Strengthening Leadership Pathways for Women Nurses and Midwives: Examining System and Organizational Opportunities in a Mixed-Methods Study.

BACKGROUND

The nursing and midwifery profession constitutes a substantial portion of the global health workforce, with the majority being women. Despite this, women nurses and midwives are underrepresented in healthcare leadership.

OBJECTIVES

To explore the perspectives and experiences of nurses and midwives to identify system- and organizational-level strategic opportunities for advancing women into leadership.

DESIGN

Two-phased mixed-methods design employing an exploratory sequential approach and weaving narrative methods.

SETTING

Large public and private healthcare services in Australia.

PARTICIPANTS

Phase one included twenty-five nursing and midwifery leaders. Phase two included 158 nurses and midwives.

METHODS

Data from the organizational change management stream of the Advancing Women in Healthcare Leadership national initiative was used. Phase one consisted of qualitative semistructured interviews and informed phase two, which comprised an online survey with qualitative and quantitative components. Qualitative data were analyzed thematically; quantitative data were analyzed descriptively.

RESULTS

System-level opportunities for advancing women nurses and midwives into healthcare leadership included reforming legal agreements and challenging perceived hierarchies within professional roles. Organizational-level opportunities included building leadership capacity through inclusive organizational policies and processes; fostering inclusive organizational cultures through awareness and engagement; expanding mentoring and networking opportunities; enhancing leadership development through accessible, tailored training; and embedding equity and transparency in recruitment and promotion.

CONCLUSION

Advancing women nurses and midwives into healthcare leadership needs a shift from individual efforts to systemic strategies. Addressing structural barriers and fostering empowerment, healthcare systems can build inclusive, resilient leadership pipelines that reflect the diversity and expertise of the nursing and midwifery workforce.

PATIENT OR PUBLIC CONTRIBUTION: This study examines nursing careers and workforce issues rather than nursing care. Consequently, no patients or members of the public were involved in its design, conduct, or reporting.