Challenges faced by male nurses in a profession historically dominated by females
In the late nineteenth century, the nursing field became predominantly female. Despite Florence Nightingale's contribution to establishing nursing as a profession, her focus on it being a career for women inadvertently marginalized men.
Nightingale worked diligently to promote nursing as a respectable profession for women and dismissed the important contributions men had made in the past (Black and Germaine-Warner, 1995). She viewed men's roles as limited to physically demanding tasks such as transportation or lifting patients, and she failed to appreciate their caregiving responsibilities. Additionally, the Industrial Revolution greatly reduced men's participation in caring professions like nursing. Instead, men were widely encouraged to pursue careers in business, engineering, and science.
Black and Germaine-Warner (1995) stated that men usually chose medical special...
ties while women opted for nursing. Nonetheless, there has been an increasing number of men joining the nursing profession, which challenges traditional gender norms. Male nurses often encounter scrutiny due to their gender as masculinity has historically been associated with specific roles performed by men (Connell, 1995). The concept of masculinity discourages men from pursuing female-dominated professions like nursing. Conversely, there is minimal resistance towards women entering traditionally male-dominated fields such as medicine and engineering.
Williams (1995) conducted in-depth interviews with 99 individuals working in predominantly female professions, including social workers, elementary school teachers, nurses, and librarians. Out of the total participants, there were 76 males and 23 females. According to Williams (1995), male nurses and others working in female-dominated fields often emphasize their masculinity and avoid socializing with their female co-workers to validate their choice of traditionall
In another study utilizing Table 2.1, Heike (1991) interviewed 15 male nurses who identified themselves as belonging to two distinct groups. Within the nursing profession, men were considered a minority group referred to as "male nurses," while society expected them to be successful and excel in their profession as part of the dominant social group (Heike, 1991).
Male nurses are a unique kind of minority group, as they are either a minority within the dominant social group or a minority in terms of numbers. This distinction between minority and majority groups places additional stress and discrimination on men in nursing compared to other factors. The study also suggests that many of the challenges male nurses face, such as societal stigma and gender stereotypes, come from outside the nursing profession (Heikes, 1991, p.398). The theoretical research conducted by Evans (2004), as shown in Table 2.1, indicates that men who choose a nursing career may face damage to their reputation and social standing in a patriarchal society.
In addition to this, male nurses face the stigma of working in a profession dominated by females. Society sees them as challenging traditional gender roles (Lammi and Kauppinen-Toropainen, 1993). Evans (1997, p.228) argues, citing Mangan (1994), that the use of stigmatizing labels separates male nurses as "deviants" who are "odd" or "homosexual." Furthermore, Evans (2002) found through interviews with eight male nurses that they experience rejection and doubt regarding their nurturing and healthcare capabilities due to the perception that male and female caregiving styles differ. One aspect of care mentioned by all participants was touch, which is seen as essential but also potentially risky due to misinterpretation, making male nurses vulnerable.
Similarly, being labeled as homosexual is a common assumption for men in nursing. Pringle (1993) asserts that any profession associated with femininity, including nursing, is believed to attract gay men.
A survey suggests a connection between sexual preferences and gender. According to Savage (1987), male nurses are often assumed to be homosexual. He further claims that men who choose nursing as a profession are seen as failures in more traditionally masculine fields, and nursing is seen as the only option left for them in the women's world. A study conducted by Harding (2007) among 18 New Zealand men employed in general nursing found that the majority of male nurses are heterosexual, but the perception remains that most male nurses are gay. This stereotype persists in general nursing because it is seen as feminine and unnatural for men, while psychiatric nursing is seen as normal for men. Male nurses are believed to be further weakened, emasculated, or ineffective by taking on traditional women's roles, in which they are expected to exhibit feminine qualities such as being soft, caring, and submissive to women.
Therefore, categorizing male nurses in the nursing profession as homosexuals leads them to feel remorseful, isolated, and discouraged. Pringle (2002) stated that in many cultures, male homosexuality is viewed as a violation of masculinity and a diminishing of men's inherent power. He further argued that as homosexuality erodes masculinity, it weakens the gender hierarchy. As previously stated, the nursing field continues to be predominantly female-dominated, which presents various personal and professional challenges for men entering this field. For instance, several male nurses have expressed concerns about doctors and head nurses expressing less confidence in their abilities.
addition, male nursing students face discrimination from doctors, practicing nurses, and the general public (Kelly et al., 1996). Female nurses often ask for assistance from male coworkers in tasks that require physical strength, reinforcing the notion of strength over professional expertise. Male nurses or students may frequently find themselves unwelcome in delivery rooms, prenatal clinics, and other settings where male doctors have unrestricted access (Black and Germaine-Warner, 1995). Another challenging issue for male nurses or students is the distrust they face from their patients. Literature suggests that a significant number of patients become hostile or aggressive when in the presence of a male nurse and are uncomfortable with intimate medical procedures.
This is a challenging environment for male nurses, as many find it frustrating when patients refuse to confide in them due to fear or unwarranted rudeness (Fisher, 1999). Additionally, research suggests that men in female-dominated careers like catering, nursing, and fashion face gender bias, increased stress levels, and job discrimination (Amour, 2003).
Advantages and disadvantages perceived in the male nursing profession
Male nurses are part of a minority group within the nursing profession. They comprise approximately 3.1% of nurses in Canada and the United States (Rott et al., 2008), around 8.77% in the United Kingdom (Rott et al., 2008), and 28% in Malta (Council for nurses and accoucheuse, 2010). Women working in traditionally male-dominated professions often face a hostile work environment according to Evans (1997), Table 2.2. However, men working in female-dominated professions may never experience such disadvantages. Nevertheless, attracting men to nursing is primarily aimed at enhancing the status and prestige of the profession as a whole.
There is uncertainty surrounding the success of this policy, as
researchers and scholars have debated its implications. Some argue that it places pressure on men to "save" the nursing profession, while others believe that allowing men to enter the profession reinforces traditional masculine gender roles (Evans, 1997). Moreover, societal stereotypes give men an advantage in nursing due to their depiction as breadwinners. In many societies, women are typically responsible for childcare and household tasks, giving men an edge. For instance, countries like the United States hold a prevalent belief that women are less committed to their work compared to men because of unequal division of labor at home.
According to Williams (1995), men still have an advantage over women, even in professions typically associated with women. Abrahamsen (2004) also suggests that favoritism towards men may be the reason why they are more likely to obtain leadership positions than women. In a 20-year quantitative study, it was found that 70% of male nurses held leadership positions and had moved away from direct patient care. These male nurses were attracted to sectors offering higher pay, highlighting the importance of salary when male nurses transition between different areas of healthcare. Additionally, nursing roles prioritize technical knowledge, leadership skills, and dedication to work - all traits perceived as masculine.
The text discusses the lack of recognition for attention to detail and display of emotions in leadership skills, particularly those traditionally attributed to females. It also mentions that male nurses have better social relationships with physicians than female nurses. This is because men feel more comfortable talking about vehicles and sports with other men, especially male physicians. This preference benefits male nurses in their career as physicians start to view them as
competent, just like their female coworkers (Bush, 1976). The research conducted by Dassen, T. and Nijhuis, J.N. further elaborates on this topic.
; A; Philipsen, H. (1990), Table 2.2, based on a National Survey among intensive-care (IC) nurses in The Netherlands, demonstrated that male IC-unit nurses perceive IC-nursing as a medical activity rather than a nursing activity, aiming to elevate their own profession to a medical level. The distribution of work among male and female nurses follows traditional gender-specific practices in technical wards, where male nurses have a higher chance of promotion to higher positions. Furthermore, the study found that 50% of male nurses aspire to become head of a nursing ward, indicating their greater inclination towards professionalization compared to female nurses.
On the other hand, Kanter (1977) theorized that tokenism, which is the underrepresentation of certain groups (such as by gender, ethnicity or race) in an organization, leads to biased treatment. This means that any profession with a numerical minority will always experience negative effects on employment. According to Kanter, minority group members are likely to achieve less success in the workplace compared to those in the majority. However, Williams (1995) challenged this by stating that when men are considered a minority in the nursing profession, they often use their dominant gender privilege to quickly rise to higher positions in the hierarchy (Saville-Smith and James, 1994). On the contrary, nursing is viewed as a feminine profession by many and is therefore undervalued in a society dominated by males. This profession is often stereotyped as embodying qualities of care, nurturing, subservience, and dependency.
The qualities associated with nursing, such as compassion and nurturing, are in opposition to stereotypically
male characteristics like aggression and strength. Consequently, male nurses often distance themselves from their female counterparts to affirm their masculinity (Heikes, 1991). Additionally, when an individual's identity contradicts societal expectations, people frequently feel uneasy and uncertain about appropriate behavior. In numerous societies, nursing is perceived as a profession dominated by women, making it challenging for individuals to comprehend why a man would choose this career path. This lack of comprehension results in the perception that male nurses are not masculine (Bagilhole and Cross, 2002).
Why men choose nursing as a profession
Most men choose nursing for the same reasons women choose nursing. They are motivated by the desire to care for patients (Boughn, 2001). In addition to this, men have various practical reasons including career opportunities, job security, job flexibility, and stable income. Traditionally, men tend to prefer active and challenging fields of nursing such as cardiac care units, trauma units, emergency departments, intensive care units, anesthesiology, or flight nursing, among others.
A study conducted by Whittock M. and Leonard L. (2003) discovered that the various aspects and difficulties of providing care for individuals with acute illnesses appeal to men in the nursing field. Interestingly, they found that one significant factor in attracting men to nursing is having a parent, especially a mother, who works in nursing or healthcare. However, not all participants in the study reported this influence from their parents. In a similar qualitative investigation, Romem P. examined the motivations of Israeli men who choose nursing as their profession.
; A ; Anson, O. ( 2005), Table 2.3. Self-administered questionnaires containing 52-items were created to identify the societal characteristics and motivations of male
nurses. These questionnaires were given to all registered nurses, 137 female and 123 male, in three general and three psychiatric infirmaries. The results of the study demonstrate that early exposure to the nursing profession and cultural background are significant factors that inspire men to choose nursing. Additionally, job security, career opportunities, and salary also play a crucial role (Romem, ; A ; Anson, 2005).
Despite social barriers, some men may not be pursuing careers in nursing because they see it as a stepping stone to other male-dominated professions such as medicine, rather than a long-term career choice. This perception stems from the historically lower wages and status associated with nursing, which has traditionally been seen as a female profession (Williams, 1989). A study conducted at the University of Pennsylvania in 2002 supported this concern. The study used data from the National Survey of Registered Nurses between 1992-2000, which provides comprehensive statistics on registered nurses in the US. The findings revealed that around 7.5% of newly graduated male nurses left the profession within four years after completing their nursing education.
Solchalski (2002) discovered that a higher percentage of male nurses left the nursing profession compared to female nurses during the same period. Solchalski's research emphasized the importance of understanding the reasons behind this nurse migration. In a study conducted by Rajapaksa & Rothstein (2009), it was found that both male and female nurses who left the profession had some similar and some different reasons for doing so. The study involved 1,589 registered nurses who were employed in other fields during the National Sample Survey of Registered Nurses in 2000. Gender served as the main independent variable, with females
comprising the majority of respondents (93.5%). At the time of the study, 63.2% of respondents were working full-time in their new jobs, while 36.8% were working part-time.
The study involved a self-administered forced-choice questionnaire, which included gender, age, working-age, income, marital status, educational degree, and race. The results showed that both men and women left nursing for better working hours and more rewarding positions elsewhere. Men did not leave nursing because of dissatisfaction with their roles as nurses but because of the perception of low financial rewards associated with the profession. However, many men who chose to remain in nursing face various issues, including emotional reactions and role strain in a profession dominated by the opposite sex. Some men may feel discontent and anxiety due to their upbringing in a culture of male-centeredness and unfamiliarity with gender inequality. Nevertheless, men are increasingly taking on leadership roles in the nursing profession.
Positions of male nurses in the nursing profession
Many male nurses have expressed their opinions about the nursing profession and often mention experiencing stress in their role. This has raised questions about whether caring is a suitable career choice for men ( Simpson, 2005 ) . In a qualitative study by Simpson ( 2005 ) , Table 2.4, which aimed to explore the experiences of men in non-traditional occupations, it was found through 40 in-depth interviews that most men feel "discomfort, embarrassment and shame" . Many have also reported challenges related to their gender, such as low pay and loss of status.
Furthermore, in the nursing profession, a good nurse is usually recognized for possessing qualities such as tenderness, servility,
empathy, and kindness (Hicks, 1999). These qualities are similar to those typically associated with females, implying that the profession requires individuals with "feminine" traits. In a study conducted by Loughrey, M. (2007), through a quantitative, non-experimental descriptive design, the gender role perception of male nurses in Ireland was examined for the first time. The analysis of this research revealed that out of 104 male nurses surveyed, 78 identified themselves as affectionate, sympathetic, and understanding—traits that are more aligned with female gender roles. This suggests that male nurses accepting and embodying aspects of the female gender role is not uncommon.
According to Table 2.4 from Hart's (2005) study on the Workforce in Nursing Survey, 38% of respondents believe that the main reason more men are not attracted to the nursing profession is because it is traditionally seen as a female profession. Other key reasons mentioned include the stereotype that all male nurses are gay (29%), low pay (15%), and a lack of role models (15%). One respondent noted that many people view a man who chooses to pursue a career as a staff nurse as a failure or lacking direction. Many others stated that male nurses are perceived as men who "flunked" out of medical school (Hart, p.48).
The given text presents several significant points about the experience of male nurses in the field of nursing. According to Wingfield (2009), these facts highlight the inadequate preparation of male nurses for caregiving roles. Moreover, male nurses have disclosed instances of homophobic abuse, where they have been subjected to derogatory terms like 'you faggot this' while tending to patients. McDougall (1997) has reported that some male nurses feel disadvantaged in
life due to their choice of entering a female-dominated profession, which results in them being viewed as having a lower status. In order to investigate the impact of nurse gender on perceptions of nurse care, Ekstrom (1999) conducted a study utilizing two similar questionnaires, each comprising 61 Likert-like items, as shown in Table 2.4.
The results from the study of 145 nurse-patient gender combinations showed that being loving is not exclusively a female quality. Both male and female nurses and patients can exhibit loving behaviors. However, men find it challenging to express loving behaviors, possibly due to avoiding identification with feminine stereotypes. This suggests that humans are constantly vulnerable and unable to handle their own affairs. The concerns and challenges faced by male nurses seem contradictory to their masculinity and the advancements in technology. The literature review confirms that men in nursing are still perceived as a unique minority in a profession dominated by females.
The text examines how male nurses challenge traditional gender stereotypes in their profession and the lack of societal acceptance, recognition, and equal opportunities they face in nursing schools. Additionally, there is a perception that caregiving is seen as a solely feminine ability, making it difficult for men in the field. Furthermore, men are often questioned about their masculinity and sexuality if they choose a career in nursing. The text also highlights the current shortage of nurses and suggests that one solution to this crisis would be to encourage more men to enter the nursing profession.
Multiple studies have used semi-structured, in-depth interviews which mainly consisted of open-ended questions. However, this approach may have influenced the interviewee's responses. Additionally, a limited number of nurses
were interviewed, often fewer than ten, making it difficult to generalize the findings. This suggests that qualitative research lacks population validity. Nevertheless, when the sample is well-defined, qualitative research can be generalized to a larger population (Hinton, cited in Carr 1994 p.717). Nursing research has the potential to be a valuable resource for the healthcare system. To provide richer and more comprehensive research findings, both quantitative and qualitative research methods should be considered if time and funding allow.
(Carr, 1994). The experiences of male nurses in Malta have been poorly documented. As a result, this survey aims to identify why men in Malta decide to pursue a career in nursing. The survey will be further discussed in the methodology chapter.
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