decided to enter nursing as a career, their experience of clinical placments and their views on gender equity. Many of the female studentsresponded in terms of "caring for others" and "the desire to help people," the males responded in terms of career prospects. Startingwith the viewpointthat caring is "both love and labour," this study analyses concepts of caring as a reflection of discursive practices relatingto notionsof the family and motherhood. Other discourses identifiedas availableto the students were those relatingto the body, body care, and sexualityand those that centred on their roles as women or men. © 1997 Elsevier Science Ltd
INTRODUCTION The concept of caring has been addressed in a variety of ways. In this paper, based on an empirical study of first year nurse education students in a faculty of nursing, the students were asked reasons why they chose nursing as a career and about their early experiences in a clinical setting. Professional nursing journals have addressed the concept of care and caring in a number or ways, however, in this paper we have utilised a feminist theoretical approach. Feminist academic literature has concentrated on the social reproduction of the family and the position of women as unpaid workers caring for the disabled, the sick, or the elderly. This focus also included consideration as to how unpaid, domestic work in the home is reproduced in the capitalist work place, where women are segregated into lower paid jobs in the human service industries, such as the concentration of women in child care, ancillary workers in geriatric in-
© 1997 Elsevier Science Ltd. All rights reserved.
stitutions, or work with the disabled (Abel & N e l s o n , 1990; G r a h a m , 1993; U n g e r s o n , 1983b). Other feminist discussions have seen caring and nurturing as an integral part of w o m e n ' s identity and that w o m e n undertaking these roles, whether in private life or the public sphere, are not doing so simply because these roles have been assigned to them, but because they are meaningful and fulfilling for them (Baker Miller, 1976; Gilligan, 1982). They believed that caring has been devalued because it is seen, in a patriarchal society, as w o m e n ' s work. They would argue that women should continue to care, that caregiving be recognised and valued as a humanising experience and that men should not only be encouraged to value the attributes of caring and nurturing but should adopt them, themselves. However, Abel and Nelson (1990, p. 7) comment; "In a society riven by divisions of class, race and gender, r e l a t i o n s h i p s of m u t u a l i t y are difficult to achieve. In both the domestic domain and the waged labor force, most caregivers are members of subordinate groups."
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The debate has sharpened considerably as governments around the world seek to reduce burgeoning health costs and the rhetoric of "community care" has entered public debate. Policy shifts on the part of governments anxious to slash health and welfare budgets have been away from residential to institutionalised care (usually provided by the state) and toward informal are by families within the community. The feminist critique that shifted to the social policy arena has been to point out that "community care" is often represented (Brown & Smith, 1993). In reality it is generally the female relatives of the sick, the elderly or the disabled who usually provide the labourintensive care. They do this with assistance from women in the community in the guise of volunteer workers or home helps and the plethora of women in the helping professions, such as nursing and social work. In what is already a complex issue, as more community care is being required of families (in general, the female members) more women are entering the paid workforce. In order to cope, they in turn, employ lower paid caregivers as child-care workers, domestic cleaners, or caregivers who might also assist the frail elderly.
T H E C O N C E P T OF CARE IN NURSING The concept of caring has a long history in the nursing curriculum and in the professional nursing journals too. Indeed caring is regarded as "the central and unifying domain for the body of knowledge and practices in nursing" (Leininger, 1988 cited in Cohen, 1993, p. 621). However, as Gordon (1991, p. 46) points out the marketplace has invaded the caring professions of education, social work, and nursing in terms of tighter regulations and concerns about budgets and performance, which have exacerbated "their traditional low pay, poor working conditions and limited opportunities for advancement." In addition to this, women have embraced those marketplace values that denigrate care. As women have tried to liberate themselves from occupational constraints they have moved away from women's traditional caregiving work toward traditional male activities and occupations. Indeed, as nurses have sought to improve their professional status they have emphasised their skills in high-tech areas, such as intensive care and surgery. This proves some-
thing of a dilemma, for while the nursing curriculum and professional ethics emphasise the holistic and caring nature of nursing, the technical aspects of medical interventions seem to provide higher status than basic skills, which are associated with the "bedside" model of care. As nurses strive for increased recognition of their professional status, for better pay and working conditions, it is not surprising that the caring model that has been associated with stereotypical constructions of femininity has been de-emphasised and become somewhat problematic. This view is supported by Roberts (1983) who, citing Paulo Freire, suggests that nurses, a subordinate group, have internalised the values of the dominant group, that is men and the medical profession. In the oppression model cited by Roberts, those in the subordinate group (nurses) who wish to become powerful will devalue the qualities of the group to which they belong and attempt to assimilate and take on the values of the dominant group.
CARING AS BOTH LOVE AND LABOUR
In the 1980s, the feminist research on caring shifted terrain. There was a move away from the domestic labour debate toward research on the emotional as well as material significance of social reproduction (Graham, 1993). The primary concern of such research still focussed on informal care with both psychological and material implications: it was "both love and labour" (Graham, 1983, p. 13) The dual nature of caring tended to be treated separately, in that the emotional aspects of caring were the domain of psychologists, while the material aspects or the labour of caring were seen as part of the gendered division of labour. Conventionally, caring is associated mainly with women and in domestic and intimate relationships. There are some occupations where this aspect of caring has been incorporated, such as primary teaching, nursing, and social work - - where the workforce is largely female. Much of the psychological literature has seen caring as part of the constellation of attributes associated with femininity. Indeed, caring may mark one of the boundaries between masculinity and femininity, that is the psychological distinction between " b e i n g " (the other-directedness of women) and "doing" or instrumentality of men (Graham, 1983, p. 18). Gilligan (1982, p. 8) has
Caring: A Gendered Concept
argued that women's identity is largely "relational" and girls and boys construct their gender identity differently: For boys and men, separation and individuation are critically tied to gender identity since separation from the mother is essential for the development of masculinity. For girls and women, issues of femininity and feminine identity do not depend on the achievement of separation from the mother or on the progress of individuation. Since masculinity is defined through separation while femininity is defined through attachment, male gender identity is threatened by intimacy while female gender identity is threatened by separation. Gilligan goes on to state that in adulthood males and females have different moral frameworks and that women's moral strengths are in their caring and nurturing roles in which women "define themselves in a context of human relationships but also judge themselves in terms of their ability to care" (Gilligan, 1982, p. 17). Some would argue that Gilligan's analysis is essentialist in nature and provides a basis for those who wish to justify that certain roles and occupations are natural for women or men. Psychoanalysts, such as Chodorow, have attempted to provide alternative frameworks for the concept of care, arguing that it is through the dynamics of the mother-daughter relationship that girls grow into adulthood with a "basis for 'empathy"' built into their primary definition of self" (Chodorow, 1978, p. 167). According to Chodorow, gender is socially constructed through the dynamics of child-raising arrangements. Traditionally, mothers have spent much more time than fathers in nurturing and tending to their children and only when men become more active in these roles will this change. FAMILIAL IDEOLOGY The material aspects of caring have been seen as part of the ideology of familialism (Barrett & Mclntosh, 1982), "which has established dominance and operates as a principle of social organisation at both the domestic and public level" (Dalley, 1988, p. 20) This ideology "underpins domestic relations and becomes a major organising principle upon which social relations
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outside the domestic group are based" (Dalley, 1988, p. 21) According to this model, a familial ideology creates a gendered division of labour in which women provide the servicing functions in both the domestic and public spheres. The validation and organisation of care giving domestically is replicated publicly in the field of social care (Dalley, 1988, p. 22) The ideology atfirms that it is natural and appropriate that caring for children occurs within the domestic sphere and extends this to the care of other dependents, such as the sick, disabled, or the elderly. Indeed as the de-institutionalisation of care continues in health and welfare policies, the family model of care is seen as an appropriate policy goal. The psychological models that see caring as part of the construction of femininity and the ideology of familial care dovetail neatly, in that women are seen as the most appropriate carers both at home and in the workplace.
EMOTIONAL LABOUR In her early writing on the sociology of the emotions, Hochschild (1983) discusses the "emotion labour" of flight attendants. She points out that in her study the majority of flight attendants are women and more than others involved in emotion work they are expected "to enact two leading roles of Womanhood: the loving wife and mother (serving food, tending to the needs of others) and the glamorous 'career woman' (dressed to be seen, in contact with strange men, professional and controlled in m a n n e r . . . ) . They do the job of symbolizing the transfer of homespun femininity into the impersonal marketplace . . ." (p. 175). This dichotomy may also be seen in nursing. The majority of nurses and nursing education students are women. The "emotion labour" undertaken by nurses is seen as an appropriate professional response not only by their employers, the patients, or clients but also by nurses themselves. These concepts provide a useful starting point for analysis in an empirical study of firstyear nursing education students. The particular focus of this study is on the reasons first-year nursing students gave for entering nursing as a career, their experience of clinical placements, and their views on gender equity. In order to bring our theorising into some kind of dialogue with our data, it seemed necessary to identify a
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number of different and often competing or contesting discourses. The discourses or sets of discursive practices available to the students were notions of the family and motherhood, of the body, body care, and sexuality, and those which centred on their roles as women or men. This approach proved helpful in illuminating the meanings embedded in the students' responses and provided a connection between what they say and what they believe.
METHODS This paper is based on a survey administered to the first-year cohort of nurse education students on the metropolitan campus of a Victorian university. The survey, in the form of questionnaires administered by academic staff at the end of tutorials was completed by 128 students, representing a return rate of 74.4%. On the basis of anecdotal evidence from tutors who administered the questionnaire, the refusal rate for completion of the questionnaires was very small and the majority of uncompleted questionnaires represented students who were absent from class on that particular day (which was at the end of the semester when absence from tutorials is likely to be higher). The gender breakdown of those who returned questionnaires was 89.1% female and 10.9% male (similar to that in the nursing profession). Of these students, almost 75% had entered university straight from school, and 97% claimed to be of Englishspeaking background. In the following months, 17 semi-structured interviews were conducted with students who had already completed the questionnaire. Questions in both the questionnaire and the semi-structured interviews dealt with a wide range of issues, including the students' family background, schooling, parents' occupations, the influence family and friends had in the choice of career, sources of stress, and how the students felt about nursing as a career in both the short term, that is upon graduation, as well as long-term career plans. Among the questions asked in the survey was " W h y did you decide to do a course in nurse education?" Many students responded in terms of "caring for others" or the desire to "help people" (37.5%); others wanted to "communicate with people" (11%) or "had always wanted to be a nurse" (23%). Not one male student from the sample responded to this question in
terms of caring. One male talked of "dealing with people." The answers from the males as to why they had decided to undertake a course in nurse education ranged from " M y mother messed up my application to university whilst I was away" to the fact that nursing was an "interesting, rewarding, challenging" career where one could "meet people" and offered good job opportunities. Far fewer (13.3%), including all the male students, responded in terms of the appeal of nursing as a career or for the flexibility and travel opportunities that a career in nursing offers. When the results of the survey were triangulated with the interviews not only were these views upheld, but some interesting differences emerged on the students' perceptions of caring and on the roles of men and women as nurses.
DISCUSSION The ideology of familialism was elucidated clearly by the female students in both the questionnaires and in the interviews. Many stated that they wanted to become nurses because it fitted in so well with their future roles as wives and mothers. On the other hand, the male students wanted to become nurses because of career structures, and job opportunities, or had aimed at other health professions (such as medicine or chiropractic) and failed to attain the necessary grades. Both male and female students saw the opportunity to travel as a reason for selecting nursing as a career. Some of the female students indicated in their comments the parallels between domestic life and nursing. Just that nursing is a nice job for a nice girl, you know sort of be a nice house wife and can have kids and nursing would be a good job for kids, to be able to have kids and do midwifery. That was a lot of why I went into nursing... Another expressed the familial ideology clearly: I guess because traditionally the girls have always been the ones that look after the sick people in the house and the boring sorts of jobs, luckily that's changing, but again I think because a large part of nursing is that
Caring: A Gendered Concept
basic sort of care and bed-making, just the basic sorts that come with housewife duties. There were comments that nursing was viewed by boyfriends as a suitable job: I just remember it was a big issue to him that I become a nurse because it would be a nice job for his wife to h a v e . . . Some students allied nursing even more specifically with that of "mothering." Some saw parallels between the patients and children to be cared for and others compared the intimate tasks of cleaning up and bathing with that of a mother dealing with her child. The things that nurses are prepared to do for people, a lot of people wouldn't be able to do that, a lot of people wouldn't be able to take the bedpan away or empty a bedpan of faeces or clean up someone who has vomited.., the most personal tasks you will ever do for anybody really, except the mother of a small child. This nurturing image of nursing, which has strong analogies to the role of wife and mother, has been noted by writers such as Vance, Talbott, McBride and Mason (1985, p. 282) who describe nurses as "housekeepers of the sick" and who believe that nurses must reject negative valuations of their worth and ensure that they themselves do not denigrate their caring role. The first-year nursing education students in this study articulate strong associations between nursing and the familial ideology. This may well be rejected later as they become aware of their own professional status and the demands of their career. Teaching a caring ideology to student nurses and providing a nursing curriculum that will enable them to balance these demands is clearly one that is both challenging and potentially full of tension. TOUCHING THE BODY AND BODY CARE FOR OTHERS The question of performing intimate personal tasks for their patients was one that was often raised by the student nurses in this study. Many had dreaded those aspects of nursing and commented that friends and relatives found this part
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of the job daunting. One said, "My sister would never consider doing nursing because she said she couldn't ever imagine ever giving anybody a bedpan or whatever . . ." Another said her Greek friends told her, "How could you do a job cleaning up vomit, they would hate i t . . . I don't know perhaps that's the reason they take on other jobs .... "Lawler (1991, p. 119) points out that in her study nurses had vivid memories of the first time they actually undertook doing body care for others and this task often represents a real confrontation with the realities of nursing. The very intimacy of these tasks was raised as an important issue by both female and male students. Many commented that not only were there difficulties in male nurses showering or toileting female patients especially the elderly (the students had already completed a clinical geriatric placement), but the female students felt that the intimacy of caring for patients set nursing as a profession apart from others. One student said: • . . the kind of intimacy you are involved in with your clients/patients whatever you want to call them, sets nurses apart. I think that the general population see nurses as something different, but there aren't any other occupations that are involved with people in that intimate way, nobody else brings you a bedpan or washes you after a shower and maintains confidentiality and that kind of stuff ... The patients (or clients as they are now termed) often were embarrassed and the students themselves commented on their own initial unease at dealing with opposite-sex patients. As Ungerson (1983a, p. 72) points out, there are is a "clear sexual division of labour in the tasks of tending" - - that, for example, fathers help least with washing, toileting, and changing the nappies of children• She asks the question of whether a taboo system exists in terms of the management of human excreta• As women may already in one sense be polluted (with menstruation and childbirth) Ungerson asks, are they the obvious candidates for further pollution? (p. 73) Or is the management of incontinence, vomit, and excreta simply an unpleasant task, and men, generally holding more power than women, simply refuse, whenever possible, to do it? Certainly there is evidence to support the view that particular kinds of cleaning are
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shunned by men and that the division of labour in housework continues much as it was in the 1950s. For example, the Australian Youth Survey conducted by the Department of Employment, Education and Training reported that not only do young women outperform young men on all forms of housework (except for lawnmowing and gardening), but of the 8,000 young people, only 16% of the young men reported that they had cleaned the bathroom in the previous week, compared with 40% of the young women (The Australian, March 15, 1994, 5). Other household surveys report that men spend very little time on unpaid domestic chores such as cooking, cleaning, laundry, and child care and that once a couple have children, the segregation of tasks by sex becomes even more distinct (Bittman, 1991). SEXUALITY
AND
THE
BODY
The other taboo discussed by Ungerson (1983a, pp. 74-75) and in a later 1987 study was what she "called 'cross-sex caring' between kin" (p. 15). Ungerson believes that two taboos may exist in the caring for elderly relatives - - one being the taboo about human dirt, which may exclude men, the other is touching the genitalia of the parent, in-law, or other close relative of the opposite sex while tending them. Although Ungerson's discussion of the cross-sex caring between kin is not relevant to this study, nevertheless, there is evidence that cultural boundaries that delineate social relationships may well exist and be crossed when nurses wash, touch, and clean the bodies of those of the opposite sex. One might interpret some of the comments made by the nursing students in this way. One male student talking about his work with geriatric women said: I get embarrassed too, quite often. Because I haven't finished my training I can sort of cop out and get a female, or say " I f you prefer I can get a female for you." But if they don't, if they want to struggle through, I can struggle through with them. Another male student described his feeling even more forcefully: • . . but I remember the weirdest thing I came up with in my life was the first time I was in the shower with a woman• I was washing her and I felt really weird, I sort of felt like everyone was looking at me, like I was a
pervert, that was something I really had problems with, basically I had to force myself... Another male student commented that perhaps "women are concerned about being nursed by men, I think men sometimes can be concerned about being nursed by w o m e n . . . " Although male nurses clearly do those intimate tasks of washing and cleaning up, many students commented that, in their limited experience, they believed men often avoided such tasks, leaving them to the women. According to some of the students, a division of labour existed. Often men would be called upon to do lifting and in psychiatric wards to control potentially violent situations, while women were more likely to do the cleaning and tending of patients. One explanation of this perceived division of labour is simply that it is one of convenience. As one male student who had previously worked as an orderly said, "they (female nurses) appreciate a male if a difficult situation, a violent situation comes up, even heavy lifting, sometimes you are treated as lifting machines." Other explanations pertain to taboos about dirt and the crossing of boundaries in terms of the relationships between carers and those receiving care. These boundaries are crossed, redefined, and changed when male nurses care for their female patients in an intimate way. Matters may be somewhat different when young women care for male patients. In some female nurse-male patient interactions, the tending and care given by nurses is viewed as an extension of mothering, and any potential embarrassment at the intimacy of the situation may be acceptable. However, in others this is not the case: • . . then the first time I got to shower a man was even worse, because that was really something I ' d never seen before, never had anything to do with. The first one we did was actually a sponge bath, and we had been warned he was a "dirty old man" and it was only a top and tail. He looked at us when we had finished him and said, "What about the front?" and we said "It happens in the shower tonight," which was the right thing to say because we didn't do it and he was going to try and get us to wash the front. But that sort of came out quite well. He wasn't the dirty old man we had been lead to expect, he
Caring: A Gendered Concept
was just a lonely old man who quite enjoyed the company of females really, and having two young girls looking after him like that either he could cringe away from it, or make a j o k e o f it. Whether or not the old man was lonely, clearly he was interacting with these young students in an explicitly sexual manner• The issue of samesex as well as cross-sex caring is, according to one female student, something of a concern to both male and female students: • . . a female exposing their genitals to a female, they still feel very uncomfortable ... on top of it is the way everything is going where everyone is so orientated towards the legal issues, and the implications of wrong doing just emphasises it n o w . . .
Lawler (1991, p. 195) discusses the delicate balance that exists in nursing practice when caring for the body of others violates many of our social rules on body exposure and touching genitalia. Nurses are required as part of their work to touch areas of the body that in adults are normally only touched during sexual encounters. The reactions of the first-year nurses in this study to naked bodies and genitalia reveal how awkward and embarrassed students become in these situations. They feel that they must control their emotions and establish some sort of professional detachment. Lawler goes on to comment that it takes skill to construct a context in which it is permissible to see other people's nakedness. The students in this study, when confronted with what was to them both embarrassing and sexually explicit, were relieved that they knew "the fight thing to say" - that is, they were able to slip into a professionally detached mode in order to deal with the situation.
NURSING AND
IS NATURAL FOR WOMEN PERHAPS NOT FOR MEN
A number of the students saw the role of the nurse as somehow natural for women, that tending and nurturing were intrinsic parts of a woman's identity, "just that women are compassionate whereas men are professionals," as one student put it. This did raise a number o f issues about the role of men as nurses that had implications about their sexuality. One mature age
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student who had formerly worked as an State Enrolled Nurse (SEN) said: I think that men feel it is a little bit of a threat to their sexuality in that area, it is becoming more acceptable but at one stage a male in nursing, they were automatically branded as homosexual• One of the male students said: I think that probably in the past it was a fact that homosexual males were sort of gravitating towards the field because they felt comfortable than in something like s a l e s . . . He also commented that he personally had found " a lot of anti-male bravado, a bit like blokes in the pub talking about women, women are the same in the hospital situation, in the nursing profession." One student said " m y mum believes that women are actually biologically suited to caring, she says men like combat roles." What we have here is not only the belief that women are innately suited to caring roles (and thus becoming a nurse) but also the belief that men are not. While less explicit, this feeling came through a number of times in the interviews - - real men are not naturally suited to caring. This is a matter that has been raised in the literature on caring, as Graham (1993, p. 463) points out the feminist critique of caring was grounded in the experiences of women who were the carers in their families, and as a result, both "carer and caring were constructed as female categories." In fact, until only recently (Arber & Gilbert, 1989) has it been recognised that in the older age groups men often cared for their sick or disabled wives and in these types of informal care there was an equitable gender distribution. Although the situation is changing, it is apparent that whilst the role of carer is constructed as female, males will face some difficulties in their attempts to enter nursing as a career. It is perhaps not surprising that once trained as nurses there seems to be a tendency for men to gravitate toward administration or the high-tech areas. CONCLUSION Caregiving, according to A b e l and Nelson (1990, pp. 4-5), continues to be associated with women, whether it involves domestic care for children or elderly relatives or those in caregiving occupations, such as kindergarten or pri-
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mary teaching, nursing, or social work. They note that "caregiving transcends the bifurcation between public and private" (p. 6). Many of the students in this study associated the desire to nurture as something uniquely applicable to women. Nursing was seen as an appropriate career in that it was an extension of the kinds of duties women perform in the home as wives and mothers. Nursing is both love and labour, women's motivation to care making them ideally suited to the job. Thus, caring is implicated in the ways in which we organise the division of labour in both the home and in the public arena. Indeed, it goes much further, for not only do these students believe nursing is a good job for a woman, but they also suggest that when men are implicated in the tending tasks of care there are hesitations. These students recognise the gendered division of labour in nursing and many imply that this should continue. If indeed, nursing is still perceived as " w o m e n ' s work," tensions will continue within the profession. In striving for status and autonomy, nurses may well find themselves in separate hierarchies - the tending jobs, those involving emotional labour being largely undertaken by women and the administration and high-tech jobs being largely undertaken by men. Whilst caring is devalued, the high salaries, power, and status will increasingly go to men. A fruitful approach in this discussion lies in recent research on the social management of emotion. As James (1989) points out, the management of emotion has been concentrated in the nuclear family with the responsibility falling upon women. The gendered division of labour has resulted in a gendered division in emotion and one of the ways in which "masculine" and " f e m i n i n e " is perpetuated (James, 1989, p. 23). As Hochschild (1983, p. 5) pointed out in her study of flight attendants, "the emotional style of offering the service is part of the service itself." Duncombe and Marsden (1993, p. 235) believe that the "gender division of emotion, emotion work and emotional skills also offer further insights into the private sphere of intimate personal relationships." Further research into the gender division of emotion may also help us in understanding why even in the same workplace women and men gain validation of their worth in different ways, ways which often lead to gendered inequalities of power and status.
REFERENCES Abel, Emily K., & Nelson, Margaret K. (1990). Circles of care: An introductoryessay. In. Emily K. Abel & Margaret K. Nelson (Eds.), Circles of care, work and identity in women's lives (pp. 4-33). Albany: State University of New York. Arber, Sarah, & Gilbert, Nigel. (1989). Men: The forgotten carers. Sociology, 23, 111-118. Baker Miller, Jean (1976), Towards a new psychology of women. Harmondsworth:Penguin. Barrett, Mich~le,& Mclntosh,Mary. (1982). The anti-social family. London: Verso. Bittman, Michael. (1991). Juggling time: How Australian families use time. CanberraAustralia: Office of the Status of Women,Departmentof Prime Ministerand Cabinet. Brown, Hilary & Smith, Helen. (1993). Womencaring for people: The mismatch between rhetoric and women's reality. Policy and Politics, 21(3), 185-193. Chodorow, Nancy. (1978). The reproduction of mothering. London: Universityof CaliforniaPress. Cohen, J. A. (1993). Caring perspectives in nursing education: Liberation,transformationand meaning.Journal of Advanced Nursing, 18, 621-626. Dalley, Gillian.(1988). Ideologies of caring rethinking community and collectivism. Basingstoke: Macmillan, Duncombe, Jean, & Marsden, Dennis. (1993). Love and intimacy- - The gender divisionof emotionand "emotion work." Sociology, 27, 221-241. Gilligan, Carol. (1982). In a different voice: psychological t h e o ~ and women's development. Cambridge, MA: Harvard UniversityPress. Gordon, Suzanne. (1991). Fear of caring: the feminist paradox. American Journal of Nursing, 91, 45-48. Graham, Hilary.(1983). Caring: a labourof love. In J. Finch & D. Groves (Eds.), A labour of love women, work and caring (pp. 13-30). London: Routledge & Kegan Paul. Graham, Hilary.(1993). Socialdivisionsin caring. Women's Studies International Forum, 16, 461-470. Hochschild, Arlie R. (1983). The managed heart: commercialization of human feeling. Berkeley and Los Angeles: University of CaliforniaPress. James, Nicky. (1989). Emotional labour: Skill and work in the social regulation of feelings. The Sociological Review, 37, 15-42. Lawler, Jocalyn. (199l). Behind the screens: Nursing, somology and the problem of the body. Melbourne: Churchill Livingstone. Roberts, Susan Jo. (1983). Oppressed group behaviour: Implicationsfor nursing.Advances in Nursing Science. 5, 21-30. Ungerson, Clare. (1983a). Womenand caring: Skills, tasks and taboos. In E. Garmarnikow,D. Morgan,J. Purvis,& D. Taylorson (Eds.), The public and the private (pp. 62-77). London: Heinemann. Ungerson,Clare. (1983h). Why do womencare? In J. Finch & D. Groves (Eds.), A labour of love: Women, work and caring (pp. 31-49). London: Routledge & Kegan Paul. Vance, Connie,Talbott, Susan,McBride,Angela,& Mason, Diana. (1985). An uneasy alliance: Nursing and the women's movement.Nursing Outlook, 33(6), 281-285.
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CARING: A GENDERED CONCEPT MARILYN POOLE School of Social Inquiry,Deakin University,221 Burwood Highway, Burwood, Victoria 3125, Australia DALLAS ISAACS Human CommunicationsUnit, Telstra Research Laboratories, 770 BlackburnRoad, Clayton, Victoria 3168, Australia
Synopsis - - The concept of caring has been explored in a variety of ways in both feminist academic literature and in the professional nursingjournals. In this study of first-year nursing students the focus was on why they decided to enter nursing as a career, their experience of clinical placments and their views on gender equity. Many of the female studentsresponded in terms of "caring for others" and "the desire to help people," the males responded in terms of career prospects. Startingwith the viewpointthat caring is "both love and labour," this study analyses concepts of caring as a reflection of discursive practices relatingto notionsof the family and motherhood. Other discourses identifiedas availableto the students were those relatingto the body, body care, and sexualityand those that centred on their roles as women or men. © 1997 Elsevier Science Ltd
INTRODUCTION The concept of caring has been addressed in a variety of ways. In this paper, based on an empirical study of first year nurse education students in a faculty of nursing, the students were asked reasons why they chose nursing as a career and about their early experiences in a clinical setting. Professional nursing journals have addressed the concept of care and caring in a number or ways, however, in this paper we have utilised a feminist theoretical approach. Feminist academic literature has concentrated on the social reproduction of the family and the position of women as unpaid workers caring for the disabled, the sick, or the elderly. This focus also included consideration as to how unpaid, domestic work in the home is reproduced in the capitalist work place, where women are segregated into lower paid jobs in the human service industries, such as the concentration of women in child care, ancillary workers in geriatric in-
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stitutions, or work with the disabled (Abel & N e l s o n , 1990; G r a h a m , 1993; U n g e r s o n , 1983b). Other feminist discussions have seen caring and nurturing as an integral part of w o m e n ' s identity and that w o m e n undertaking these roles, whether in private life or the public sphere, are not doing so simply because these roles have been assigned to them, but because they are meaningful and fulfilling for them (Baker Miller, 1976; Gilligan, 1982). They believed that caring has been devalued because it is seen, in a patriarchal society, as w o m e n ' s work. They would argue that women should continue to care, that caregiving be recognised and valued as a humanising experience and that men should not only be encouraged to value the attributes of caring and nurturing but should adopt them, themselves. However, Abel and Nelson (1990, p. 7) comment; "In a society riven by divisions of class, race and gender, r e l a t i o n s h i p s of m u t u a l i t y are difficult to achieve. In both the domestic domain and the waged labor force, most caregivers are members of subordinate groups."
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The debate has sharpened considerably as governments around the world seek to reduce burgeoning health costs and the rhetoric of "community care" has entered public debate. Policy shifts on the part of governments anxious to slash health and welfare budgets have been away from residential to institutionalised care (usually provided by the state) and toward informal are by families within the community. The feminist critique that shifted to the social policy arena has been to point out that "community care" is often represented (Brown & Smith, 1993). In reality it is generally the female relatives of the sick, the elderly or the disabled who usually provide the labourintensive care. They do this with assistance from women in the community in the guise of volunteer workers or home helps and the plethora of women in the helping professions, such as nursing and social work. In what is already a complex issue, as more community care is being required of families (in general, the female members) more women are entering the paid workforce. In order to cope, they in turn, employ lower paid caregivers as child-care workers, domestic cleaners, or caregivers who might also assist the frail elderly.
T H E C O N C E P T OF CARE IN NURSING The concept of caring has a long history in the nursing curriculum and in the professional nursing journals too. Indeed caring is regarded as "the central and unifying domain for the body of knowledge and practices in nursing" (Leininger, 1988 cited in Cohen, 1993, p. 621). However, as Gordon (1991, p. 46) points out the marketplace has invaded the caring professions of education, social work, and nursing in terms of tighter regulations and concerns about budgets and performance, which have exacerbated "their traditional low pay, poor working conditions and limited opportunities for advancement." In addition to this, women have embraced those marketplace values that denigrate care. As women have tried to liberate themselves from occupational constraints they have moved away from women's traditional caregiving work toward traditional male activities and occupations. Indeed, as nurses have sought to improve their professional status they have emphasised their skills in high-tech areas, such as intensive care and surgery. This proves some-
thing of a dilemma, for while the nursing curriculum and professional ethics emphasise the holistic and caring nature of nursing, the technical aspects of medical interventions seem to provide higher status than basic skills, which are associated with the "bedside" model of care. As nurses strive for increased recognition of their professional status, for better pay and working conditions, it is not surprising that the caring model that has been associated with stereotypical constructions of femininity has been de-emphasised and become somewhat problematic. This view is supported by Roberts (1983) who, citing Paulo Freire, suggests that nurses, a subordinate group, have internalised the values of the dominant group, that is men and the medical profession. In the oppression model cited by Roberts, those in the subordinate group (nurses) who wish to become powerful will devalue the qualities of the group to which they belong and attempt to assimilate and take on the values of the dominant group.
CARING AS BOTH LOVE AND LABOUR
In the 1980s, the feminist research on caring shifted terrain. There was a move away from the domestic labour debate toward research on the emotional as well as material significance of social reproduction (Graham, 1993). The primary concern of such research still focussed on informal care with both psychological and material implications: it was "both love and labour" (Graham, 1983, p. 13) The dual nature of caring tended to be treated separately, in that the emotional aspects of caring were the domain of psychologists, while the material aspects or the labour of caring were seen as part of the gendered division of labour. Conventionally, caring is associated mainly with women and in domestic and intimate relationships. There are some occupations where this aspect of caring has been incorporated, such as primary teaching, nursing, and social work - - where the workforce is largely female. Much of the psychological literature has seen caring as part of the constellation of attributes associated with femininity. Indeed, caring may mark one of the boundaries between masculinity and femininity, that is the psychological distinction between " b e i n g " (the other-directedness of women) and "doing" or instrumentality of men (Graham, 1983, p. 18). Gilligan (1982, p. 8) has
Caring: A Gendered Concept
argued that women's identity is largely "relational" and girls and boys construct their gender identity differently: For boys and men, separation and individuation are critically tied to gender identity since separation from the mother is essential for the development of masculinity. For girls and women, issues of femininity and feminine identity do not depend on the achievement of separation from the mother or on the progress of individuation. Since masculinity is defined through separation while femininity is defined through attachment, male gender identity is threatened by intimacy while female gender identity is threatened by separation. Gilligan goes on to state that in adulthood males and females have different moral frameworks and that women's moral strengths are in their caring and nurturing roles in which women "define themselves in a context of human relationships but also judge themselves in terms of their ability to care" (Gilligan, 1982, p. 17). Some would argue that Gilligan's analysis is essentialist in nature and provides a basis for those who wish to justify that certain roles and occupations are natural for women or men. Psychoanalysts, such as Chodorow, have attempted to provide alternative frameworks for the concept of care, arguing that it is through the dynamics of the mother-daughter relationship that girls grow into adulthood with a "basis for 'empathy"' built into their primary definition of self" (Chodorow, 1978, p. 167). According to Chodorow, gender is socially constructed through the dynamics of child-raising arrangements. Traditionally, mothers have spent much more time than fathers in nurturing and tending to their children and only when men become more active in these roles will this change. FAMILIAL IDEOLOGY The material aspects of caring have been seen as part of the ideology of familialism (Barrett & Mclntosh, 1982), "which has established dominance and operates as a principle of social organisation at both the domestic and public level" (Dalley, 1988, p. 20) This ideology "underpins domestic relations and becomes a major organising principle upon which social relations
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outside the domestic group are based" (Dalley, 1988, p. 21) According to this model, a familial ideology creates a gendered division of labour in which women provide the servicing functions in both the domestic and public spheres. The validation and organisation of care giving domestically is replicated publicly in the field of social care (Dalley, 1988, p. 22) The ideology atfirms that it is natural and appropriate that caring for children occurs within the domestic sphere and extends this to the care of other dependents, such as the sick, disabled, or the elderly. Indeed as the de-institutionalisation of care continues in health and welfare policies, the family model of care is seen as an appropriate policy goal. The psychological models that see caring as part of the construction of femininity and the ideology of familial care dovetail neatly, in that women are seen as the most appropriate carers both at home and in the workplace.
EMOTIONAL LABOUR In her early writing on the sociology of the emotions, Hochschild (1983) discusses the "emotion labour" of flight attendants. She points out that in her study the majority of flight attendants are women and more than others involved in emotion work they are expected "to enact two leading roles of Womanhood: the loving wife and mother (serving food, tending to the needs of others) and the glamorous 'career woman' (dressed to be seen, in contact with strange men, professional and controlled in m a n n e r . . . ) . They do the job of symbolizing the transfer of homespun femininity into the impersonal marketplace . . ." (p. 175). This dichotomy may also be seen in nursing. The majority of nurses and nursing education students are women. The "emotion labour" undertaken by nurses is seen as an appropriate professional response not only by their employers, the patients, or clients but also by nurses themselves. These concepts provide a useful starting point for analysis in an empirical study of firstyear nursing education students. The particular focus of this study is on the reasons first-year nursing students gave for entering nursing as a career, their experience of clinical placements, and their views on gender equity. In order to bring our theorising into some kind of dialogue with our data, it seemed necessary to identify a
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number of different and often competing or contesting discourses. The discourses or sets of discursive practices available to the students were notions of the family and motherhood, of the body, body care, and sexuality, and those which centred on their roles as women or men. This approach proved helpful in illuminating the meanings embedded in the students' responses and provided a connection between what they say and what they believe.
METHODS This paper is based on a survey administered to the first-year cohort of nurse education students on the metropolitan campus of a Victorian university. The survey, in the form of questionnaires administered by academic staff at the end of tutorials was completed by 128 students, representing a return rate of 74.4%. On the basis of anecdotal evidence from tutors who administered the questionnaire, the refusal rate for completion of the questionnaires was very small and the majority of uncompleted questionnaires represented students who were absent from class on that particular day (which was at the end of the semester when absence from tutorials is likely to be higher). The gender breakdown of those who returned questionnaires was 89.1% female and 10.9% male (similar to that in the nursing profession). Of these students, almost 75% had entered university straight from school, and 97% claimed to be of Englishspeaking background. In the following months, 17 semi-structured interviews were conducted with students who had already completed the questionnaire. Questions in both the questionnaire and the semi-structured interviews dealt with a wide range of issues, including the students' family background, schooling, parents' occupations, the influence family and friends had in the choice of career, sources of stress, and how the students felt about nursing as a career in both the short term, that is upon graduation, as well as long-term career plans. Among the questions asked in the survey was " W h y did you decide to do a course in nurse education?" Many students responded in terms of "caring for others" or the desire to "help people" (37.5%); others wanted to "communicate with people" (11%) or "had always wanted to be a nurse" (23%). Not one male student from the sample responded to this question in
terms of caring. One male talked of "dealing with people." The answers from the males as to why they had decided to undertake a course in nurse education ranged from " M y mother messed up my application to university whilst I was away" to the fact that nursing was an "interesting, rewarding, challenging" career where one could "meet people" and offered good job opportunities. Far fewer (13.3%), including all the male students, responded in terms of the appeal of nursing as a career or for the flexibility and travel opportunities that a career in nursing offers. When the results of the survey were triangulated with the interviews not only were these views upheld, but some interesting differences emerged on the students' perceptions of caring and on the roles of men and women as nurses.
DISCUSSION The ideology of familialism was elucidated clearly by the female students in both the questionnaires and in the interviews. Many stated that they wanted to become nurses because it fitted in so well with their future roles as wives and mothers. On the other hand, the male students wanted to become nurses because of career structures, and job opportunities, or had aimed at other health professions (such as medicine or chiropractic) and failed to attain the necessary grades. Both male and female students saw the opportunity to travel as a reason for selecting nursing as a career. Some of the female students indicated in their comments the parallels between domestic life and nursing. Just that nursing is a nice job for a nice girl, you know sort of be a nice house wife and can have kids and nursing would be a good job for kids, to be able to have kids and do midwifery. That was a lot of why I went into nursing... Another expressed the familial ideology clearly: I guess because traditionally the girls have always been the ones that look after the sick people in the house and the boring sorts of jobs, luckily that's changing, but again I think because a large part of nursing is that
Caring: A Gendered Concept
basic sort of care and bed-making, just the basic sorts that come with housewife duties. There were comments that nursing was viewed by boyfriends as a suitable job: I just remember it was a big issue to him that I become a nurse because it would be a nice job for his wife to h a v e . . . Some students allied nursing even more specifically with that of "mothering." Some saw parallels between the patients and children to be cared for and others compared the intimate tasks of cleaning up and bathing with that of a mother dealing with her child. The things that nurses are prepared to do for people, a lot of people wouldn't be able to do that, a lot of people wouldn't be able to take the bedpan away or empty a bedpan of faeces or clean up someone who has vomited.., the most personal tasks you will ever do for anybody really, except the mother of a small child. This nurturing image of nursing, which has strong analogies to the role of wife and mother, has been noted by writers such as Vance, Talbott, McBride and Mason (1985, p. 282) who describe nurses as "housekeepers of the sick" and who believe that nurses must reject negative valuations of their worth and ensure that they themselves do not denigrate their caring role. The first-year nursing education students in this study articulate strong associations between nursing and the familial ideology. This may well be rejected later as they become aware of their own professional status and the demands of their career. Teaching a caring ideology to student nurses and providing a nursing curriculum that will enable them to balance these demands is clearly one that is both challenging and potentially full of tension. TOUCHING THE BODY AND BODY CARE FOR OTHERS The question of performing intimate personal tasks for their patients was one that was often raised by the student nurses in this study. Many had dreaded those aspects of nursing and commented that friends and relatives found this part
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of the job daunting. One said, "My sister would never consider doing nursing because she said she couldn't ever imagine ever giving anybody a bedpan or whatever . . ." Another said her Greek friends told her, "How could you do a job cleaning up vomit, they would hate i t . . . I don't know perhaps that's the reason they take on other jobs .... "Lawler (1991, p. 119) points out that in her study nurses had vivid memories of the first time they actually undertook doing body care for others and this task often represents a real confrontation with the realities of nursing. The very intimacy of these tasks was raised as an important issue by both female and male students. Many commented that not only were there difficulties in male nurses showering or toileting female patients especially the elderly (the students had already completed a clinical geriatric placement), but the female students felt that the intimacy of caring for patients set nursing as a profession apart from others. One student said: • . . the kind of intimacy you are involved in with your clients/patients whatever you want to call them, sets nurses apart. I think that the general population see nurses as something different, but there aren't any other occupations that are involved with people in that intimate way, nobody else brings you a bedpan or washes you after a shower and maintains confidentiality and that kind of stuff ... The patients (or clients as they are now termed) often were embarrassed and the students themselves commented on their own initial unease at dealing with opposite-sex patients. As Ungerson (1983a, p. 72) points out, there are is a "clear sexual division of labour in the tasks of tending" - - that, for example, fathers help least with washing, toileting, and changing the nappies of children• She asks the question of whether a taboo system exists in terms of the management of human excreta• As women may already in one sense be polluted (with menstruation and childbirth) Ungerson asks, are they the obvious candidates for further pollution? (p. 73) Or is the management of incontinence, vomit, and excreta simply an unpleasant task, and men, generally holding more power than women, simply refuse, whenever possible, to do it? Certainly there is evidence to support the view that particular kinds of cleaning are
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shunned by men and that the division of labour in housework continues much as it was in the 1950s. For example, the Australian Youth Survey conducted by the Department of Employment, Education and Training reported that not only do young women outperform young men on all forms of housework (except for lawnmowing and gardening), but of the 8,000 young people, only 16% of the young men reported that they had cleaned the bathroom in the previous week, compared with 40% of the young women (The Australian, March 15, 1994, 5). Other household surveys report that men spend very little time on unpaid domestic chores such as cooking, cleaning, laundry, and child care and that once a couple have children, the segregation of tasks by sex becomes even more distinct (Bittman, 1991). SEXUALITY
AND
THE
BODY
The other taboo discussed by Ungerson (1983a, pp. 74-75) and in a later 1987 study was what she "called 'cross-sex caring' between kin" (p. 15). Ungerson believes that two taboos may exist in the caring for elderly relatives - - one being the taboo about human dirt, which may exclude men, the other is touching the genitalia of the parent, in-law, or other close relative of the opposite sex while tending them. Although Ungerson's discussion of the cross-sex caring between kin is not relevant to this study, nevertheless, there is evidence that cultural boundaries that delineate social relationships may well exist and be crossed when nurses wash, touch, and clean the bodies of those of the opposite sex. One might interpret some of the comments made by the nursing students in this way. One male student talking about his work with geriatric women said: I get embarrassed too, quite often. Because I haven't finished my training I can sort of cop out and get a female, or say " I f you prefer I can get a female for you." But if they don't, if they want to struggle through, I can struggle through with them. Another male student described his feeling even more forcefully: • . . but I remember the weirdest thing I came up with in my life was the first time I was in the shower with a woman• I was washing her and I felt really weird, I sort of felt like everyone was looking at me, like I was a
pervert, that was something I really had problems with, basically I had to force myself... Another male student commented that perhaps "women are concerned about being nursed by men, I think men sometimes can be concerned about being nursed by w o m e n . . . " Although male nurses clearly do those intimate tasks of washing and cleaning up, many students commented that, in their limited experience, they believed men often avoided such tasks, leaving them to the women. According to some of the students, a division of labour existed. Often men would be called upon to do lifting and in psychiatric wards to control potentially violent situations, while women were more likely to do the cleaning and tending of patients. One explanation of this perceived division of labour is simply that it is one of convenience. As one male student who had previously worked as an orderly said, "they (female nurses) appreciate a male if a difficult situation, a violent situation comes up, even heavy lifting, sometimes you are treated as lifting machines." Other explanations pertain to taboos about dirt and the crossing of boundaries in terms of the relationships between carers and those receiving care. These boundaries are crossed, redefined, and changed when male nurses care for their female patients in an intimate way. Matters may be somewhat different when young women care for male patients. In some female nurse-male patient interactions, the tending and care given by nurses is viewed as an extension of mothering, and any potential embarrassment at the intimacy of the situation may be acceptable. However, in others this is not the case: • . . then the first time I got to shower a man was even worse, because that was really something I ' d never seen before, never had anything to do with. The first one we did was actually a sponge bath, and we had been warned he was a "dirty old man" and it was only a top and tail. He looked at us when we had finished him and said, "What about the front?" and we said "It happens in the shower tonight," which was the right thing to say because we didn't do it and he was going to try and get us to wash the front. But that sort of came out quite well. He wasn't the dirty old man we had been lead to expect, he
Caring: A Gendered Concept
was just a lonely old man who quite enjoyed the company of females really, and having two young girls looking after him like that either he could cringe away from it, or make a j o k e o f it. Whether or not the old man was lonely, clearly he was interacting with these young students in an explicitly sexual manner• The issue of samesex as well as cross-sex caring is, according to one female student, something of a concern to both male and female students: • . . a female exposing their genitals to a female, they still feel very uncomfortable ... on top of it is the way everything is going where everyone is so orientated towards the legal issues, and the implications of wrong doing just emphasises it n o w . . .
Lawler (1991, p. 195) discusses the delicate balance that exists in nursing practice when caring for the body of others violates many of our social rules on body exposure and touching genitalia. Nurses are required as part of their work to touch areas of the body that in adults are normally only touched during sexual encounters. The reactions of the first-year nurses in this study to naked bodies and genitalia reveal how awkward and embarrassed students become in these situations. They feel that they must control their emotions and establish some sort of professional detachment. Lawler goes on to comment that it takes skill to construct a context in which it is permissible to see other people's nakedness. The students in this study, when confronted with what was to them both embarrassing and sexually explicit, were relieved that they knew "the fight thing to say" - that is, they were able to slip into a professionally detached mode in order to deal with the situation.
NURSING AND
IS NATURAL FOR WOMEN PERHAPS NOT FOR MEN
A number of the students saw the role of the nurse as somehow natural for women, that tending and nurturing were intrinsic parts of a woman's identity, "just that women are compassionate whereas men are professionals," as one student put it. This did raise a number o f issues about the role of men as nurses that had implications about their sexuality. One mature age
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student who had formerly worked as an State Enrolled Nurse (SEN) said: I think that men feel it is a little bit of a threat to their sexuality in that area, it is becoming more acceptable but at one stage a male in nursing, they were automatically branded as homosexual• One of the male students said: I think that probably in the past it was a fact that homosexual males were sort of gravitating towards the field because they felt comfortable than in something like s a l e s . . . He also commented that he personally had found " a lot of anti-male bravado, a bit like blokes in the pub talking about women, women are the same in the hospital situation, in the nursing profession." One student said " m y mum believes that women are actually biologically suited to caring, she says men like combat roles." What we have here is not only the belief that women are innately suited to caring roles (and thus becoming a nurse) but also the belief that men are not. While less explicit, this feeling came through a number of times in the interviews - - real men are not naturally suited to caring. This is a matter that has been raised in the literature on caring, as Graham (1993, p. 463) points out the feminist critique of caring was grounded in the experiences of women who were the carers in their families, and as a result, both "carer and caring were constructed as female categories." In fact, until only recently (Arber & Gilbert, 1989) has it been recognised that in the older age groups men often cared for their sick or disabled wives and in these types of informal care there was an equitable gender distribution. Although the situation is changing, it is apparent that whilst the role of carer is constructed as female, males will face some difficulties in their attempts to enter nursing as a career. It is perhaps not surprising that once trained as nurses there seems to be a tendency for men to gravitate toward administration or the high-tech areas. CONCLUSION Caregiving, according to A b e l and Nelson (1990, pp. 4-5), continues to be associated with women, whether it involves domestic care for children or elderly relatives or those in caregiving occupations, such as kindergarten or pri-
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mary teaching, nursing, or social work. They note that "caregiving transcends the bifurcation between public and private" (p. 6). Many of the students in this study associated the desire to nurture as something uniquely applicable to women. Nursing was seen as an appropriate career in that it was an extension of the kinds of duties women perform in the home as wives and mothers. Nursing is both love and labour, women's motivation to care making them ideally suited to the job. Thus, caring is implicated in the ways in which we organise the division of labour in both the home and in the public arena. Indeed, it goes much further, for not only do these students believe nursing is a good job for a woman, but they also suggest that when men are implicated in the tending tasks of care there are hesitations. These students recognise the gendered division of labour in nursing and many imply that this should continue. If indeed, nursing is still perceived as " w o m e n ' s work," tensions will continue within the profession. In striving for status and autonomy, nurses may well find themselves in separate hierarchies - the tending jobs, those involving emotional labour being largely undertaken by women and the administration and high-tech jobs being largely undertaken by men. Whilst caring is devalued, the high salaries, power, and status will increasingly go to men. A fruitful approach in this discussion lies in recent research on the social management of emotion. As James (1989) points out, the management of emotion has been concentrated in the nuclear family with the responsibility falling upon women. The gendered division of labour has resulted in a gendered division in emotion and one of the ways in which "masculine" and " f e m i n i n e " is perpetuated (James, 1989, p. 23). As Hochschild (1983, p. 5) pointed out in her study of flight attendants, "the emotional style of offering the service is part of the service itself." Duncombe and Marsden (1993, p. 235) believe that the "gender division of emotion, emotion work and emotional skills also offer further insights into the private sphere of intimate personal relationships." Further research into the gender division of emotion may also help us in understanding why even in the same workplace women and men gain validation of their worth in different ways, ways which often lead to gendered inequalities of power and status.
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