Gendered Pathways to Nursing Leadership in Italy: An Interpretative Phenomenological Study

Abstract

Introduction. Although nursing is largely composed of women, leadership pathways continue to reflect gendered inequalities. The persistence of a “glass ceiling” for women alongside a “glass escalator” for men highlights this paradox. In the Italian context, where women dominate the workforce but remain underrepresented in leadership, this qualitative study explores nurse managers’ interpretations of their trajectories towards senior roles.

Methods. An interpretative phenomenological analysis (IPA) was conducted with 20 nurse managers (13 women and 7 men) working in different regions of Italy. Data were collected through in-depth semi-structured interviews conducted. The analysis followed an IPA process aimed at capturing participants’ lived experiences.

Results. Three overarching themes emerged: (1) the persistence of gender stereotypes shaping the perceived legitimacy of leadership; (2) subtle and systemic forms of sexism operating in organisational interactions; (3) agentic strategies developed by women to navigate structural barriers, including professional development, identity renegotiation and support networks.

Discussion. The findings suggest that access to leadership in nursing is shaped not only by individual competence but also by cultural expectations and organisational norms. Participants described the development of agentic strategies aimed at negotiating these constraints and legitimising their leadership within professional contexts.