According to the latest statistics, male nurses represent just a small fraction of the nursing workforce in the United States (http://www.highbeam.com/). The popular notion that nursing is not for men and admission capacity constraints of Nursing Schools seem to be major obstacles towards bringing more men to the profession. Although male nurses often face the challenges of gender discrimination, especially in specialties like obstetrics and gynecology, where, women often prefer to have female nurses, male nurses often end up in leadership roles and in specialties like intensive care, emergency and operating room nursing (http://www.jscms.com/).
Attitudes, gender role perceptions, intimate care issues, nurse shortage, retention and motivation influence the professional presence of men in nursing to a great extent.
A recent study to examine the relationship between six demographic variables
of 174 respondents and acceptance of males in the nursing profession by multiple regression analysis has indicated that only two of the variables, namely, respondents' educational level and sex, significantly predict the attitudes toward male nurses (Laroche and Livneh, 1983).
Gender Role Perceptions
Although studies indicate an overall positive acceptance of men in nursing, they do indicate a need for professional adaptations in core issues like care for men to remain and flourish in the profession. Studies have also shown that men entering a predominantly female profession are perceived more deviant than women (Hesselbart, 1977). A quantitative non-experimental descriptive study to elucidate quantitatively the gender role perceptions of male nurses using the Short-form Bem Sex Role Inventory has shown that adherence to the female gender role is an important prerequisite to caring and adoption of facets of the female gender role may not be unique to male nurses (Loughery, 2008). Studies have also shown that men experience the process of nursing differently than women (Anthony, 2006). A recent study into gender issues in nursing has found male nurses being stereotyped both outside and within the profession as homosexuals, low achievers and feminine-like (Armstrong and Fiona, 2002). A social constructionist study to examine the construction of the stereotype of male nurses as gay and to describe the impact on male nurses has shown that despite the fact that male nurses are professionals who care the same way as female nurses, stereotyping them as homosexuals does exist exposing male nurses to homophobia in the workplace. Sex role stereotype in nursing has been shown to elicit role strains in male nurses using a Role Strain Instrument in a sample of 367 randomly selected male RNs in Oregon (Egeland and Brown, 1988). Such stigmatizing factors form a barrier to patient care, deter men's entry into the profession and play a major role in problems related to retention (Harding, 2007). Published evidence also suggests that success of men in nursing is disproportionate and male nurses face gender-based disadvantage compared with that of women (Tracey and Nicholl, 2007). Recent research studies have shown that male nurses face gender-based barriers even during their nursing education programs (Keogh and O'Lynn, 2007).
On the other hand, studies on the effect of nurse gender on nurse and patient perceptions of nurse care by two-factor ANOVA have shown that no significant differences in actual caring exists based on nurse gender from either from the nurse or the patient perspective although male nurses exhibit lower caring behaviours (Ekstrom, 1999). Studies also suggest that even in female-dominated occupations such as nursing, patriarchal gender relations which reflect a high valuation of all that is male and masculine, play a significant role in placing a significant number of men in administrative and elite specialty positions and male nurses employ strategies that allow them to distance themselves from female colleagues and the feminine image of nursing (Evans, 1997).
Intimate Care Issues
A semi-structured, open-ended study of male nurses' experiences of providing intimate care for women clients has identified three themes namely, the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. A latent content analysis of the data obtained has shown that providing intimate care for women clients is a challenging experience for male nurses due to situations that demand invasion of clients' personal space (Inoue et.al, 2006). Another exploratory cross sectional survey study to explore the role of men as obstetrical nurses using structured and open-ended questions in a sample of 599 male Registered Nurses by univariate, bivariate and logistic regression has shown that most male nurses lack interest in working in the specialty of obstetrics (McRae, 2003).
Statistics show that the total number of nurses working in the healthcare field in the United States has decreased from 2,669,603 in the year 2000 to 2,262,020 in year 2001(World Health Organization, 2006). This shortage can be defined by either a need based approach or a ratio technique. The need based approach identifies the number of professionals needed to perform certain tasks based on the judgment of a nursing or a medical professional. The ratio technique compares the current professional population ratio to a projected future ratio and identifies a difference as a shortage (Lane and Gohmann, 1995). Recruiting more men into nursing is viewed as a way to address the increasing critical shortage of nurses.
Motivation and Retention
A descriptive qualitative research study to explore male nurses' motivations for becoming a nurse, reveal their professional developmental process in nursing, understand the difficulties hindering their professional development and identify the strategies they use to cope with these difficulties in a convenience sample of fifteen male nurses has shown that the difficulties encountered by male nurses during career development are related to the gender expectations of patients and male nurses improve their professional knowledge and skills to obtain higher levels of satisfaction and better opportunities for promotion (Cheng-I et.al, 2004). A study designed to increase understanding of the career choices of men in nursing by exploring what they find important in their career, their sex role identity and their personality components using Important Components of a Career Scale, Bem Sex Role Inventory, and the Cattell 16 Personality Factor Measure in a total sample population of 1,000 has shown that male nurses value relationship-oriented components of their careers. Men seem to be more interested in the technical aspect of nursing. A national survey among intensive-care nurses, to establish if male nurses and female nurses can be distinguished with reference to career orientation and preference for technical departments has shown that there is an over-representation of men in technical wards and at IC/CCU units and male nurses seem to be particularly oriented towards upgrading their own professional status (Dassen et.al, 1990). A recent study to explore the motive of men to choose nursing as their profession using a 52-item questionnaire covering sociodemographic characteristics, exposure to the profession and reasons for choosing the profession has shown that an early exposure to the profession and ethnic background are prominent factors in this motivation process (Romem and Anson, 2005). Another recent study to explore the motive of men for entering nursing has identified career opportunities, job security and salary as important factors. The study has also highlighted sexual stereotypes, lack of recruitment strategies, female-oriented profession and lack of male role models as barriers (Meadus and Twomey, 2007).
Male nurses represent just a small fraction of the nursing workforce in the United States. Although recruiting more men into nursing is viewed as a way to address the critical shortage of nurses, significant professional barriers deter male entry into the profession.
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Agency San Francisco, Inc.
San Francisco, California
Charles L. Berman
Liz Di Bernardo