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Overview of the balancing act: Having it allKristen M. Swanson‐Kauffman RN, PhD a

a University of Washington , SeattlePublished online: 14 Aug 2009.

To cite this article: Kristen M. Swanson‐Kauffman RN, PhD (1987) Overview of the balancing act: Having it all, Health Care forWomen International, 8:2-3, 101-108, DOI: 10.1080/07399338709515775

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OVERVIEW OF THE BALANCING ACT:HAVING IT ALL

Kristen M. Swanson-Kauffman, RN, PhDUniversity of Washington, Seattle

Managing the multiple roles that women confront is described as abalancing act laden with personal and environmental motivationsand implications. The opportunity for choice is examined as poten-tially a source of both celebration and aggravation for modernwomen. Contrasts and comparisons are drawn between the demo-graphic trends of women today, their mothers of the baby-boom era,and their grandmothers of the earlier part of this century. Demo-graphic trends are further analyzed in terms of historical expecta-tions of women. The implications for nursing are identified as two-fold: Since most nurses are women, they are personally affected bythe trends described; and since nurses are providers of care towomen, they assume some responsibility for the support providedto women, as they balance their many commitments and desires.

Preparing a manuscript for this issue has proven to be quite a challenge.Reading, writing, and thinking about this topic has come altogether tooclose to home. My tendency has been to want to fill the pages withpersonal experience, yet my goal has been to sound critical and distant.My charge as moderator for the Western Society for Research in Nurs-ing (W.S.R.N.) symposium from which this issue sprang was to providean overview for the "Balancing Act." The act under discussion is atimely one for women of the 1980s and 1990s, the juggling of commit-ments related to parenting and working.

Notice the generic terms employed. "Working" implies a way tocontribute meaningfully to the welfare of the household, a containedcommitment away from, or perhaps within the home, and a necessarymeans to a desired comfortable end. "Parenting" encompasses a

This manuscript was prepared while the author was individually funded by the NationalCenter for Nursing Research as a National Research Service Award Postdoctoral Fellow,Fellowship #NU05927-02.

Copyright © 1987 by Hemisphere Publishing Corporation 101 [1]

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gender-free term for one who is responsible for feeding, clothing,and raising a related or adopted member of the next genera-tion.

The other words I could have used, the ones that really get myadrenaline pumping, are motherhood and career. Mother: another wordfor lover, nurturer, protector, cheerleader, madonna, martyr, carpooler,and cookie baker. Career: a metaphor for commitment, status, security,challenge, travel, competition, success, and choice.

Therein lies the crux of the time: choice. To be a woman in theUnited States today is to know the pain and pleasure associated withchoice. Granted not all opportunities are afforded all women; howeverthere is available quite a range of options for control of fertility andchoice of livelihood. Recent trends in North America have moved inthe direction of opportunity. Whereas equality for all has not beenlegislated; opportunities have opened up for women and minority groupsto achieve fulfillment outside of their traditionally prescribed roles.

We are a changing culture; women who postpone or choose to avoidchildbearing are not so rare. The number of females in many of thetraditionally male-dominated workplaces is moving beyond the level ofmere tokenism. Households headed by single parents are commonenough to provide grist for popular movies. Working outside the home ismore the norm for women than not. Hayghe (1983), in fact, reports thatthree of every five American married-couple families have at least twowage earners. Obviously, in the majority of those families, one of thetwo workers is the wife/mother.

In this issue we concern ourselves with describing the roles of womenand discussing the implications of balancing work and family obliga-tions. Of specific concern is the impact of managing multiple commit-ments on women's health. As nurses and women we have a doubleinterest in this topic. Personally and professionally we are only tooaware that the demands and challenges of career do not necessarilyalways coincide with the obligations and pleasures associated with bear-ing and rearing children.

Within the clinical setting, the human price associated with choice isoftentimes observed. Frequently nursing practice involves counselingcareer-conflicted clients as they negotiate life plans as well as deal withthe daily hassles associated with "having it all." As female faculty ob-serve, the keepers of tenure and biological timeclocks have, unfortu-nately, not bothered to synchronize. Decisions between the donning ofthe academic cap and the shedding of the cervical cap weigh heavy.Professional and personal experience teaches that management of fertil-ity of ideas and of offspring is as likely to result in exhaustion as exhila-ration.

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Overview: Having It All 103 [3]

EMERGING ROLES OF WOMEN

Recently, the magazine Cosmopolitan commissioned the Batelle Cor-poration to "create a coherent picture of American women." The team,headed by Dr. Steven McLaughlin (McLaughlin et al., 1986;McLaughlin & Melber, 1986), pulled together information from a vari-ety of attitudinal and demographic longitudinal data sets to provide alarge-scale model of women's behavior that would be "useful to market-ers and a contribution to science." The results of these efforts are sum-marized in a three-part interrelated report. Some key points made inMcLaughlin's report are most relevant to discussion of societal transi-tions which have an impact on not only the expectations of modernwomen, but also, as discussed by Woods in this issue, the overall healthof women.

Part 1 of the Batelle report was completed in 1985. In this phase oftheir study, McLaughlin and colleagues examined census bureau data inorder to highlight some basic demographic trends. They noted two ma-jor themes in the demographic data. The first observation was that to-day's young women are more similar to their grandmothers than theyare to their mothers. From this perspective the so-called baby-boom erais an aberration in historical trends from the early 1900s. Women's be-havior in the 1950s is, in essence, a marked deviation away from theemergence of women's roles since the turn of the century. Like theirgrandmothers, today's young women are: marrying later (if at all); moresimilar to their male counterparts in educational attainment; havingfewer children; and, overall, showing a greater propensity for making iton their own (McLaughlin et al., 1986).

The second major theme identified in Part 1 of the Batelle report waslabeled "the rise of women as primary individuals" (McLaughlin et al.,1986). This theme suggests that while young women are similar in de-mographic behavior to their grandmothers, their actions are driven by adifferent environment and set of life objectives. Whereas in the pastwomen have traditionally set goals to meet family needs, they are nowdriven by other personal and environmental demands. The personal mo-tivation seems to come more from a yearning to live independent adultlives as well as a desire to control and organize their lives in order tomeet personal and career objectives. Environmental forces that contrib-ute to the emergence of women from strictly family directed goals in-clude financial demands, increasing societal acceptance of employmentof wives and mothers outside of the home, and declining restrictions asto sex-appropriate employment and parenting roles. Supporting the find-ings of the Batelle report, some of the effects of lifting societal restric-tions and opening of opportunities to women are evident in this issue.

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For example, in Brown's paper, the perceived health and amount ofsupport experienced by both employed and nonemployed pregnantwomen are examined.

What does it mean to be a woman who has emerged as a "primaryindividual?" What is it like to live in a world in which one's obligationsextend to the self, family, and workplace? Klausner (1971) suggests thatin order to understand any one person's capacity to exist within a givenenvironment the demands, constraints, and resources of both the indi-vidual and environment must be studied. Within this issue, Killien andBrown address some of the questions that surround the meaning of beingprimary women. Their research examines not only what women defineas daily hassles but also how women manage the variety of disturbancesthat arise from their multiple commitments.

BABY BOOMERS: WOMEN IN TRANSITION

The primary woman theme is supported in Part 2 of the report ofMcLaughlin and Melber (1986). This part of the Batelle study involvedsecondary analysis of data from a large national survey (originallydrawn from 1967 U.S. Census Bureau data) that followed two groups ofwomen for 15 years between 1967 and 1982. Group 1 involved thosewomen who were of childbearing age in the 1950s, the mothers of babyboomers. Group 2 involved women who entered adulthood in the late1960s and early 1970s, the baby boomers. Longitudinal data were avail-able from each group of 5000 women on a number of measures, whichdescribed attitudes toward employment, home, and education.

The most consistent theme to arise out of analysis of McLaughlin'sattitudinal data was the recognition that those young women who wereborn in the baby-boom era experienced a major transition in home andwork attitudes as they grew up. The baby-boom generation enteredadulthood with work and family attitudes and expectations not muchdifferent from their mothers. They did, however, subsequently undergoa dramatic transition to new lifestyles and values as they matured. Thetransition involved a profound reevaluation and integration of work andfamily roles. In essence there was a shift from pure family-orientedmotivation to a climate in which the economy became a significant so-cial institution for the shaping of women's lives (McLaughlin et al.,1986b).

Since women of the baby-boom cohort live in an environment inwhich the "game rules have changed," they may well be subject tostress related to the societal transitions in which they are embedded.Marris (1974) notes that transitions of any nature involve a break fromthe familiar past and a venturing into the unknown. Transitions involve a

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giving up of the known for the challenges of previously uncharteredpaths. As humans we have a conservative impulse which Marris de-scribes as "a tendency of adaptive beings to assimilate reality into theirexisting structures" (Marris, 1974, p. 4). Unfortunately when transi-tions or changes occur, conservative impulses are challenged and whatpreviously had meaning may suddenly be rendered useless. Marris sug-gests that grieving will oftentimes ensue when that which we cling tomay no longer hold true.

Conceivably, women born in the 1950s and early 1960s may be ageneration of adults who grieve for the familiar traditional role prescrip-tions while celebrating the opportunities awaiting them. The ambiva-lence associated with the simultaneous experience of grieving and cele-brating is alluded to in at least three of the papers in this issue. Killien'sresearch examines the forces brought to bear on the decisions of profes-sional dual-career couples as to whether to parent and, if so, when.Some of the struggles between the childhood picture of self as mother,and the present reality of the demands and seduction of career are evi-dent in the ambivalence with which some of Killien's couples approachand act on childbearing decisions. The study by Jordan brings the par-enting decisions question one step further and examines how a secondchild fits into and alters the family life of both employed and nonem-ployed women.

Olshansky examines childbearing decisions as they relate to unwantedinfertility. Her qualitative study of infertile women draws attention to apotential pitfall of having previously exercised control over fertility onlyto discover an inability to conceive after having devoted a number ofpotential childbearing years to career enhancement. This leaves somewomen bitter or grieving over a variety of lost opportunities. Olshanskyhighlights the tendency of women to reassess their view of career self inlight of the discovery of the infertile self. Infertility superimposed onexercised choice may render the previously embraced freedom a sourceof anguish.

DAUGHTERS OF BABY BOOMERS

Interestingly, in surveying younger women of today, McLaughlin andcolleagues (1986b) have noted that the new generation of women isgrowing up with the primary women attitudes and values firmly inplace. Thus, our daughters, and daughters of baby boomers, will notknow the transition and, perhaps the conflicts, of their mothers.

This is not to say that young women entering their childbearing yearsdo not face their own share of problems. One can only wonder what willhappen to young women who opt for the role of homemaker. Will they

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be judged harshly for their choice? Will they be viewed as "backslid-ers," the ones who sold themselves short? In the midst of the doorsopening in front of women it behooves us to be aware of the doors beingshut behind us. Caution must be exerted to allow young women theopportunity to act according to their own wishes and to choose the life-style most in accordance with their own desires and economic demands.An environment that encourages anything less would be an era ofpseudo-options, one where choice is allowed only if it concurs with apresently valued ideal. When women are truly liberated all of theirroles, traditional and nontraditional, will be valued and supported.

The third part of the Batelle report is due to be published soon. Thefocus of Part 3 will be marketing trends for the "emerged primarywoman." Although, at the time of this writing, the findings of this as-pect of the study are not yet known, it is nonetheless fascinating toconjecture on the outcomes. As nurses we might ponder the health careneeds that accompany women who are comfortable answering to eco-nomic and family goals.

With women taking on more and more obligations, some of the bur-den of the mother will have to be disbursed. In fact, an entrepreneurialindividual might well recognize that if the mother is out of the housethere are a number of jobs she traditionally performs that could conceiv-ably be marketed at a decent price.

The implications for childcare and household help are obvious. Ofcourse, the decent price issue may be a double-edged sword. As anyworking parent can attest to, the price of childcare may seem prohibi-tive. Yet as any childcare provider knows, the pay scale for this work isembarrassing. Like most female-dominated occupations the labor hashistorically been cheap. The importance of the work is undeniable, but ifit can be bought for a lesser price, who will choose to pay more? Theissue of traditional female roles being undervalued and underpaid willnot go away unless all people (women and men) recognize the necessarycontribution of the nurturing professions to society. When it comes rightdown to it, is there anything more valuable than our children? Shouldn'tthose to whom we entrust their care be paid in proportion to the chargewhich they have been given?

Another role held by the mother in most households is that of in-homehealth care provider and individual in charge of accessing the health caresystem. This brings to the fore two potential roles for the entrepreneur-ial nurse. The first role is that of "substitute in-home health care pro-vider" especially during those pressure-filled times when both parentshave work commitments and their child is sent home ill from school ordaycare. This substitute role could, conceivably, be provided in a clinicsetting (much like a college infirmary) where ill children from more

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than one family could be simultaneously cared for and more than onefee for the substitute services could be collected. As many parents whodepend on day care or school hours can attest to, all goes well until oneof the children starts sneezing!

Another role for nursing to capitalize on while mothers are employedoutside the home is the mother's traditional responsibility for managingthe health care of the family. In most households it is the mother whokeeps track of well baby visits, dental check-ups, yearly pap smears,orthodontia maintenance, and so on. Eisenhauer (1985) has suggestedthe role of "health care broker" for the nurse. In addition to schedulingthe routine health care needs, this nursing role would capitalize on anurse's familiarity with the health care community. Within this role, thenurse could logically market herself to two audiences. As a health careprofessional she could assist clients in need of care by drawing on herfamiliarity with medical jargon, services, and speciality practices. Thenurse, in assisting those in need of care, serves as translator betweenpotential clients and the oftentimes overwhelming system they are tryingto access. Second, the nurse could also work for health care providersby introducing clients to the services of a provider she represents. Thenurse entrepreneur in this role would operate in much the same was as areal estate agent: both selling the homes of the owner-clients she repre-sents while at the same time finding ideal homes for the house-huntingbuyers she may also represent.

It behooves nursing as a discipline to recognize demographic trendsand to capitalize on emerging lifestyles. Keeping pace with societymeans maintaining a constant vigilance as to where our society is as wellas where it is heading. As a predominantly female profession, we needto capitalize on our role as women and value the variety of services wehave to market to society as a whole. In a society in which women areanswering to forces outside of the home,we need not only to be influ-enced by this trend but also to strive to be a vital force in encouragingthis trend, while expanding our services to promote the health of allwomen.

CONCLUSION

In this issue we focus on the balancing act of the woman. Each paperaddressed a different aspect of the human response to being a womanwho has grown up during an era of transition. Of particular concern areissues that arise from the interaction between work and family duringthe childbearing epoch. It is our hope that the papers provided in thisissue will not only contribute to the understanding of how women bal-

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ance their multiple roles, but also stir up some issues and opportunitiesfor future nursing research and practice.

REFERENCES

Eisenhauer, L. A. (1985). The professional nurse as health care broker: A response toemerging health care trends. Nursing as a force for social change, Proceedings of the50th Anniversary Symposium (pp. 92-104). Philadelphia: University of PennsylvaniaSchool of Nursing.

Hayghe, H. (1983). Married couples work and income patterns. Monthly Labor Review,706(12), 26-29.

Klausner, S. Z. (1971). On man and his environment. San Francisco, CA: Jossey-Bass.Marris, P. (1974). Loss and Change. New York: Pantheon Books.McLaughlin, S. D., Billy, J. O. G., Johnson, T. R., Melber, B. D., Winges, L. D., &

Zimmerle, D. M. (1986). The Cosmopolitan report on the changing life course ofAmerican women. Seattle, WA: The Hearst Corporation.

McLaughlin, S. D., & Melber, B. D. (1986). The changing life course of Americanwomen: Lifestyle and attitude changes, draft. Seattle, WA: Battelle Human AffairsResearch Centers.

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