Men in Nursing
By Vicki Chung
"Times and rules have changed a lot since I was first in nursing school back in the '60s," recalls Eddie Hebert, R.N., B.S.N., director of nurses at Louisiana State University Health Sciences Center in Houma, La. "However, many of the prejudices which males faced back then are still with us today."
"For example, I was not allowed to enter the delivery room because I was a male student, but had to stand at the door of the room to catch a glimpse of the delivery," he explains. "I was also not allowed to have a female patient. This all had to do with gender."
Hebert also remembers studying textbooks that made no mention of the male gender--except as the patient. "All educational materials were oriented to the female gender," he notes. "Males were seen in nursing texts as the anatomy to be studied--the one in need of female assistance. Every picture seemed to identify the nurse as the 'caring female individual,' while the patient was always a 'male in need of care.'"
However, that was almost 40 years ago, some may argue. Certainly the bias and prejudices toward men in nursing that existed at that time no longer exist. Right?
Wrong, according to Gene Tranbarger, Ed.D., R.N., CNAA, associate professor of nursing at East Carolina University in Greenville, N.C. "Open discrimination against men is fast disappearing from schools of nursing but remains imbedded in the school fabric," he observes. "The faculty still relies on feminine pronouns when discussing nurses. Male nurses who wish to work in obstetrics/gynecology still face obstacles and often have to resort to legal remedies."
What about male nurses who happen to be racial/ethnic minorities? Do they face similar issues as non-minority male nurses, or do they experience a whole other array of issues? Though there is no single united viewpoint or experience that speaks for all minority men in nursing, theirs is a voice that is growing in strength and numbers. It is a voice that loudly proclaims the importance of the nursing profession reflecting the diversity of its patient population--including gender.
Approximately 5.4% of the 2.1 million R.N.s employed in nursing in the United States are men, according to the National Sample Survey of Registered Nurses conducted in March 1996 by the Health Resources and Services Administration. Of these working male R.N.s, the racial and ethnic breakdown is:
"The last survey showed a progressively aging work force and that we needed to do more to encourage young people from diverse backgrounds to go into nursing," says Vincent C. Rogers, D.D.S., M.P.H., the HRSA's associate administrator for health professions. "The 2000 survey results will help us develop policies and programs to strengthen the nurse work force in practice and education."
The survey also found that roughly 13% of students enrolled in nursing schools are men. Dwight Elliott, a senior in nursing at East Carolina University, is one of two men in his class of approximately 80 students. "I am the only black male in my graduating class," he notes. "It has been kind of tough being a black male in a predominantly white female profession. I've caught some looks like, 'What is he doing in nursing? He doesn't look like a nurse.' I feel like I must work twice as hard as others because one, I'm black, and two, I am a male."
Elliott is not the only one turning heads as a male nurse. Ifeanyi John Nwokocha, R.N., B.S.N., a staff nurse at La Rabida Children's Hospital in Chicago, recalls receiving a few strange glances himself while at a previous nursing job. He explains, "When I used to work in med/surg, I got reactions like, 'Oh--a male nurse?' I even got questions like, 'Are you an orderly?' People do not expect to see a black male nurse."
Elliott agrees, noting that nursing has traditionally been a white female profession. "I feel that as more men come into nursing, [men as nurses] will become more widely accepted. My family and friends ask, 'You want to be a nurse? Why not a doctor?' I guess they feel that traditionally males are doctors and females are nurses."
Stereotypes of nurses as being female and white have persisted throughout the years but do seem to be lessening as the number of minorities (including men) in the nursing profession has gradually increased.
Francisco Navarro, R.N., a nurse at La Rabida Children's Hospital, has seen the effects of such stereotypes firsthand. "Some of the kids [I work with] have a hard time dealing with the fact that I am a nurse because they say that only women can be nurses," he explains. This bothers Navarro, who believes the notion that only women are nurses is an idea the children learned from schoolmates or family. He also notes that society often labels male nurses as being homosexual.
To some extent, male nurses have been viewed as being different or gay due to their close working relationship with women combined with the assumption that nurses are female, believes Hebert. "For many years, nurses were considered the 'handmaids' of the physician," he observes. "Today, things are a little different. Physicians have come to realize that nurses are much smarter than given credit for years ago. Nurses are now moving into higher management roles and are more educated than in the past."
Hebert also feels that society is slowly becoming more comfortable with men as nurses. "Although people may feel a little uncomfortable at first sight of a male nurse, they will quickly come to trust and respect him for his professionalism." He also believes that unlike female nurses, male nurses have had to prove themselves before being accepted.
"Because of years of publicity and propaganda, [the image of nurses] is fixed in the mind of the general public as being white and female and trustworthy. Minorities in nursing do not have this image."
It's Not Always a Man's World
So how has the stereotype of the white female nurse affected minority men in nursing? The responses range from "a lot" to "not at all." For Nwokocha, the stereotype has hurt.
"Right now where I'm working, they treat me with respect," he says. "But in my experience, when it comes time for promotions, I feel like the male minority nurse lags behind.
"For example, when I worked in psych at another hospital, I was bypassed [for a promotion]. Even though I knew the unit very well, they bypassed me and gave the position to another person. I feel like it was because I'm black and I'm male. All the promotions there were given to females."
Bernard Smith, R.N., M.S.N., clinical educator and recruiter at Benjamin Rush Hospital in Syracuse, N.Y., observes that it is sometimes more difficult for male nurses to work in certain specialties (e.g., women's health) than others. He remembers, "There was at least one physician (in obstetrics) who did not want us around his patients. He did not want any male nurses around his patients."
Navarro agrees that it is harder for a male nurse to work in women's health than in other areas of nursing. "I could never work in a maternity unit," he says. "There was one instance while I was in school when I was asked to interpret for a new mother who did not speak English. My instructor was showing the mother how to hold her breast and the newborn so that the baby would latch on to her breast. I could tell that the mother was uncomfortable--she would not feed her baby while I was present. Her feeling uncomfortable made me feel uncomfortable; I felt as if I did not belong in that environment."
Both minority and non-minority men in nursing face similar issues, believes Hebert. As a board member of the American Assembly for Men in Nursing, an organization for nurses to discuss and influence the issues that affect men in nursing, Hebert hears of the discrimination and harassment experienced by some of AAMN's members.
"The fact that male nurses are not given equal opportunity to move up in the ranks or are being denied equal employment opportunities is repeatedly heard during our annual conferences by our membership," he states. "Many male nurses are denied [the opportunity to work in] certain areas in hospitals, such as labor and delivery units, or nursery units. In my 30 years as a nurse, I have seen many unfair practices in which male nurses and minorities were passed up for promotions due to gender. This practice continues today and is slowly surfacing in courts throughout the country."
Neutralizing the Gender Issue
At the same time, some men in nursing have experienced no repercussions from the "nurses are women" stereotype and have actually received positive treatment because of their gender.
For example, Ramon Lavandero, R.N., M.A., M.S.N., director of the International Leadership Institute of Sigma Theta Tau International, headquartered in Indianapolis, had a very positive experience working in obstetrics. As one of the first men to go through an obstetrics class at Columbia University's School of Nursing in New York, Lavandero found the faculty to be extremely supportive, contacting him even before the course began to see if he had any questions or concerns about being the first (and only) male in the class.
"Some people might consider that favoritism because it wasn't done for the women," Lavandero says. "On the other hand, it was an acknowledgment of a new circumstance, and they were planning ahead."
In fact, Lavandero was offered three different positions within the women's health service after graduation. He believes his experience working in obstetrics taught him an important lesson about the role of gender in nursing. As he explains, "I learned that in great part, I had the upper hand depending on how I treated and dealt with other people. If I was comfortable and didn't see my gender as being a distraction, then there was no issue. If I was assigned a woman as a patient and if I was at all unsure as I interacted with that patient, then it would become a question.
"So I would go in and say to the patient, 'My name is so-and-so, and I'm the nurse who will be working with you today.' Ninety-nine percent of the time, there was never any question. There were a few times when, for example, a mother in postpartum requested a female nurse because she felt she would be more comfortable with a woman. But we had set a very comfortable tone. I can't really say I have problems because of my gender any more than a woman nurse might occasionally have a problem with a male patient."
Lavandero agrees that there are stereotypes of women in nursing but emphasizes that there are stereotypes attached to many other careers. "There are stereotypes that soldiers in combat duty are men," he points out. "Well, you know where that can lead in terms of stereotypes. In the same way, there are stereotypes of men in nursing just like there are stereotypes of women in nursing--just like there are stereotypes of women who teach physical education and of men in engineering."
Finding Strength in Numbers
Given these stereotypes, what can men in nursing do to find camaraderie?
Join organizations that support men in nursing, encourages Hebert. "There is voice in numbers, and you should seek your special interest organization and see if they will stand behind you and support your issues of concern."
One such organization is the American Assembly of Men in Nursing, of which Tranbarger is president-elect. "We are a small group of male nurses and their supporters and represent a wide diversity of age, educational background, work experience, sexual orientation, ethnicity and almost any other characteristics one can think of," he says. "I look forward to each meeting so I can interact with others who share my work, my experiences, my concerns and my hopes for the future.
"I must also add that I enjoy greatly our dedicated women members who share our beliefs that nursing is a profession, not a gender-based occupation," adds Tranbarger. "AAMN is a healthy organization of men and women and is better because of all who join us."
Each year, AAMN holds a conference, rotating the theme so that one year focuses on men's health issues and the next focuses on issues of gender in nursing. "Diverse Nurses for a Diverse World" is the theme of this year's conference, which will be held in Seattle from November 30 to December 2.
Another organization which offers support to nurses is Sigma Theta Tau International, an honor society of nursing with over 120,000 active members. As part of the International Leadership Institute, the Chiron Mentor-Fellow Program was started in January 2000 to provide the opportunity for individualized leadership development to members of Sigma Theta Tau. Although there were not any men involved in the program at the time of this article's writing, Lavandero states, "We very much would like to have men involved. We really would like it to be a very diverse program." He encourages potential mentors to identify a potential fellow and to apply to the program as a pair, believing it to be a valuable way for an experienced nurse and mentor to help another person to develop.
Other sources of support can be one's fellow nurses--both men and women; it is important not to adopt an "us against them" mentality and alienate those of the opposite gender. Smith urges male nurses to develop friendships with their female colleagues.
"By far, [female nurses] are going to be your greatest source of support and strength," says Smith. "They always have been for me--just by the sheer weight of their numbers, if for no other reason. But it's more than that. I've learned so much from the women who are colleagues of mine."
Reflecting the Face of Society
In order to encourage other men to enter the nursing profession, Nwokocha speaks with high school students on an informal basis.
"I meet the students through my nephew," he explains. "He introduces me to his friends: 'This is my uncle. He's a nurse.' And the students come to me and say, 'Oh, you're a nurse? How do you like it? What's it like being a male nurse?' Some of the students are excited--they want to become nurses, too. But they also want to hear what it's like from someone who's a man. So I talk to them, giving them advice and telling them what nursing entails."
Tranbarger believes the best way to encourage minorities (including men) to consider nursing as a career is first to speak well of nursing as a profession. "No one wants to join a group that dislikes their work," he says. "We also need to make schools of nursing more welcoming to non-females and non-whites. Language, symbols and policies all need to give each person a full and fair chance at success or failure.
"I do not know a man who wants an advantage in nursing," he continues. "Every man I know just wants a fair chance. I think that is true for other minorities as well."
Lavandero offers some additional insight on this issue. "Rather than simply saying, 'We need more minority nurses,' I would phrase it as, 'We need more men and more people from varied ethnic and cultural backgrounds in nursing because that is the composition of our society today.' In general, what nurses really bring to the table is an ability to help identify the health care needs of the patients and families in our communities. If we are not representative of our [patient population], then it becomes a lot more difficult to identify and meet those needs."
Vicki Chung is associate editor of Minority Nurse. E-mail her at firstname.lastname@example.org.