Male Nurses Break Through Barriers to Diversify Profession

    • September 28, 2011

Derived from a Latin word that means to nourish or suckle a child, the word "nurse" has a long and deep cultural association with women.

Yet men have played a vital—albeit often overlooked—role in the history of the nursing profession; they attended the world’s first nursing school in India in 250 B.C., started a hospital to provide nursing care during the Black Plague epidemic, and tended to the sick, injured, wounded and impoverished over the millennia, according to an online historical timeline.

Now, at the dawn of the third millennium, more men are going into a profession they helped create some 2,000 years ago. Nurses, and the patients they serve, will benefit if they do, according to a report released last year by the Institute of Medicine (IOM).

Men provide unique perspectives and skills that are important to the profession and society at large, according to the IOM report, called The Future of Nursing: Leading Health, Advancing Change. The nursing profession, the report states, needs to place a greater emphasis on recruiting more men to the field to meet a larger goal of a more diverse nursing workforce.

“Patients are much more receptive to health care providers of similar cultural and ethnic backgrounds, and that may well translate to gender as well,” says Vernell DeWitty, PhD, MBA, RN. DeWitty is deputy director of New Careers in Nursing, a program funded by the Robert Wood Johnson Foundation (RWJF) that supports students in accelerated baccalaureate and master’s nursing programs, which tend to attract relatively high numbers of men.

Randy Jones, PhD, RN, an associate professor of nursing at the University of Virginia and an RWJF Nurse Faculty Scholar who is conducting research into prostate cancer screening and treatment, echoes the sentiment. Male patients, he says, may feel more comfortable discussing certain conditions, especially those related to sexual and reproductive health, with other men than with women.

Men are urgently needed in the profession for another key reason, DeWitty and others say: a looming nursing shortage that is projected to grow to 260,000 nurses by 2025, according to a 2009 article in Health Affairs. “The shortage of the future will likely not be solved unless men are part of the equation,” says William T. Lecher, RN, MS, MBA, president of the American Assembly for Men in Nursing. “We really have to figure out how to provide more gender inclusion and balance in the nursing workforce.”

Men Make Slow Inroads in Female Preserve

The demographics of nursing are beginning to change. In 1980, there were 45,060 male nurses, according to the IOM report; by 2004, that number jumped to 168,181. Today, men comprise just over 7 percent of all RNs, and that number is projected to grow; more than 11 percent of students in nursing baccalaureate programs in the 2010-2011 school year were men, reports the American Association of Colleges of Nursing.

Despite auspicious signs for men in nursing, significant barriers remain. The public image of a nurse continues to be a White woman in a white dress and a white cap. And the news, advertising and entertainment industries, meanwhile, play up “feminine” traits associated with nursing, which often has the effect of turning men off to the field. Nursing is “usually projected as this nurturing, very soft, very caring kind of profession,” DeWitty says.

A 2005 survey of men in nursing backed up that assertion. Male nurse respondents indicated they were influenced by the misperception that the profession is not “appropriate” for men. These misconceptions are spread by the media, according to The Truth About Nursing, a website that critiques media portrayals of nurses. One prime example comes from the popular Meet the Parents movie trilogy, where Greg Focker, a male nurse character, fends off suggestions that he is an unfit mate because of his career choice.

One area that can have especially high barriers is obstetrics and gynecology. Elias Provencio-Vasquez, RN, MS, PhD, an RWJF Executive Nurse Fellow (2009) and dean of the nursing school at the University of Texas in El Paso, met with resistance from some female patients in the maternity ward early in his career. “I remember back then when I was doing my labor and delivery rotation in the hospital, some patients had some hesitation because we were men,” he recalls. “But we overcame that by presenting ourselves as students, and our faculty members were very professional and very supportive.”

The public attitude toward male nurses plays out in everyday life, Lecher adds. Men in nursing are often presumed to be physicians or asked why they opted against medical school “as if it is not appropriate or socially OK to have chosen nursing,” he says.

Jones has experienced the affront on numerous occasions in his clinic and at interprofessional conferences. But instead of taking offense when patients or colleagues assume he is a physician, he sees it as a teaching moment. “It gives me the opportunity to speak to them about being a male nurse and how that percentage is increasing throughout the nation and worldwide. We provide excellent care just like any other provider.”

Other barriers to men in nursing include a lack of male role models and mentors in nursing schools and health care organizations, DeWitty says.

One of the best ways to knock down some of these barriers is by transforming the nurse education system, according to the IOM report. It urges academic nurse leaders to partner with health care organizations, school systems and other community organizations to recruit and advance nursing students from underrepresented groups. It also calls on private and public funders to expand loans and grants for accelerated degree nursing programs and second-degree nursing students, who are disproportionately male.

The Foundation launched a massive, multifaceted campaign last year to implement the IOM report recommendations, called the Future of Nursing: Campaign for Action. It also supports workforce diversity programs such as New Careers in Nursing, which has granted 38 percent of its scholarships to men.

The American Assembly of Men in Nursing, meanwhile, has launched a recruitment initiative to encourage more men to enter nursing school. Through this initiative, called 20 x 20: Choose Nursing, it awards scholarships to undergraduate and graduate male nursing students; recognizes excellent nursing schools for men; and has created a poster advertising campaign designed to appeal to men. The group is also active in the work of the Center to Champion Nursing in America and is helping to advance the IOM report’s diversity recommendations.

Another key way to diversify the profession is through personal appeals to students—an effort that Jones makes on a regular basis. Once or twice a semester, Jones speaks to children in elementary and primary school so they can better appreciate the diversity within the profession. “When the students see me, an African American male who is also a nurse, they see an opportunity,” he says.

The economy will play a huge role as well, experts said. Nursing, the largest profession in the health care workforce, offers comparatively stable employment and relatively high wages at a time when many other industries are contracting. “We certainly have seen a lot of men laid off, or want a more stable secure job,” Provencio-Vasquez says, and that may draw more men to the field.

Demand for nursing services is projected to surge as the population ages and the health care reform law takes effect, increasing access to care for tens of millions of people.

“One day, men might actually make up 50 percent of the nursing workforce, in a similar way that women have been able to enroll and work in law, engineering and medicine,” Lecher says. “That would be true gender inclusion and balance.”