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they were assigned too many responsibilities at an early age and were systematically mistreated both
during their training period and on the job, especially when they were very young. 17 For many of
them, although they were content to have their own income, nursing was therefore not at all a
fulfilling occupation. As Susan Jo Roberts has observed,
The development of personal and professional self‐esteem is not an easy process,
especially in a group that works long hours and often has multiple commitments in and
outside of work. Also many nurses are action oriented and rarely have time to reflect.
Many nurses are women and have been taught from their earliest years how to behave as
women. 18
Today some nurses and nursing authorities within the profession usually tend to disqualify others
on behalf of licensed nurses. While the professional status of nursing is still dubious and is not clearly
recognized as an independent profession, nurses are confronted with each other in an ambivalent
hierarchy of rank. 19 There are proposals now and then for the regulation of nursing whereby only
university graduates would be qualified as nurses; at the same time, through political manipulations,
new vocational nursing schools are being opened – and since 2010, private ones as well. These
ambivalent developments make nurses who have been practicing for 20 to 30 years feel uneasy.
Though they appreciate the demand for higher education in nursing, they do not want to be
systematically scapegoated as insufficiently professional after having practiced nursing for so long.
These attempts help constitute a subclass, a “nonprofessional strata” 20 within the profession, and
trigger stratification and inequalities among women.
Fanon (1963) noted that aggression and anger toward the powerful often is turned
inward toward one’s own group because of the same fear and low self‐esteem. He called
this internal conflict “horizontal violence” and felt that it functioned as a way of
maintaining the status quo by limiting revolt. This behaviour keeps the group from
organising and from developing the sense of unity and cohesiveness necessary to revolt. 21
During interviews with older‐generation nurses, they described some relatively youngergeneration,
university‐educated nurses as arrogant and accused them of seeking promotion
immediately after being employed, before gaining the skills, experience and expertise demanded by
the post they desire. They even accused some of the university graduates of viewing care work as
something with low social value, even degrading, and of being inclined to reject such work and
aspiring to be researchers or administrators. Because of the low social value of care work, some
university graduates might find it contradictory to perform such work when they have a university
diploma. But for nurses of the older generation, there was a contradiction in someone who is
qualified as a “nurse” avoiding care work. And that was a big problem, because
…nurses who leave clinical work for administration and education often feel “better
than” other nurses and are proud of their elite status. These leaders may hide their
nursing roots when they reach these positions because they feel that “being a nurse”
makes them less credible. Educators and administrators also may pass their negative
feelings about nursing to their students and to others, thus continuing the cycle of low
self‐esteem. 22
Fortunately, the fact of belonging to different generations does not necessarily portend conflict.
Some of my informants reported a harmonious work life in solidarity with other colleagues who had
different educational backgrounds and statuses, especially in units where nurses had more autonomy
and were less subject to domination or manipulation by medical or other superiors. Nurses who were
unhappy in their own units also referred to those exceptional units rather positively: they likened
such units to safe islands in the hospital because there nurses were part of the team. Some
informants expressed the feeling that the multilayered oppressions they were confronted with in the