NurseWeek: Men at Work

"We are definitely making a better attempt to recruit men into nursing, but we are still far behind," said Jerry Lucas, RN, publisher of Male Nurse Magazine, a magazine for male nurses that is expected to launch in the fall. "We get them in, but we can't keep them in."

Some studies have shown that men drop out of nursing school and the profession at a greater rate than women do, although reasons for this are unclear and need further research. One possibility is stress resulting from gender discrimination; another is that the work does not meet expectations-a common reason for new female nurses to drop out.

In an online survey Lucas conducted and published on Male Nurse Magazine's Web site, 113 of 126 respondents said they did not feel that men were "fairly represented within nursing." More than two-thirds of men who responded to a write-in survey said they thought men were overlooked in the profession. Men might be more likely than women to leave a job if they don't feel respected and valued, Lucas said.

Studies also show a greater percentage of men in management, which some men say is because men are pushed away from bedside care. Nursing schools have few or no male faculty members. Some men report harassment at work or in school by female colleagues or professors. Male and female nurses tell stories about men not being allowed in labor and delivery rooms, not because patients objected but because staff nurses or instructors disapproved.

But many male and female nurses say that although they have encountered or heard about gender discrimination against men, they believe it is the fault of a few individuals rather than a pervasive problem. Most nurses, they say, don't care who you are as long as you can do the job. Most patients don't care either.

"Decades ago, there was a bias against men in nursing," said Polly Bednash, Ph.D., RN, FAAN, executive director of the American Association of Colleges of Nursing. "I would be surprised to see any of those biases continue to exist" as more men move into the profession. "I see strong respect and sharing between men and women."

Nurses also admit they need to work to overcome the gender bias that became automatic in the 1900s. Burton said she still forgets sometimes and refers to all nurses as "she," even though she makes a conscious effort not to. Textbooks with pictures of all female nurses need to be updated.

"If nursing wants to become diverse, it needs to portray itself as a diverse profession," Wilson said. "In its language, in its textbooks, in its journals." For the first time, he said, he is starting to see a change. "I'm starting to see articles in some of the major journals saying perhaps we should let men into nursing."

Burton said that in her region at least, she's hearing fewer horror stories about men facing discrimination in nursing. Her next campaign, which begins in the fall, will focus on bringing minorities of both sexes into the profession.

When she's walking around the campus of the University of Portland, a private school, Burton sometimes comes across young men visiting the campus with their parents. They usually are lost and need directions. While helping them, she asks where they are from, what the son plans to study. If the student says he doesn't know, she asks if he's ever considered nursing.

The responses are as regular as clockwork, Burton said. The father laughs. The mother says, "I don't think so."

Like a sign on a bathroom door, it's a small thing, but it could mean a great deal to the future of nursing.

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History of men in nursing

If nursing is so good for men, and men seem to be so good for nursing, why is it taking so long to get them into the profession? Studies of other traditionally female professions like teachers, librarians and legal assistants show they have greater percentages of men working in them than nursing has.

Men point out that nearly half of medical school students-once almost exclusively men-are women. Female physicians are ubiquitous in the media and popular culture, as opposed to the nearly invisible male nurse. When he does show, he usually is an object of derision.

Many blame the heroine of modern nursing-Florence Nightingale. Until the late 1800s, men had a long and storied tradition as nurses, said Bruce Wilson, Ph.D., RN, professor in the department of nursing at the University of Texas-Pan American in Edinburg.

According to Wilson's research, the first nursing school in the world-in India in 250 B.C.-taught only men because women were considered not "pure" enough to be nurses. Military and religious orders like the Alexian Brothers provided male nursing care throughout the Middle Ages. Men were nurses during the Civil War.

But after Nightingale and others put forward the notion that nursing was a good career for women-and only women-who were entering the workforce as farming families moved to the cities, male physicians made it clear they preferred female assistants who would follow orders and accept low pay without complaint, helping create the image of the nurse as a not-too-bright, poorly paid handmaiden, said Deborah Burton, Ph.D., RN, executive director of the Oregon Center for Nursing, a nonprofit organization dedicated to solving the nursing shortage.

Men either withdrew or were actively excluded from the profession. The American Nurses Association did not admit men until 1930.

Wilson and others point out that male nurses in World War II were not allowed to serve as nurses, even though they were trained RNs. Men were not allowed to be nurses in the U.S. military until the Vietnam War, Wilson said, and after the war the number of male civilian nurses began to grow. Now, more than one-third of all military nurses are men, and many civilian male nurses have military backgrounds.

Since the mid-1900s, numerous studies have recommended recruiting more men into nursing, usually to avert a nursing shortage, Wilson said. Until recently, those recruitment efforts have met with little success.

Richard Brock, MA, RN, director of medical/surgical nursing at Good Samaritan Hospital in Los Angeles, recalled that after he and another man who had been a Green Beret in the Vietnam War graduated from nursing school in Indiana, the school decided to recruit 50 more Green Berets into the nursing program. It was a disaster, he said.

The Green Berets, who were used to giving emergency tracheotomies and saving lives in the trenches, did not take well to learning how to fan-fold a postop bed, he said. "The instructors hated them. They were bossy and confrontational and chauvinistic."

But he also recalled being in New York in the 1970s when the city's budget woes forced many firefighters into early retirement during a huge nursing shortage. A number of the firefighters were successfully retrained as nurses.

"They saved health care there," Brock said.

-Cathryn Domrose

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