The power of women as nurses in South Africa.
An epistemological analysis of the power of women as nurses in one of the larger and more deprived regions of South Africa, KwaZulu-Natal, was carried out. The premises of the standpoint theory were used as a justificatory strategy for participant selection. A fourth premise of rurality was added to the existing three premises of race, class and gender. A phenomenological research approach incorporating two to three in-depth interviews with each participant following a flexible guideline was utilized. Key concepts and realities such as powerlessness, powerfulness and empowerment were explored and a total of 44 audio-taped interviews was transcribed. Data analysis was aided by a software programme for qualitative data analysis (NUD. IST) and focused on the exploration and development of themes, categories, relationships and condensed forms of outcomes. Detailed attention was given to ethical considerations such as anonymity, freedom of expression and rapport. The credibility of the study was enhanced through prolonged engagement, thick descriptions and the input of three experienced researchers. In reflecting on powerlessness, women as nurses belonging to the enrolled category were alienated as they were severed from the nursing profession and from the ruling gender of men. They were lost in routine activities, were misused, maternalized and domesticated at home and at work. These phenomena were voiced more strongly by the rural group of women. Registered nurses created their own freedom, often away from their men as in divorce, and sought solutions concerning powerlessness in more distant terms. They communicated a sense of empowerment in terms of education and personal qualities. Culture rather than race was emphasized as an essence of women's oppression. Recommendations of the study focused on ways to limit categorial division, of aligning scope of practices with current health care practices in South Africa and further research regarding the value of the fourth premise of the standpoint theory is suggested.