My L&D misadventure

[labordude]

Here's my story. I'm a neonatal intensive care unit (NICU) nurse, a certified lactation counselor, and a father of two beautiful children. I love what I do. I've done some traveling and worked with some amazing people in some great hospitals. It's all been a great experience.

For 18 months now I have been trying to expand my practice and transfer into Labor and Delivery prior to (hopefully..applications are in, fingers crossed) starting a nurse-midwife program in Spring 2010.

At this point here are my statistics:

4 states | 18 applications | 3 calls (2 of which were "mistakes") | 1 interview

Let me point out that for two facilities, I submitted two applications to each one with the same resume. One was me, (my name) RN and the other was (female version of my name) RN...can you guess what happened? Apparently (female version of my name) would have made a great candidate, thus the "mistakes" in the phone calls.

In April of this year I interviewed with a great teaching facility in the major city near my home. The interview went great. Come to find out, one of the girls that works in the L&D unit at my current facility was working at that other place at the time. The manager went around taking a poll about hiring a male nurse. Since more than 50% of the staff said "No", well you get the idea. Funny thing about this, the former nurse manager (McRae, 2003) of that facility published a study in which the majority of patients were FINE with having a male nurse, caring more about competency and professionalism. The weak links in the study, those who showed the most negative perception about men in OB nursing were nurse managers and clinical educators.

I had a long talk with someone near and dear to me whose opinion I value dearly about this and she was playing devil's advocate trying to throw every reason in the book why I may not have gotten calls back or why places might want to hire a guy. She and others that I have talked to have questioned my motives for wanting to work in such an area. Quoting from the article The Hidden Barrier: Gender Bias Fact or Fiction? by Gayle Cude and Karen Winfrey (2007).."I feel their questioning of my professional motives based on my gender is as inappropriate as would be their questioning my motives based on race or religion."

AWHONN (Association of Women's Health, Obstetric, and Neonatal Nurses) has a position statement entitled Gender Bias as a Factor for Nursing Positions in Women's Health, Obstetric and Neonatal Nursing. Some excerpts include

• "AWHONN supports that nurses, regardless of gender, should be employed in women's health, obstetric and neonatal nursing based on their ability to provide such care to their clients."
  
• Gender is not a qualification requirement to practice as a nurse, and gender discrimination in employment is unlawful.
  
• In addition to legal requirements barring discrimination, there is no evidence that female nurses provide superior care to male nurses in the areas of women's health, obstetric or neonatal nursing.
  

I'm frustrated at this point as I am being stifled in my career development based on my gender and because of other people's antiquated stereotypes.

Any suggestions?

References

http://www.awhonn.org/awhonn/binary.content.do?name=Resources/Documents/pdf/5H4c_PS_Gender05.pdf

Cude, G., & Winfrey, K. (2007). The hidden barrier: gender bias: fact or fiction? Nursing for Women's Health, 11(3), 254-265.

McRae, M. J. (2003). Men in obstetrical nursing: perceptions of the role. MCN: The American Journal of Maternal Child Nursing, 28(3), 167-173.

[labordude, BSN, RN]

I respect the fact that you are a competent professional. Your gender wouldn't be a problem for me. I would welcome gender diversity among my female-only Mother-Baby Unit colleagues. Would my nurse-manager hire you? I don't know.

Having worked on a female-nurses-only unit for the past decade or so, I notice quite a lot of clique-ish politically (as in "office politics") motivated behaviour that I never noticed on units where I trained where male nurses were better represented in the staff pool.

Maybe a gender bias lawsuit would wake people up to the fact that there are males who want to work in the OBS-GYN specialty, just as there are females who want to work in urology. The old biases don't work anymore. Patients here have to sign a release form accepting the fact that they will receive care by medical staff of either gender, and I don't see why that form cannot encompass nursing care too. The focus should be on the nurse's ability to provide professional nursing care, not whether the nurse has a member or a lady parts.

The funny thing is that there was a case in 2005 in WV where the male RN won the case. This guy won his case OVER the objections of the nurse manager saying, "it would create a problem, cost money, patients wouldn't like it..etc). Unfortunately it sort of got buried in the fray, I only found it when I was doing my research project on men in OB nursing.

See: http://www.state.wv.us/WVSCA/docs/spring04/31404.htm

[labordude, BSN, RN]

I'm pretty sure that you are being discriminated against based on your gender. This is illegal, but you may have a problem proving it. I agree with ToxoplasmaGandhi that your best bet would be to apply for a transfer to L&D at the hospital where you already work and then get help from the union if the hospital tries to keep you out of the job.

That said, I am one of those women that would not want to have a male L&D or postpartum nurse. I will not even see a male ObGyn doctor. The two times that I have seen male doctors were the most horrific and unpleasant interactions of my life. In my hospital more than 90% of the ObGyn docs are women, and this year's new interns are 100% female.

So, although I completely respect and support your right to be an L&D nurse, I have to say that I would be one of those patients who would request another (female) nurse, irrational as that my sound to you.

Good luck. I hope you don't encounter too many patients like me!

NOCnewbie, I appreciate your comments and I will always respect those who don't want male caregivers (though I want some more respect for those who don't want female ones too!). I am sorry you have had those experiences and I am sure that others share your feelings. As I completed my research project it became clear that the number of women for whom the gender of the provider didn't matter has grown significantly over the years, despite many staff nurses belief that it hasn't. However, using those feelings and unsubstantiated beliefs to deny a person a position based on their gender is illegal.

After Sept 23, I am eligible to transfer within my hospital, I am interested to see what will happen. I have worked with the RNs in that unit very closely since I started as I am on the high-risk delivery team. I am curious to there response when I actually want to work with them. I am getting to know more of the docs and the midwives to have increased support when I do apply as well.

What states are you looking in? We have a male nurse in our L&D unit!

I have looked in MA, FL, OH, and IN. I would love to talk with your co-worker if he would talk to me.

[runmommy1]

I think the difference is that if you want a male OB or nurse midwife you can, but when you check into the hospital there really is no choice about who you get as a nurse. I would not want a male L&D nurse......and I would want the choice.

I asked my husband what he thought of a male L & D nurse. He said it was my choice but he did not like the idea. He asked around at his work and every one of his coworkers said they would not want a male nurse in the room with their wife. A few said they would be offended if they walked in and the nurse was a man.

I do believe that you are being discriminated against, but I don't agree that males should be hired for L&D or Mother baby.

[labordude, BSN, RN]

I think the difference is that if you want a male OB or nurse midwife you can, but when you check into the hospital there really is no choice about who you get as a nurse. I would not want a male L&D nurse......and I would want the choice.

I asked my husband what he thought of a male L & D nurse. He said it was my choice but he did not like the idea. He asked around at his work and every one of his coworkers said they would not want a male nurse in the room with their wife. A few said they would be offended if they walked in and the nurse was a man.

I do believe that you are being discriminated against, but I don't agree that males should be hired for L&D or Mother baby.

I appreciate your response. I disagree that you have no choice in who you get as a nurse. A patient is always free to refuse a nurse and the hospital is bound by certain laws and statutes to provide a replacement (though there are guidelines). I would never deny the patient the choice. Are you saying that male nurses shouldn't be hired or males including OBs and CNMs?

[jlrevis]

I work in Chattanooga TN in a large teaching hospital. The male nurse we have is older (60's or so) and has been doing it for 10-15yrs. He has been to many states too. I hope everythng works out for you. Personally, I don't care who takes care of me, male or female, as long as you know what your doing. Well good luck!

[runmommy1]

I am not sure what that answer is....I think because you are asking nurses and other medical professionals you are getting a different answer than if you asked the general public. I would love to hear what pregnant women and their significant others would say if asked if they would mind a male nurse in the delivery room. My gut says most would not want a male, but I may be wrong. From the people I have asked I have not had a single person say they would be ok with it.

A male OB is a choice from the onset of pregnancy. A person has a choice who they want to care for them. When you arrive at the hospital in labor and the person who walks in to take care of you is a male you are put in an uncomfortable position. I know that the patient can as for another nurse, but should she have to?

During my OB clinical we had a male student in our class. He was asked to leave the room every time! Our instructor put him in the nursery for the entire clinical because it made him, the staff, and patients uncomfortable. This is just one example, but I think it explains where my thoughts are coming from.

[labordude, BSN, RN]

I am not sure what that answer is....I think because you are asking nurses and other medical professionals you are getting a different answer than if you asked the general public. I would love to hear what pregnant women and their significant others would say if asked if they would mind a male nurse in the delivery room. My gut says most would not want a male, but I may be wrong. From the people I have asked I have not had a single person say they would be ok with it.

A male OB is a choice from the onset of pregnancy. A person has a choice who they want to care for them. When you arrive at the hospital in labor and the person who walks in to take care of you is a male you are put in an uncomfortable position. I know that the patient can as for another nurse, but should she have to?

During my OB clinical we had a male student in our class. He was asked to leave the room every time! Our instructor put him in the nursery for the entire clinical because it made him, the staff, and patients uncomfortable. This is just one example, but I think it explains where my thoughts are coming from.

Well, therein lies the problem. The most recent evidence, the study I quoted from by McRae, showed that a majority (67-68%) of pregnant women (they were all primips and mostly married) DID NOT care about gender. That study was done at the very hospital that I interviewed at, the one that clearly showed me discrimination.

I guess what I am missing is this. You are saying that a patient CHOOSES to have a male provider in the OB role, but would refuse a male provider in the RN role. I have also asked a few nurses sitting next to me to explain this and they are unable to understand it as well. Can you elaborate why you think someone would choose a male OB but not allow a male nurse?

[nkara, CNA]

Isn't that discrimation? I would consult with legal experts on this. I too worked with a male nurse and he was excellent. I think that's horrible that you are being refused jobs which you are obviously qualified for.

Good luck and I'll send good thoughts your way.

[ducknurse]

I feel so bad for you! I work in L&D and my husband is a nurse in ER. He always has to have a female nurse go in with the doc for pelvic exams etc. He has to bother a co-worker to stop what they are doing b/c he is not allowed to do his job! I absolutly hate that male nurses are seen as less professional and perverts when it comes to obstetrics or female problems! Men having prostate surgery rarely get the opportunity to request a male nurse post-op and it is not an issue:flamesonbI just don't get it. And coming from a wife AND a nurse, if you are qualified, competant, and caring, you should get to DO YOUR JOB!!!!!

[RootedRedwood]

I don't think it is right that males are discriminated against in this area of nursing. Personally, I feel that our all-female nursing staff could really use some gender balance!

With that said, I can see why many nurse managers would be reluctant to hire a male in L&D/Postpartum. On our unit, there is often only 1-2 labor nurses on each shift, so if a patient didn't want a male nurse there might not be another female nurse available. Also, us nurses are often doing most of the pelvic exams, and as a male nurse (just as the male MDs) you would have to get another female nurse to accompany you for this task- and that would put a fair amount of strain on our small (but often very busy) unit.

In our last group of nursing students, we had 4 males (out of 8! yay for more males going into nursing!) who never got to see a birth because ALL of the patients refused to have a male nursing student in the labor room. Maybe it was partly because they were students AND they were male....but it was definitely primarily about gender as none of the female nursing students were denied entry to the labor room. Sad, but true.

It is very likely that if you were to get a job in L&D you would face daily gender discrimination by patients. That could be tough to deal with. I'm not saying you shouldn't go for it anyway- only that you should go into this (if you can get a job at all) with your eyes wide open. Good luck to you.

[labordude, BSN, RN]

I don't think it is right that males are discriminated against in this area of nursing. Personally, I feel that our all-female nursing staff could really use some gender balance!

With that said, I can see why many nurse managers would be reluctant to hire a male in L&D/Postpartum. On our unit, there is often only 1-2 labor nurses on each shift, so if a patient didn't want a male nurse there might not be another female nurse available. Also, us nurses are often doing most of the pelvic exams, and as a male nurse (just as the male MDs) you would have to get another female nurse to accompany you for this task- and that would put a fair amount of strain on our small (but often very busy) unit.

In our last group of nursing students, we had 4 males (out of 8! yay for more males going into nursing!) who never got to see a birth because ALL of the patients refused to have a male nursing student in the labor room. Maybe it was partly because they were students AND they were male....but it was definitely primarily about gender as none of the female nursing students were denied entry to the labor room. Sad, but true.

It is very likely that if you were to get a job in L&D you would face daily gender discrimination by patients. That could be tough to deal with. I'm not saying you shouldn't go for it anyway- only that you should go into this (if you can get a job at all) with your eyes wide open. Good luck to you.

I appreciate your comments. I could potentially understand the reluctance in your unit which is far, far smaller than the one I interviewed in, as well as the one at my current hospital that I want to transfer to. There are never less than 5-6 nurses in our birthing unit. I have also never seen a shift where at least 2-3 of the MD/DO's were male. There is also not a standing policy that all males must be accompanied by a chaperone. Should there be a policy to this effect, it must be written to avoid discriminatory language and state that all patients must be asked if they want a chaperone, REGARDLESS of the gender of the care provider.

As a student, I was never denied the opportunity, though it had a lot to do with the attitude of the staff nurses as well as the attitude of the clinical instructor. I do not believe I would face "daily" gender discrimination by patients, at least any more than the OBs would. The most current research suggests that patients are far more okay with care regardless of gender and that it is the nursing staff who are the ones still holding the biases.

[roser13, ASN, RN]

"I do believe that you are being discriminated against, but I don't agree that males should be hired for L&D or Mother baby. "

I don't understand how one person can hold those two conflicting thoughts.

Under the premise that OB patients should be able to dictate male vs. female nurse, I would ask: what does the male prostatectomy patient deserve? The male cystoscopy patient? Or penile implant patient? Nurses are professional caregivers, just as MD's are. I do not choose a primary care physician or surgeon based upon his/her gender; therefore I do not believe that I need/require a choice my nurse.

The thought of my husband being "uncomfortable" because my caregiver is a male is just wrong, wrong, wrong. On so many levels.