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Why Aren’t There More Men in Nursing?

January 8, 2013
Male nurse action figure/ gcfairch, flickr

Male nurse action figure/ gcfairch, flickr

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

Men have served in nursing roles since at least the third century, when a special order of men was said to have existed to care for plague victims in Alexandria. And various religious orders seem to have had groups of men devoted to nursing tasks during the Middle Ages. More recently, a number of men served as nurses or in nursing roles during the U.S. Civil War—Walt Whitman, who extensively visited wounded soldiers during the Civil War, has sometimes been described as one, though he mostly focused on tasks like writing letters for illiterate soldiers, bringing them special foods and necessary items, and providing companionship. (See our article on Whitman, free until February 10, from our 100th anniversary issue of October, 2000.)

There were schools of nursing for men since the early 1900s. Last year, we published “My Grandfather’s Unpublished Manuscript” (August, 2012; free for all readers until February 10), a wonderful story of how the author (a nurse) found an article describing her grandfather’s experiences during his education and nursing career, which began with graduation from nursing school in 1929.

There were several early articles about male nurses in AJN—the oldest one I found was from March, 1924: “A School of Nursing for Men,” by Kenneth T. Crummer, described the school of nursing for men at the Pennsylvania Hospital and its founding 10 years earlier, in 1914. (Free until February 10, 2013; we recommend clicking through to the PDF version when viewing archival articles.) The final sentence reads, “Who knows but that the nursing text of the future will speak of the nurse, not as ‘she,’ but as ‘he or she?’”

Despite the early presence of men in nursing, today men still represent “fewer than 10% of the RNs licensed since 2005 and fewer than 12% of the students enrolled in baccalaureate nursing programs,” according to the authors of “Men in Nursing,” a CE feature article in the January issue of AJN. As the abstract describes, the article

examines the ability of the nursing profession to recruit and retain men in nursing schools and in the nursing workforce. The authors consider such educational barriers as role stress, discrimination, and stereotyping, and explore questions of male touch and the capacity of men to care. In identifying challenges faced by men entering or working in a profession in which women predominate, the authors hope to promote actions on the part of nurse leaders, educators, and researchers that may address issues of sex bias and promote greater sexual diversity within nursing.

There’s also a podcast interview (scroll down to select the “Men in Nursing” podcast) with the authors, offering additional insight into the issue from their personal experiences as well as some suggestions for us to consider as we work alongside our male colleagues. Stop and think: do you act differently or treat male colleagues differently than women colleagues? Are your expectations different because of their sex? Do you think men bring the same abilities for caring to their nursing work as women? Read the article and listen to the podcast—you might find yourself reexamining your thinking.

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19 comments

  1. I’ve worked with many nurses who happened to be men. Sometimes they are expected to do more of the heavy lifting, literally, of patients and equipment, leading one of my favorite colleagues to develop a vague “back condition”. When I worked in Pediatrics, occasionally a parent would express concern about leaving their child with male nurses, making me realize the barriers these colleagues can run up against.

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  2. There are many patients who prefer male nurses and there are also those who react very poorly. Most feedback, good or bad, is different ie. assuming I am the doctor is very common. I often feel like my actions are always over-scrutinized. This is the second pediatric unit I have worked on where I am the only male. Being the odd man out is getting old enough that I am considering leaving Peds.

    BTW, JParadisiRN self-expression article was excellent.

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  3. Ethan, pediatrics is a challenging nurse environment for nurses of both (all) genders in that the smaller the patient, the more Obessive/Complusive the nurses are about protecting their tiny, and often helpless charges. Yes, you are being scrutinized by your colleagues, the medical providers, and especially the parents. I almost quit too, during my first year.
    I don’t know how long you’ve been in practice, but it does ease up as you gain experience. Becoming a unit expert in some area of care (airway management, DKA management, seizures, for example) will gain you some support and a place on the team, if you choose to stay. Some of my favorite coworkers have been male peds and neonatal nurses. If you’re up for it, hang in there.

    And thank you for the compliment on the JParadisiRN post.

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  4. Thanks for the encouragement. Too late. Not so much about genders in this case. Was overwhelmed by Level I ICU. From ECMO to CVVH to 23 weekers to failed BMTs. I did not sign up to nurse to manage death., especially of young ones. HOT kids in the ICU is not for me and after 15 little angels in 5 months and my last weekend that included 3, I resigned. Not feeling like I had support or a proper mentor did not help and reinforced the gender differences. Not sure if my holiday respite helped me heal, but I have to get back on some horse very soon. I will however search for some words of wisdom throughout your blog.

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  5. As a long time peds nurse I considered making the switch from peds when working with so many women seemed to make the catty-ness factor unbearable! I had transitioned from psych to medical nursing pretty much straight to peds and missed the male nurses and counselors on the team in the other specialty. The men I DID work with in peds were very special guys and I admired them. I’ve seen parents (and their kiddos) absolutely stand behind and request the nurse they relate to best, male or female.
    My advice is to stick with peds if you feel the calling and love the kids. As Juliana admits, it can be a challenging place, particularly the parents, but the kids always kept me coming back for more.

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  6. When my 3-year old daughter got hospitalized, she made friends with two male nurses in the hospital. :) The male nurses were very caring and they love playing with my kid. I hope more males will get interested to take up nursing and become as efficient as those guys we met in the hospital.

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  7. It’s nice to see this topic being addressed. At Barco’s Nightingales Foundation, we actively encourage individuals to embrace the nursing profession, and are proud to have our latest profile be of Adam, a male student nurse. To read his story visit us at http://facebook.com/BarcosNightingalesFoundation.

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  8. @Ethan Thanks for more explanation. PICU is one of the most overwhelming environments in nursing. Even seasoned trauma nurses from adult ICU with backbones of steel express their unwillingness to work with critically ill children. Besides skills, there is a particular form of emotional resiliency required. Sometimes nurses lose this resiliency after becoming parents. It’s not something you can control. There is no shame in that.

    It’s one of the downfalls of nursing that hospitals are encouraged, but not required to provide staff the training needed to care for patients needing the advanced technology you describe, despite studies which show it would improve nurse retention and patient safety. CVVH requires the nurse knows how to manage a complex and often cantankerous machine that is used when a patient is too hemodynamically unstable for renal dialysis, AND managing the patient. I would have been lost if a kindly nephrologist hadn’t taken an hour of his own time to teach me the ins & outs of the machine, which is how I became the nurse training other nurses in our unit.

    Oh yeah, and ECMO: those licorice ropes of blood-filled tubing tethering even the smallest baby to a machine doing all of the work its body should do…Stress? What stress?

    Being emotionally affected by the plights of these small souls doesn’t make you less of a man, it makes you a compassionate, caring nurse. Shame on your coworkers for not supporting you and losing a good nurse in their unit. I can tell you it’s a familiar story and one leading many nurses away from our profession. I hope this will not be the case for you.

    I have written about some of my own problems becoming a nurse under The Roz stories (categories)

    http://jparadisirn.com/2011/02/07/how-i-became-a-nurse-it-could-not-have-begun-worse/

    Good luck to you.

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  9. Thanks for the very thoughtful comments here. Great to see. -Jacob

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  10. Ethan,
    Your comments remind me of a Viewpoint piece written by our former editorial director, Thom Schwarz, on his frustrations with being identified as a “male nurse”. See http://bit.ly/TLHitQ

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  11. About the only profession more female dominated than nursing is being a nun. What is really needed is a study of high school boys who are choosing a major. What keeps them from choosing nursing even though it is respected profession with decent pay and good opportunities for employment? Obviously something is keeping them from even applying. My guess is the fact the word Nurse has a distinctly feminine connotation, combined with the stereotypes of both male and female nurses are the major factors. The sexual confidence of most high school boys is very fragile. Fear of being seen in a feminine role is stronger than the perceived benefits of being a nurse.

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  12. The movie Meet the Parents drives your point home, beginning with the leading character, male nurse Gaylord Focker.

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  13. Maybe it was just my winning personality that was the issue. As far as the resiliency, I think if my skills and knowledge base were more advanced I may have been better suited to cope. Often just overwhelmed with complex multi-organ issues and accompanying tech that just left me spinning. Many no win situations. Plus the Level I/ teaching hospital environment where we throw everything against the wall to see what sticks was daunting to say the least. I became very fond of two sentiments. Just because we can does not mean we should and my head can rationalize what my heart cannot justify. To be fair to my colleagues. Any nurse that can walk into a 9+ drip, maxed out pressors, oscillating, CVVH and no prognosis to speak of room and treat their fully sedated patient like a princess day in and day out as well as having equally as much positive energy for family watching their young one waste away for months is nothing short of a miracle worker. And many did home nursing on the side. Those were some of the best nurses I have ever seen and I’ve worked with PICU nurses before. I can only hope to be as good and compassionate someday. It would have been nice to see one HOT kid survive the ICU before I left. Not my cup of tea at the moment, but strangely I still feel like the PICU is my place. The other two ICU’s had more males. Perhaps I’ll return to the ED where I worked before PEDS. Definitely a higher % of males nurses.
    By the way Brent. Even as a young EMT, I still never thought nursing was a possibility. When I went back to the ambulance in my 30s, the medics that I worked with convinced me to nurse. Plus the ED is easier on the back than pre-hospital work. I did not become a nurse until I was 40. Which also may be an issue. I am an old dog and a male. Double disadvantage. Never wanted to be a floor nurse. Even left school once disillusioned with adult med-surg floor nursing. Then I found PEDS. And now I find I just want run of the mill boring med-surg floor nurse with lap appy/choli and GI/GU issues and all of the above for awhile to catch my bearings. That said, the gender issue is definitely weighing heavily on my mind considering returning to PEDS, even as a floor nurse.

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  14. And by the way, the first school I went to 85% of the males were set back at least one semester. There was a class action suit forming, but I left before that. The school I did graduate from I believe I was one of less than 20 males in a class of close to 300. I should have gone for the accelerated masters. Sigh

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  15. I participate in career day at the school where one of my cousins is a teacher. A few things really came to light for me. One, the perception of male nurses by the students even though there is a male nurse at their school. Two, the comments from a few middle eastern male students that said “my father would not let me become a nurse.” Usually after my spiel regarding all of the good nurses do and the qualities a nurse brings to the profession I produce a photo of my son in his Marine uniform and then another in his BSN photo and then his family. It brings a glimmer to their eyes but not one male voices an interest in the profession. This has not changed in ten years. I graduated many years ago and as an LPN there were three males in my class. Two years later as an RN there was one male in my class. Then when i obtained my BSc in 1982 there were no men in my class. I continue to encourage young and not so young males to enter the profession because I know they bring a different perspective. Recently during a hospitalization I was a little startled myself when a male came to give my im antibiotic. However I am older now so there was no objection. I could see a younger female actually requesting a female nurse. We are really gender biased and I wonder what it will take to get over this hurtle. Personally I truly enjoy working with male nurses. There are none of the many issues that can and often occur with my counter parts. I have found men to be just as caring and nuturing as many females in fact in some cases more so. Looking forward to the day when your profession is not colored by perception real or unreal. P. Sumner RN BSc.

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  16. My mother served in Korea as an Army Nurse. In those days, even men who had BSNs were denied the ability to serve in the Corps. They were provided enlisted positions or commissioned in other branches of the Army (e.g. Infantry, Artillery).

    In my thirty years of professional nursing I’ve experienced unbelievable gender bias and have seen many men driven out of the field, though that has changed dramatically in the last decade. I served in the Army Nurse Corps for 24 of those years. In those early post-Vietnam years men were not welcomed in the ANC, even though they had been finally admitted legally in 1958. Opportunities for men were few and positive ratings were often withheld in deference to female peers. In an era when female Army Nurse Corps officers were only recently given the right to have children and remain on active duty, there existed a cold welcome to men who had families in the Corps. Male ANC Officers were statistically selected at a higher rate for separation during the Reduction of Forces of the early 1980s. In one of my early duty stations, I was the only male officer to leave that hospital and remain on active duty. I saw seven male officers drummed out of the Corps by the Chief Nurse. Even I left with the worst evaluation that I or anyone I’ve ever known has ever seen.

    It’s very different now. The selection of BG William Bester in 2000 was proof that we’d turned the corner. The Army Nurse Corps is now egalitarian and fair in the treatment of male officers. When I retired as a Colonel, my gender had climbed to nearly 40% of the Corps and male officers held a proportionate number of positions at all levels of leadership. I am very proud of what the Corps became in terms of gender equality and heartily laud those unheralded leaders who made the difference in the 1980s and 1990s. The current leadership has continued to provide opportunities for ALL nurses, regardless of race, gender, marital status, or, now, sexual orientation.

    But, please don’t call me a “male nurse”–it’s degrading and a throw back to those years when men were treated as less than nursing professionals; relegated to “orderly” status, regardless of our education, experience, or abilities. I am a nurse!

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  17. …and a Chief of the Army Nurse Corps stated during an interview with Jet magazine in 1986 or 1987 that the reason she wasn’t working on projects to increase the proportion of males in the Corps was that men, by nature, are not very nurturing.

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  18. Dear AJN, well done! While the experiences and feelings expressed by the bloggers and reported in the article may not all be mine, I think that overall this is an important piece, if for no other reason that to begin to dispel the notion that men are not equipped to be nurturing in ways that make excellent nurses –and human beings!
    Respectfully,
    Thom Schwarz RN CHPN

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  19. I’ve been a “male nurse” for 20 years. Nursing has provided me some great opportunities and overall been a very rewarding career. More important than the money is hearing from a patient letting me know I made a bad situation better or mentoring a new nurse and watching them grow. The hardest part of being a male in this field over 20 years is watching administration perpetuate the female nurse stereotype. The title “nurse” itself is a deterrent for males.

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