Sexual division of labour: the case of nursing
This paper is concerned with the structural determinants of the sexual division of labour, with particular reference to the occupational structure of nineteenth-and early twentiethcentury nursing. The period I shall be looking at stretches from 1860, the year in which Florence Nightingale opened the Nightingale Fund School of Nursing at St Thomas's Hospital (a traditional landmark in the history of modern nursing), to 1923 when the profession elected its first General Nursing Council. I shall argue that the patriarchal character of the sexual division of labour manifests itself in the nursing profession in a number of interrelated ways. First, in the total operation of health care, nursing occupies a role in subordination to medicine, in that it is the medical profession which possesses the sole right of decision as to who is to be defined as a patient. This subordination structures the nurse-doctorpatient relationship, which comes to take on the ideological resonances of power relations between men, women and children within the patriarchal family – the doctor being the incumbent of the 'rule of the father'. The female dominance of the nursing profession and the male dominance of medicine are of obvious relevance to the situation, the implications of which none the less obtain in the 'anomalous' instances of woman doctors and, particularly, male nurses – although in
such cases the tensions and contradictions in the situation are perhaps more likely to surface in the doctor-nurse relationship. Moreover, in the period under consideration, the moral traits of the 'good nurse' were evidently seen within the profession itself as identical with the characteristics desirable in a 'good woman'. Finally, I shall argue that the character of nursing as a profession for 'good women' , together with the patriarchal and familial character of authority relations within the health care professions, meant that many aspects of the nurse's work became identifiable with domestic labour; but that because of the claim of nursing to some professional status, certain tasks commonly defined as within the province of domestic labour – cleaning and 'hygiene' in particular – come to occupy a central, but at the same time a problematic, position.