Male Call
Despite cultural bias and relatively small numbers, more men are making contributions to the profession and discovering its rewards

By Donna Hemmila
October 21, 2002

When Mark Barnett's heating and air-conditioning company was sold and he lost his job, the Texas dad went hunting for a new career.

He wanted to return to school, but didn't know what to pursue. Then his wife reminded him how much he enjoyed helping her study when she was in nursing college, and Barnett decided to give the profession a test run. First, he obtained an emergency technician certificate and worked for an ambulance service.

That experience hooked him. In June, Barnett, a registered nurse, started working in the emergency room of the Medical Center Hospital in Odessa, Texas. He's also enrolled in a BSN program.

"I like the fast and furious stuff and getting things done," Barnett said. "I like a job that will keep me busy."

With a critical RN shortage, nurses like Barnett say it's time to get the word out that nursing is a viable career for a man and that men are making significant contributions to the profession.

"Men in society are coming around to feeling comfortable with showing emotion and feeling that feminine side," said Mark Hawk, MSN, ACNP, RN. "It's OK for men to nurture. It's OK to be nurses now."

In theory, it might be all right for men to choose a career in nursing, but in practice, only a small number are actually doing it.

In the last 20 years, the number of male nurses has doubled. In 1980, 2.7 percent, or about 45,000 nurses, were men, according to the Health Resources and Services Administration's National Sample Survey of Registered Nurses. In 2000, that number jumped to 5.4 percent, or about 147,000 nurses.

Hawk started his health care career in the ninth grade when he became a pinstriper, the male equivalent of the hospital candy striper. Through his high school years, his father was in and out of the hospital and died when Hawk was a senior. The exposure to hospitals may have inclined him toward nursing, but it wasn't until recent years that Hawk realized he had what many nurses refer to as "the calling." His first dream as a young man was to become an actor and move to Hollywood.

"I was 21. What did I know?" Hawk said. Today, he's entrenched in the nursing profession as an assistant clinical professor in the acute care practitioner program at the University of California, San Francisco, and as a nurse practitioner in trauma services at San Francisco General Hospital.

There, he's seen the gender roles in health care shift. He's had days in the trauma center when the nurses on duty were all men and the doctors all women. But Hawk and other nurses still see cultural biases against men becoming nurses. Many people assume all male nurses are gay, Hawk said, and that they weren't good enough to get into medical school.

"There are very few guidance counselors who tell a boy, 'You can grow up to be a nurse,' " said Richard Martin, MSN, RN, vice president of patient care services and chief nursing officer at Hoag Memorial Presbyterian Hospital in Newport Beach, Calif.

Hoag Hospital, where Martin said about 30 of the 900 nurses are men, has a recruitment effort directed at middle school students. While the message about the benefits of a nursing career is the same for men and women, Martin said he would like to see more boys take that message to heart.

Martin, like many male nurses, started his health care career as a hospital orderly. The son of a coal miner, he didn't have much growing up in West Virginia, but his family never turned anyone away who needed help. Armed with that strong family commitment to helping others, he pursued a career in nursing starting with an LVN program and then an AA nursing degree.

Although Martin said he always felt welcomed and nurtured by women colleagues at the beginning of his career, male nurses in the 1970s were such a novelty that patients sometimes had trouble adjusting.

In the beginning, he would always ask a female patient's permission to bathe her or perform other intimate procedures. After about three months, Martin realized that if he asked, they would say no. When he approached them with confidence, female patients were more accepting, he said.

Something to prove

Once, when Martin had to give an injection to a male patient, the man said, "I didn't know you were allowed to do that." When Martin asked what the man meant, he replied, "I didn't know housekeeping was allowed to give shots."

Today, it's more likely for a male nurse to be mistaken for a doctor.

"Some people acted disappointed that I was just going to be a nurse," said Richard Clapp, RN, a recent nursing school graduate who works on a med/surg unit in Mattoon, Ill. "I think there's a stigma attached to it. It's considered a female position."

Statements like "Why are you only a nurse?" or "You're too smart to be a nurse" haunt male RNs. Yet most chose nursing school over medical school for the same reasons female nurses say they made that career decision.

"I tell people I wanted to work with people, and it's the nurses who do that," Martin said.

Do men really make a difference in the nursing profession?

"I think what a nurse brings to the table is not because of hormones or genes," said Pamela Kidd, Ph.D., APRN, FAAN, associate dean for graduate programs and research at Arizona State University College of Nursing. "If a nurse has mastered the art and science of nursing, people do not care if their nurse is a man or a woman."

While female nurses might say they don't see any difference between male and female colleagues, male nurses say they have helped change the nursing relationship with physicians and patients.

As more men have joined the ranks of nursing, Martin believes the attitudes of male doctors toward nurses have improved. That is one big contribution men have made, he said.

"Male nurses have been less tolerant of the verbal abuse than women have been in the past," Martin said.

That attitude may have opened the eyes of doctors that it's not OK to treat any nurse with disrespect. Throughout his career as both a nurse and a hospital administrator, Martin said physicians have treated him in a more positive way than they do female nurses.

The communication difference between women and men is well-documented by linguists and sociologists, and male nurses say they see it on the job.

Men are more matter-of-fact, Martin said. They're less likely to base decisions on social or emotional considerations.

At his Texas hospital, Barnett said he's noticed that teens many times will be more compliant when he speaks to them than when a female nurse does. They respond to the male authority, he said, and sometimes the female nurses call on him when they're fearful of an unruly patient.

Men bring a new element to the work environment, said Herb Geary, MBA, RN, senior administrator for patient care and chief nursing officer at Good Samaritan Regional Medical Center in Phoenix.

"If you have an all-woman workforce, the women get catty," Geary said. "We as a society do best when there's a balance of men and women. Our patient population responds well to that."

Powerful messages

Robert Ismeurt, Ph.D., MS, RN, has been a nurse for 28 years and agrees that communication styles of male and female nurses differ.

"When men get together and have a dialogue, they don't care if they're going to be liked," said Ismeurt, an associate professor at the Arizona State University College of Nursing. "Women sometimes won't say something if it's going to ruffle feathers."

A male nurse might focus more on the bottom line and outcomes, but, Ismeurt said, female nurses care more about the process of communication and sharing information.

Ismeurt finds the academic side of nursing still predominantly a woman's world. That means there aren't a lot of men to mentor men who do come into nursing programs.

When he started one of his first teaching jobs, he discovered that the seven-story building in which he worked had two rest rooms on each floor, but they were both for women. When he asked where the male students and professors were suppose to go, he was directed to a bathroom in the basement of the building next door.

"If that isn't the most powerful message you could give, I don't know what is," Ismeurt said.

That was almost 15 years ago, but the profession still is viewed as a white woman's job, he said, and nurses need to make an effort to attract more men and more minorities into the profession.

Nursing makes a terrific career for a man, said Ismeurt, whose wife is a nurse. The two can juggle their schedules to accommodate child care needs, and they can go anywhere and quickly find a job. More men need to wake up to these benefits, Ismeurt said.

Mike Nilsson, RN, did just that more than 20 years ago when he retired as a New York City firefighter and became a nurse. In the early '70s, during another shortage of nurses, he said, the city started a grant program to train police officers and firefighters to be nurses. That got him thinking about the similarities between firefighting and nursing.

Both professions are committed to helping people and to public service, Nilsson said, so when he came close to retirement eligibility, even though the grant program had ended, he enrolled in nursing school.

"There was certainly some teasing, but that was normal give-and-take in the firehouse," Nilsson said of the reaction of his comrades. "They tease you about everything from your wife to your kids."

But his fellow firefighters pitched in and covered shifts so he could work weekends and nights and still go to school. Even back then, jumping from a virtually all-male to an all-female profession never was an issue, said Nilsson, a senior community health nurse supervisor for the Pasco County Health Department in Florida and also first vice president of the Florida Nurses Association.

Nilsson thinks many police officers and firefighters could be tapped to help fill the nursing shortage. In most departments, police officers and firefighters can retire after 20 years of service, he said, and many look for a second career. The profession needs a national recruitment effort targeting firehouses and police stations with grant money to fund education, he said.

"We definitely have to reach more men, but we have to get nursing recognized for what it is," Nilsson said.

That means improving nursing salaries, he said, and respecting the value nurses bring to the nation's health care system.

Contact Donna Hemmila at dhemmila@prodigy.net.