Pink Collar Blues: The legacies of Jo Ann Ashley and Gloria Steinem

This year marks the 50th anniversary of the publication of Jo Ann Ashley’s book, “Hospitals, Paternalism, and the Role of the Nurse” ​(Ashley, 1976)​. The slim volume was published four years after Ashley’s dissertation research which served as the basis for the book, and four years before her untimely death from breast cancer. It was the only book Ashley published, but it had a profound impact through Ashley’s direct and blunt way of connecting with nurses about what they were experiencing in the workforce and why.

Ashley was angry. Her anger came through in her book, her many articles, and her speeches, and it was commented on by her supporters and critics alike. She was angry at the established order, at the patriarchy and paternalism that characterized healthcare organizations, and at the economic disparities that hamstrung nurses. But Ashley directed much of her anger toward nurses themselves, once calling them “oppressed losers” and saying, “we have been blacklisted for a century” (Ashley, 1975a). She often pointed out the role nurses played in maintaining the system that suppressed them. As Ashley stated, “Young nurses quickly learn that they are to use their power, cooperatively and collaboratively, to keep the system operative. They learn less about the ways and means of using their power to change a system that needs changing” (Ashley, 1973).

Ashley’s book was released during the height of the second wave of feminism that began in the early 1960s and lasted about twenty years. The movement accelerated after the founding of the National Organization for Women in 1966. The second wave owed much to the recent introduction in the late 1950s of reliable oral contraception, creating for the first time the ability for women to focus on their own bodily autonomy and control over childbearing and childrearing. Workplace equality, family roles, and sexuality were primary foci of the second wave, as contrasted with the suffrage efforts of the first wave.

While most women (and most nurses) today have no memory of the reasons for the second wave of feminism, it was a part of Ashley’s everyday life, and that of many other women, to confront seemingly intractable barriers to equal treatment under the law. For example, until the 1960s there were no federal laws prohibiting gender discrimination. Individual industries held unchecked authority over the treatment of men and women as employees and as customers. Many banking institutions routinely refused service to single women and forced married women to get a husband’s signature to open a bank account. It almost went without saying that women would not be paid a salary equivalent to a man’s for doing the same job. Most of society saw nothing wrong with the assumption that it was the man who needed to support a family and who thus “deserved” a higher salary.

Until the passage of the federal Equal Credit Opportunity Act of 1974, the vast majority of banks required a male cosigner for a woman to secure a credit card, a mortgage, or a business loan. Lenders assumed a married woman with a full-time income would soon leave the labor force to rear children, and thus entirely discounted her earnings when considering any credit application. Women did not have the freedom to so much as use their own names after marriage until well into the 20th century. Beliefs about women’s roles in the household were so persistent and so biased that women who attempted to vote, get a passport, or execute a contract under their birth names were often refused, just because the person in charge felt like refusing them. A woman who found herself in such a situation had no recourse, despite there being no law outlawing their use of their own name. These are just a few examples of the gender-based discrimination that pervaded society in the United States and elsewhere, and that were called out and challenged by second wave feminists.

The entire history of nursing, since its rise as an organized and educated profession, is full of examples of the impact of sexism and gender bias. Nursing belongs, along with teaching, secretarial work, and social work, to the career paths dubbed “pink collar” professions. They are so identified because workers in these fields are primarily women. Indeed, few career paths other than those above were considered acceptable choices for women based on the societal standards of the mid-20th century. Pink-collar jobs have historically and persistently been linked to lower average pay, lower social status, and fewer promotional paths when compared with male-dominated jobs. Over and over again in her writings, Ashley emphasized the link between nursing as a female-dominated profession and power imbalances, including economic power. As usual, Ashley pointed the finger at her own profession, stating ”Largely ignorant of their commercial value, nurses have not demanded changes” (Ashley, 1975b).

In our postfeminist world, many women assume that there is no further need for a feminist movement. After all, the problems above have been settled in favor of women. We have choices, equality, and freedom, correct? Not so fast. In a recent integrative review of the literature on workplace gender discrimination, investigators found that while both men and women in nursing experience workplace gender discrimination the types of discrimination experienced and the consequences differ. Men may represent the minority of nurses, but because they are members of a “dominant patriarchal group …. they do not suffer the same consequences as other minority groups in regard to career success” (Gauci, 2023). The work, it seems, must go on.

The writing of this editorial commemorating the anniversary of Ashley’s book coincided with news of the death of Gloria Steinem, a journalist who became perhaps the most iconic leader of the second wave of feminism in the United States. Steinem, like all leaders of societal change, was a controversial figure, but her role in “women’s liberation”, as a founder of Ms. Magazine, and as a consciousness raiser for a generation of women cannot be overstated. Jo Ann Ashley clearly identified strongly with this movement and its implications for the nursing profession.

Ashley’s single (and singular) book served as a wake-up call to untold numbers of nurses in the 1970s. Indeed, some might call it a slap in the face. Ashley’s work was an added source of awareness for many women of how they were being defined, and in many cases constrained, by their gender. It undoubtedly caused some nurses to question their choice of career path. Her work should be revisited. Nurses should regain a focus on this most historic form of discrimination while remaining attentive to others. As Ashley (1980) put it, “Remaining deaf, dumb, and blind to the suffering and destruction of our own kind is agreeing to the political dominance of those who wish to continue destroying the strengths of women.”

References:

Ashley, J. A. (1973). This I believe about power in nursing. Nursing Outlook, 21(10), 637-641.

Ashley, J. A. (1975a, February). Health care, American style. Supervisor Nurse, 8, 46-57.

Ashley, J. A. (1975b). Power, freedom, and professional practices in nursing. Supervisor Nurse, 6(1), 12-29.

Ashley, J. A. (1976). Hospitals, Paternalism, and the Role of the Nurse. New York: TeachersCollege Press.

Ashley, J. A. (1980). Power in structured misogyny. ANS/Politics of Care, 2(3), 3-22.

Gauci P, Luck L, O’Reilly K, Peters K. Workplace gender discrimination in the nursing workforce-An integrative review. J Clin Nurs. 2023 Sep;32(17-18):5693-5711. doi: 10.1111/jocn.16684

Kim Curry

September, 2026