Do male nurses face gender bias in nursing education?

This article discusses gender bias from the perspective of the nursing student. Men are a minority in the nursing profession and may face bias that can have a negative impact on their self-concept and career path. Solutions for dealing with gender bias are included. Nurses General Nursing Article

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  1. Do you identify as a male nurse?

    • 67
      Yes
    • 18
      No

85 members have participated

The next time you’re at work, look around. How many of your fellow nurses are men? I teach nursing and in a class of forty students, I have only three students who identify as men. None of the forty faculty members at my school of nursing are male. Back in the 1960s, only 2 percent of nurses were male, but now the number has risen to 13 percent.1 Why is nursing so female-centric?

History

We were taught in nursing school that the first nurses were male caregivers in Ancient Rome, tending the sick and dying during the Crusades. Male nurses were also found in the Civil War in both the Union and Confederate armies. The shift to an all-female workforce didn’t begin until the Army Nurse Corps (ANC), established in 1901, banned men from serving as nurses. It wasn’t until 1955 that they commissioned the first male officer.2

Media

You may have seen a movie called Meet the Parents, in which Ben Stiller plays Greg Focker, a male nurse who perpetuates stereotypes that women are nurses and men are doctors. If you look at Grey’s Anatomy, Scrubs and ER, the stereotypes continue. We might see a female doctor, but never a male nurse. In a survey of male nurses, 70 percent stated that gender stereotypes are the main barrier to entering the field of nursing.1 Male nurse respondents indicated they were influenced by the misperception that the profession of nursing is not “appropriate” for men.

Challenging Masculinity

In an article in American Nurse Today, David Foley shares some of his experiences as a male nurse. “The pressure to create a masculine identity within a historically female profession proves overwhelming and they [male nurses] flee for the operating room, emergency department or intensive care unit.” Male nursing students may face questions from family and friends about choosing nursing and may face challenges to their masculinity because women are traditionally seen as nurturers, while men are in more dominant leadership roles. Foley shared a story about a student who was actively discouraged from going into a less technical discipline in nursing with comments like, “You’ll never be accepted,” “Why would you want to make your life so hard,” and “What’s wrong with critical care? You’ll make more money.”3

Edward Bennett, named 2018 Student Nurse of the Year by the National Black Nurses Association, said, “I’ve definitely gotten pushback for being a black male nurse. Other people look at me like, ‘why would you want to be a nurse when you can be doctor?” Bennett continues to advocate for changing misconceptions by reminding prospective male nurses that, “You work with your hands, you think critically and you advocate for your patients every day.”4

Male nurses face a particularly steep challenge in obstetrics and OB-GYN. Even if they overcome stereotypes about who should pursue this field of nursing, often they cannot obtain access to patients. As an instructor I have seen it happen many times – a woman giving birth or having a pelvic exam doesn’t want a male nursing student to observe or care for her.3

In a survey of 462 undergraduate nursing students in Canada, male students demonstrated significantly lower scores on the efficacy subscale, suggesting that some men experience feelings of marginalization and discrimination.5

Solutions

According to the IOM report, The Future of Nursing: Leading Health, Advancing Change, we must find a solution. Men provide unique perspectives and skills that are crucial to the profession and to society as a whole. We need to place a greater emphasis on recruiting men into the field. We know that patients are more receptive to healthcare providers of similar cultural and ethnic backgrounds.1 Male patients may feel more comfortable discussing certain conditions, especially those related to sexual and reproductive health, with other men, than with women. The World Health Organization identifies the “men’s health gap” – men visit the doctor less frequently and are less likely to ask questions or bring up concerns during appointments. “Having a male nurse could help open them up” says Bryan Smith, president of the American Association for Men in Nursing.6

The nursing shortage is another reason to recruit men. The president of the American Assembly for Men in Nursing, William T. Lecher, states that “The shortage of the future will likely not be solved unless men are part of the equation.”1

Elias Provencio-Vasquez, a Robert Wood Johnson Foundation Executive Nurse Fellow, shares that when he was met with resistance from some female patients in the maternity ward early in his career as a student at the University of Texas, in El Paso, “We overcame that by presenting ourselves as students, and our faculty members were very professional and very supportive."1

Bennett recommends creating pipeline programs for male students at predominantly African American high schools to diversify the profession in multiple ways.4

The AAMN

To encourage more men to join the profession, the AAMN conducts outreach, challenging local chapters to reach as many male middle and high school students as possible through classroom visits, career fairs and more. The AAMN also offers an award to the best schools for men in nursing to recognize programs that have made efforts in recruiting and retaining male students. Award winners include Nebraska Methodist, Duke, Goldfarb, New York University, Rush, Rutgers, Vanderbilt and West Coast University. In addition, the AAMN enlists members to guest lecture at nursing schools. Only 6 percent of faculty are men. Having a lecture from a male nurse can have a powerful impact on male students who are feeling isolated and alone. “Just seeing a male being successful in nursing, even though it seems like something so small, can really trigger a sense of belonging.” says Smith.4

Nurse educators and preceptors must acknowledge that gender bias exists. We need to refrain from gender-biased language and teaching practices that may discourage male nurses from embracing a career in any of the specialties of nursing.

What do you think?

I’d love to hear from male nurses out there – what has your experience been? Did you find support when you needed it? Do you have ideas for how we can recruit more men into nursing and remove some of the misconceptions that are preventing a diverse workforce?

Read Gender Bias in Health Care to learn more about gender bias in health care.


REFERENCES

  1. Male nurses break through barriers to diversity profession
  2. Men in Nursing: History, Stereotypes, and the Gender Pay Gap
  3. How to Avoid Gender Bias in Nursing Education
  4. Bohanon M. (2019, January 8). Men in nursing: A crucial profession continues to lack gender diversity.
  5. Sedgwick, M. G. & Kellett, P. (2015). Exploring masculinity and marginalization of male undergraduate nursing students’ experience of belonging during clinical experiences. Journal of Nursing Education, 54(3):121-129.
  6. American Association for Men in Nursing.
Specializes in Psychiatric and Mental Health NP (PMHNP).
26 minutes ago, PeakRN said:

Your posts are marginalizing women traumatized by women.

Nice try. You just don't have any evidence and don't want to admit it. I happen to live in the real world and am very busy.

How about this:

You: "Dear Ms. X (patient), what would be your gender preference today for a nursing student to observe you, as I don't want to marginalize any trauma you may have suffered and I also don't want to make any nursing student feel that they have suffered from bias by patients, which may result in psychological trauma for them?"

Patient: Huh? I just need someone to help me go to the bathroom so I can pee.

Here's what happens in the real world:

Me: Ms X (patient). Would you be okay today with a nursing student observing?

Patient: OK

[Female nursing student walks in]

Patient waves me to come closer so she can speak softly: I'm sorry, but I am uncomfortable with a female nursing student.

Me: OK, no problem. Thank you for letting me know.

1 Votes
Specializes in Critical Care.
41 minutes ago, FullGlass said:

Please give me some evidence that female Ob/Gyn patients are traumatized by being asked if they are okay with a student observing. There is none because we have to ask patients if they are okay with a student observing.

Now give me some evidence that female Ob/Gyn patients are traumatized by being asked if they are okay with a male nursing student observing. Oh, wait, there is none!

Let me be very clear: I don't care about gender bias against males in the Ob/Gyn setting. Not one little bit.

I certainly wouldn't go so far to say they are "traumatized" by being asked, but I have found that patients take the fact that the question is being asked to mean they should feel uncomfortable with it.

I've worked at two different teaching hospitals where having a medical student or a nursing student weren't options. If you didn't want a student then you were free to arrange transfer to another facility, students are just part of the deal.

The interesting thing was that I don't think I ever had a patient or even knew of a patient that had a problem with it, they had no reason to find this concerning because we didn't suggest that it should be concerning by asking what their preference might be.

3 Votes
Specializes in Psychiatric and Mental Health NP (PMHNP).
9 minutes ago, MunoRN said:

I've worked at two different teaching hospitals where having a medical student or a nursing student weren't options. If you didn't want a student then you were free to arrange transfer to another facility, students are just part of the deal.

The interesting thing was that I don't think I ever had a patient or even knew of a patient that had a problem with it, they had no reason to find this concerning because we didn't suggest that it should be concerning by asking what their preference might be.

Interesting. At my nursing school, patients were always asked if it was okay for a student to be present. In addition, the RNs on the shift were asked about students before the shift, as sometimes the RNs would say they didn't want students in with certain patients. As students, we were taught to clearly identify ourselves as a student. I did rotations in multiple teaching hospitals in the city and this was always the case.

I'm in primary care, and our clinic precepts NPs and PAs. I always ask my patients if it is ok for a student to observe. When I've been on job interviews and asked to shadow, patients were always asked if it was ok.

The situation may be different with regard to medical students, interns, and residents, I just don't know.

2 Votes
Specializes in Diabetes, Transplant, CCU, Neurology.

As a student, I have to admit, I got to deliver 2 babies. Anyway, I got to catch them as they came out. I got to do a few things with patients after they had their baby also. One older instructor almost always put me in the nursery. As a nurse, about the only time I have had a patient ask for a female nurse were elderly female patients that wanted a female nurse to take them to the toilet. Most got over it very quickly, and I'm guessing it was the way I approached them. I have never had a problem with a younger female patient requesting a female nurse. I think its also more a sign of the times. I've never worked L&D, and never really wanted to, so there were no hard feelings there. I was called to L&D once, but only to start an IV on a really tough stick. I've know a guy who worked L&D for 15 years before he came to my wife's ICU. He was well thought of, and became a manager of that unit after time.

But, I have also worked in a teaching hospital. Unless they were private pay patients, the nurse would come into the room, tell the patient that since this is a teaching hospital, you will have a student nurse with you today. She/he will be monitored by their instructor and by the staff nurse assigned to you. If a non-paying, no private insurance patient said she didn't want a student, some nurses would give the patient a map to the private hospitals in the area, stating, "like I said, this is a teaching hospital. This is where nursing students and medical students learn to be nurses and doctors while they are closely supervised."

3 Votes
Specializes in Critical Care.
19 minutes ago, FullGlass said:

Interesting. At my nursing school, patients were always asked if it was okay for a student to be present. In addition, the RNs on the shift were asked about students before the shift, as sometimes the RNs would say they didn't want students in with certain patients. As students, we were taught to clearly identify ourselves as a student. I did rotations in multiple teaching hospitals in the city and this was always the case.

I'm in primary care, and our clinic precepts NPs and PAs. I always ask my patients if it is ok for a student to observe. When I've been on job interviews and asked to shadow, patients were always asked if it was ok.

The situation may be different with regard to medical students, interns, and residents, I just don't know.

I do think there is often a different situation with regard to medical students, it doesn't seem unusual that a facility where patients are first asked if they would agree to having a nursing student, they don't first ask patients if they are ok having a medical student/resident, etc. Maybe that's partly due to nurses being more 'sensitive' to that sort of thing, but I also think it's at least part due to assuming patient's will think it weird to have a male nurse.

1 Votes
Specializes in Psychiatric and Mental Health NP (PMHNP).
5 minutes ago, MunoRN said:

I do think there is often a different situation with regard to medical students, it doesn't seem unusual that a facility where patients are first asked if they would agree to having a nursing student, they don't first ask patients if they are ok having a medical student/resident, etc. Maybe that's partly due to nurses being more 'sensitive' to that sort of thing, but I also think it's at least part due to assuming patient's will think it weird to have a male nurse.

I think it might be because our hospital was international and had a lot of Middle Eastern patients - very wealthy patients and a wing of the hospital is named after a wealthy Mid-East donor. The city also had a significant population of Muslims. As a result, we had to be careful about making sure that female patients were okay with a male nurse/student, to respect their religion if they were Muslim and you can't always tell if someone is Muslim just by looking at them, obviously. There was also a sizeable population of Orthodox Jews and they also have strict religious practices about only being cared for by the same gender.

In reality, very very few patients refuse to have a nursing student help out. About the only times were when the patient was very upset emotionally and only wanted to deal with the providers and nurses they were familar with, which is perfectly understandable. Our male nursing students never had an issue with getting their L&D rotation completed and seeing plenty of patients. The hospitals were big enough that if one patient didn't want a male or female, it was easy enough to find another patient. One of my male classmates became an L&D nurse and he got a job doing that as soon as he graduated and passed the NCLEX. He seemed very happy.

1 Votes
Specializes in Adult and pediatric emergency and critical care.
3 hours ago, FullGlass said:

Nice try. You just don't have any evidence and don't want to admit it. I happen to live in the real world and am very busy.

How about this:

You: "Dear Ms. X (patient), what would be your gender preference today for a nursing student to observe you, as I don't want to marginalize any trauma you may have suffered and I also don't want to make any nursing student feel that they have suffered from bias by patients, which may result in psychological trauma for them?"

Patient: Huh? I just need someone to help me go to the bathroom so I can pee.

Here's what happens in the real world:

Me: Ms X (patient). Would you be okay today with a nursing student observing?

Patient: OK

[Female nursing student walks in]

Patient waves me to come closer so she can speak softly: I'm sorry, but I am uncomfortable with a female nursing student.

Me: OK, no problem. Thank you for letting me know.

I'm only responding to your statements.

1 Votes
Specializes in Oncology, Home Health, Patient Safety.

I teach a course called Digital and Information Literacy and we've been talking this week about how differently people behave online as opposed to in-person. I'm reading this last string of comments and thinking about how we seem to assume the worst in each other - and it's easy when you can't see the person's face or their body language. When we assume the worst, then our fight or flight response kicks into high gear, our hearts pound and our breathing gets shallow and our brains even short circuit a little bit. The comments fly back and forth and no one feels understood. The more we type the less we seem to communicate.

Can we agree to disagree and perhaps give one another the benefit of the doubt? Try assuming the person making comments is good hearted and that we are all just doing our best to communicate in an imperfect world. I know that makes me a bit of a goodie two-shoes, but if the costume fits, I gotta wear it.

Ya'll are awesome for caring so much. Thank you.

2 Votes
Specializes in Critical Care.

I feel like I’ve been treated all round better for being male. Nursing instructors trusted me when they didn’t trust equally skilled females, patients trust me/do as I say more than they do female nurses (often the females ask me to get their patients to take meds or other sorts of treatments), and my employers mention that they’re glad to have “another guy on the unit”.

Another thing I’ve noticed is how I talk to doctors. “Hey dr so and so, this is ___ on ___ unit. I got mr so and so here with xyz going on, can we get this, that and the other ordered? Okay you want to add that in too? Cool. Sounds good. Thanks man”

Females on my unit have noted that talk to doctors differently than them. One said they have to “play dumb” with the doctor like “I don’t know what to do... his blood pressure is high... what should we give him?” Sometimes i have doctors ask me things like “do you think we should go with metoprolol or cardizem push for her afib?”

“Hell, I don’t know doc, you’re the one with a medical degree?

1 Votes
On 11/1/2019 at 1:38 AM, jinct said:

Im curious because it would seem to me that a study of gender bias in nursing would, by definition, have to consider the objective truth of a person's gender in order to be taken seriously. What I mean by that is, if I am objectively a female, despite "identifying" as a male, than how can I be discriminated against for being a male, or vice versa? For example, I think that a female L&D nurse who identifies as a male would face much less bias from her patients than would an actual male L&D nurse. I understand and fully appreciate that you are trying to be sensitive to others, but the fact remains that objective truth still exists even if one "feels" otherwise.

OK, so I am a trans man.. meaning I was born female but identify and present as male. absolutely nobody would know my birth sex unless I told them, knew me pre-transition, or did a very in-depth background check. in conclusion, I would be included in the male portion of the gender bias study. with the exception of those who do not choose to medically transition (hormone replacement therapy) so they may still have their birth sex's characteristics. did that clarify it any?

honestly, unless they work at an openly trans-inclusive facility, trans people are going to experience bias regardless of what they identify as ?

1 Votes