Running head: OBSTACLES MALE NURSES FACE

Analyzing obstacles male nurses face today in a dominated female career

Tyler Nickels
Ferris State University

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Abstract
Male nurses are have faced scrutiny for choosing a profession not suitable to them, 44%
of male nurses agreed that they experienced discrimination while practicing nursing as a result of
their gender, and 31% of the participants reported experiencing social isolation as a male nurse
(Rajacich, 2013, p. 71). The purpose of this is to analyze what issues male nurses will face and
what interventions are appropriate to apply along with how to use them. Interpreting theories of
nursing and other disciplines allows for support in this issue among nursing today. This paper
will assess the healthcare environment of nursing and associated consequences with male nurses.
Recommendations will be provided to improve the quality of care, communication and
collaboration in male nursing. Changing the stigma of nursing is important to provide equality in
gender and reduce biases of male nurses.

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Analyzing obstacles male nurses face today in a dominated female career
Nursing is a profession that many see as a career fit for females as it is one of caring and
compassion, which are traits mothers often emulate. Today, male nurses have become a more
popular choice of career than in years past. A survey completed by the U.S. Census Bureau in
2011, published in 2013 found that the number of males in nursing from 1970 to 2011 has tripled
from 2.7 percent to 9.6 percent (Landivar, 2013). With the increasing numbers over the last 40
years it is clear that nursing is becoming a common choice of career for men. As men enter the
field of nursing they may face problems throughout their career. The purpose is to analyze issues
and provide recommendations for male nurses today, in a profession dominated by females.
Issues Today
Before analyzing the issue, it is important to understand what issues are present. As a
male enters the nursing field he is walking into a profession that is highly populated by women,
he needs to embrace this and accept this. Being the minority in a profession brings opportunity
for issues that will come forward. These issues may steer some males away from nursing or
make it difficult for them to enjoy the career. Stereotypes are often brought about for males
working in nursing, along with questioning emotional intelligence, and problems protecting
female patient dignity.
Male nurses face stereotypes working in healthcare, and more specifically nursing. Men
in healthcare may be confused with being a doctor rather than a nurse if they do not have any
distinctive identification displaying they are a nurse. This can be due to the traditional mindset
that men are doctors and women are nurses. There is always the possibility that people will ask
why they did not want to become a doctor and instead became a nurse. Many question if it was
their intelligence that kept them from pursuing a further career, but it is almost always a matter

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of being able to care for patients. Doctors are not there to care for patients as much as nurses are,
nurses are at their bedside for long periods of time. An article by Jess Scherman of Rasmussen
College (2014), interviewed four males who are shattering the male nursing stereotype, one
male said, I chose nursing due to its emphasis on the art of caring and compassion coupled
with the hard science of nursing (para. 7). Another nurse was asked the similar topic, he said
I was much more comfortable at the bedside carrying out physicians orders and having the
time to add the extra, and frequently needed, TLC (Scherman, 2014, para. 10). Patients are in
the hospital because they are sick, they need proper care and support from others, and nurses are
there to provide this to patients. This may be something that is sought as a motherly instinct, but
men do just as well of a job caring for patients as women do.
Some question whether men have that emotional intelligence that women have with their
innate ability of being a mother or caregiver. Years ago, men were seen as the worker of the
family, the laborer who was strong, fierce, and was as tough as nails. This established a poor
view that men are not capable of being emotional and compassionate to people. Florence
Nightingale, who is seen as the founder of modern nursing, did not believe men should be
nurses. She saw nursing as being natural for women, to be a nurse and unnatural for men, she
was opposed to men being nurses stating that their horney hands were detrimental to caring
(Anthony, 2006). This may be the beginning of the bias toward men and nursing. Considering
Nightingale was the founder of modern nursing and she was very influential and a well-educated
individual, she may have caused people to develop a stigma in males being nurses. It is difficult
to determine if that is the cause, nursing was much different in the 1800s compared to today.
Later in the 1940s, during a debate about expanding training and licensure to men who were
already providing nursing care, a South African councilor was quoted as saying, A man is a

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clumsy thing who does not know how to handle a sick person [horizontal ellipsis] Nursing is the
proper profession for women. They are created for that purpose (Anthony, 2006, para 8.). The
history of nursing being an only women job was difficult to overcome, and it still is today. We
are making progress though, as more males are entering nursing. Nightingale appeared to
question the emotional intelligence of men, considering she did not see them fit for a profession
in nursing. A study in 2012, of male and female nurses emotional intelligence, used a
psychological survey to test the emotional intelligence. Using an instrument that has proven valid
and reliable over the last 20 years, it found there is not a significant difference in the emotional
intelligence of men and women nurses (Codier, 2012). There was no significant difference in
male or female intelligence in age, education and six other subscores. This study was conducted
in Hawaii, with a large percent of participants being Asians, Pacific Islanders, and Native
Hawaiian nurses. There may be some limitations from this as the cultures may view emotion
differently compared to other American cultures. It is still a valid study showing how males and
females are not different in emotional intelligence as nurses. Codier concludes with, EI
(emotional intelligence) appears to be an innate ability that nurses of both genders possess
(2012, p. 4)
Providing dignitiy to patients is of great importance in nursing. No one wishes to be
exposed and embarrassed, nurses need to prevent this and provide care with patient dignity in
mind. This may be especially difficult to males who are nurses caring for female patients. Many
females are uncomfortable with males caring for them; they may have a previous abuse history
or simply feel awkward when a male is caring for them. Gender stereotypes may fuel a belief
that certain men are incapable of compassion or sensitive care, are inappropriate in a caregiving
role, or that their use of touch is sexual rather than therapeutic (Whiteside, 2015, p. 335). Males

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need to be mindful, provide quality care with respect, and do their best to not provide
inappropriate touch. If touching a patient in a way that may impose on patient dignity they may
have allegations against them. In a quasi-experimental research by Lynn (2014), regarding male
nursing students and intimate touch, found that students with a three-hour instructional
laboratory had better outcomes in patient dignity. Intervention group participants were
significantly more comfortable with cleansing genitalia, less apprehensive about touch being
misperceived as sexual, reported less gender requirement rigidity, and scored significantly higher
on measures associated with client dignity, comfort, and respect than control group participants
(Lynn, 2014, p. 126). This is interesting to hear how three hours of instruction on intimate touch
can improve the care and confidence of students. Something of this impact should be utilized
throughout nursing programs to both males and females in order to provide best quality care and
protect dignity of the patients.
Theory Base
Supportive theory for this issue is present in nursing and in psychological theories. The
nursing theory that supports the issue of male nurses as a minority is the Change Theory by
Kurt Lewin, considered the father of social psychology. The psychological theory that supports
this issue is the Schema Theory by Frederic Bartlett proposed in 1932.
Nursing is a changing profession; there is new research and evidence-based practice
presented every year. Nurses have to adapt to change, whether it is management, patients, staff,
or policies. It is important for those to embrace change and apply it in the future. Change in the
stigma of male nurses is important to provide equality among nurses. Lewins Change Theory
presents three stages for change to occur. The first stage is the unfreezing, second is change, and
the third is refreezing (Petiprin). The unfreezing stage consists of letting go of an old pattern,

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understanding that change is needed. Changing the stereotype of nursing is important and needed
today. Without the initial need for change there will always be a stigma for males in nursing.
The second stage is change; Lewin saw this as a process or transition. It is difficult for people to
overcome this stage as it is something new and some may be fearful of change. People need time
to understand the change, often need encouragement and support from others to accept change
Connelly (2015), says that the use of role models in change, and allowing people to develop
their own solutions also helps to make the changes (para. 15). We need male nurses as role
models to display the idea that nursing is not just a female career. With these roles models
society will accept this and allow change to happen. The last stage in Lewins Change Theory is
refreeze. This is about establishing the change as a new standard. It has now become acceptable
to people and they apply this. It is important to reach this stage to prevent the return of old
habits. Reaching this stage may take some time, if the stereotype of male nurses is to change; it
needs to be accepting among people as the new norm.
The Schema Theory by Bartlett is concerning the idea of something, a mental
representation. Such as nursing, people have a mental representation of what a nurse is. When
people hear the word nurse, it is often picturing a female nurse, not that of a male. Just like the
Change Theory, we need to change the schema of nursing to include males. For this to happen, it
will take a long time. Schemata are developed over time and through various experiences, this
could be from childhood and maintain throughout life. Bartlett developed this theory when
noticing how inaccurate Native American folktales were, that the recalls involved the
replacement of unfamiliar information with known facts. Pappas (2014) states, In order to
categorize this class of memory errors, Bartlett suggested that human beings apparently possess
generic knowledge in the form of unconscious mental structures (schemata) and that these

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structures produce schematized errors in recall when they interact with incoming information
(para. 2). Schema is often knowledge we already know, as mentioned before often from
childhood. This may be from parents, siblings, movies, teachers and many other factors. This
schema is than maintained throughout life unless it is changed. It is important for the schema of
nursing to be changed so men and women are seen as equals in the career.
Assessment of Healthcare Environment
When assessing the healthcare environment of male nurses, systems frameworks are
measured. These frameworks include resources, quality and safety issues in a system. Finding
policies related to gender specific nursing in patient care is difficult to find. Due to this, policies
present on the issue will not be addressed as none were found specific to male nurses, this may
promote discrimination in gender.
Utilizing resources as a male nurse is important in the healthcare environment. These
resources may consist of other nurses, nurse assistants, managers, charge nurse, supervisor, or
other floor staff. Exercising the resources will benefit male nurses when they have a patient who
does not want them to care for them. Female patients may be uncomfortable with males caring
for them; this is more often dealing with perineal care or assisting with bathroom necessities.
Getting help from female floor staff to do these tasks makes it easier for the nurse and the
patient. If an incident with a patient were to occur, it is important for the nurse to explain the
incident to the charge nurse and/or the manager of the unit. Not saying something that has a
negative reflection on your care, specifically female accusations, can impact a male nurse
significantly. Failing to do so may involve entities of other departments and those who oversee
the manager of the unit to investigate on the incident. This can result in time off of work and a

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bad reputation on the floor among peers. Being open with the nurse manager of any occurrences
on the floor is encouraged to promote trust within the organization.
Quality and safety issues have an impact for a male nurse compared to a female nurse.
Quality of care may be affected if patient dignity is not promoted. As mentioned before, dignity
of patients is imperative, it provides great, quality care and reflects well on the system if done
well. A patient will often times be dissatisfied with care if they are embarrassed about an event.
When looking at the safety aspect of the issue, it is important to think about the patient. If the
patient were to have a history of being abused by a male they may not have a good experience in
future encounters with males. They may feel unsafe; have posttraumatic stress disorder from the
event, having a direct impact on quality of care. If a patient does not feel safe they will not
recover as quickly and have a poor experience within the stay.
It is assumed that males entering the nursing field understand what they are entering into.
This may be wrong, some may not realize the impact they have on a female when walking into
the room. They may face challenges transitioning into the nursing field if they have never faced
rejection from someone in the workplace. Nursing is patient-centered care, patients have the
right to refuse care, and it will include males. Males entering the profession need to understand
the possibility of this and not take it personally.
Inferences/Implications/Consequences
Understanding the impact of male nursing in the healthcare system is essential to
consider. In regards to the issues related to males provided earlier, many outcomes may originate
from the topics. Along with outcomes there is potential for complications related to them.
Inferences specific to male nursing are that of the stereotype, the respectful touch, and
intellect of emotion. It is concluded that there is a stereotype present in male nursing and it is

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important to address it. If it is not address there may be consequences that can cause job
dissatisfaction and an increased likelihood of males steering away from nursing. New male
graduates were less satisfied with nursing than their female counterparts. Only 67% of new male
graduates reported being satisfied with their jobs as compared with 75% of new female graduate
nurses (Rajacich, 2013, p. 72). This is interesting that men are less satisfied in nursing as
women. The article also said that men are more likely to leave nursing than females. It is
undetermined as to the cause of the retention. Job satisfaction may be improved if this problem is
addressed, allowing more male nurses to choose to stay with the profession. If men continue to
leave the profession it is harder to close the gap between male to female nurses and developing a
gender equal profession.
Patient dignity has been brought up often and it is important to identify consequences
related to it and not implementing respectful touch to patients. Without protecting dignity
patients will not feel they are receiving quality care. They will have a bad experience of the
organization and may pass this along to other of their poor experience. The article by Rajacich
(2013) included review of literature and data along with collecting data from a descriptive
qualitative with purposeful and snowball sampling strategies of sixteen men. The study found
that men often experience difficulty with patients and colleagues. Several men reported
colleagues discouraging them to carry out tasks on those with a poor rapport and may have legal
concerns. One nurse states, no, youve got to have somebody else go in there with you
continuing to say that it is a pet peeve of his and if its a female that was going in to see a male
there would be no question there (Rajacich, 2013, p. 76). This is something to consider that
males are less likely to develop accusations against females nurses compared to female patients
developing accusations against males. This relates back to staying open and in touch with

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management on the unit, if accusations may arise, it is important to explain the situation to the
superior on the unit before it develops worse.
Without males understanding emotional intelligence, it is extremely difficult to
care for patients. Men need to care for, listen to, and be empathetic toward patients.
Consequences may arise if male nurses do not meet patients on an emotional level. It will be
more difficult for those to stray away from the thought that it is a career fit for women and men.
The men in Rajacichs study believed that caring is associated with women historically and
caring is an aspect of what it is to be a decent human being, no matter gender (2013). This idea
of caring should be brought to attention to people, caring is not something that women
understand, it is something that all should understand. People with this mindset will more likely
accept men in the nursing profession.
Recommendations for Quality and Safety Improvements
Interventions need to be set in order to change how men appear in a dominated female
career. For these interventions to be implemented addressing American Nurses Association
(ANA) Standards of nursing need to be integrated.
Standard 10 in the ANA standards of nursing is quality of practice. White (2013) defines
this as, The registered nurse contributes quality nursing practice by assuring that patients
receive evidence-based care that is patient-centered, safe, effective, timely and equitable (p. 145).
Nursing is patient-centered, and quality of practice reflects on care centered on the patient. It is
difficult for one to meet standard quality if they are not developing care around the patient.
Males need to keep in mind the quality of care they are providing to patients. They need to
promote patient dignity and prevent any instances of intimate touch.

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Standard 11 in the ANA standards of nursing relates to communication. It is defined as,
The registered nurse communicates effectively in a variety of formats in all areas of practice
(White, 2013, p. 153). Communication is a very important aspect of nursing. Without
communication it would be difficult to provide quality care to patients. Understanding patients
desires and preferences is important in nursing. Males need to communicate with patients
effectively to determine what procedures the patients are ok with the nurse performing. Patients
may not speak up about being uncomfortable during a procedure, which is why it is important to
communicate before and establish a good nurse to patient relationship. Communicating with
other staff on the floor is important as well, it benefits the staff to know if patients on the floor
have specific requests involving their care, along with who should and should not be involved in
their care.
Standard 13 of the ANA nursing standards is collaboration. Collaboration defined by
White (2013), as The RN collaborates with healthcare consumers, family, and others in conduct
of nursing practice. Teamwork and collaboration are important factors in nursing. Without
collaboration from family and other interdisciplinaries, it is difficult to make plans of care
centered on the patient. Collaborating with other staff relates to communicating with them.
Working with one another and communicating will provide more affluent care on the unit to
patients. Males may need to collaborate with other staff if they are unable to do procedures
because the patient does not desire a man to complete it.
Improving the quality and safety of patients with male nurses incorporates Quality and
Safety Education for Nurses (QSEN) competencies into care. QSEN has six competencies to be
met, they are patient-centered care, teamwork and collaboration, evidence based practice, quality
improvement, safety, and informatics. Only evidence based practice, quality improvement and

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informatics have not been addressed thus far. Quality and safety can be improved with the
application of evidence based practice in intimate touch. Males understanding what is most
evidence based to prevent the patient from being uncomfortable will provide better quality care
to the patients. Developing quality improvements in organizations related to male nurses may be
difficult to come across. This may be gender discrimination. Males can improve the quality of
patients by being present with evidence based practice and utilizing the staff on the unit.
Applying informatics to the issue of males in nursing is challenging. This nursing issue does not
relate to technology and informatics.
Conclusion
Males entering nursing as a profession may face many of obstacles. Many question the
emotional intelligence, if they are capable of caring. A problem of providing patient dignity to
females and preventing the belief of intimate touch during procedures may arise. Males need to
intervene when these problems arise, use their knowledge and skills, along with collaborating
with staff to overcome them. Nursing is a career common for females and still has a stigma for
males. In order to overcome this stigma nursing needs to be seen as a career not for just females,
but males as well. This can be difficult for society to accept as it is something that we are grownup with, a schema that nursing is a job for women. Nursing is often perceived as a motherly
instinct, that men do not have the innate ability to do. This can develop a poor stereotype against
male nurses. Overcoming this stereotype may take time, but it should be addressed as males have
an increased interest in nursing. To promote a change in schema, nurses should be viewed as
heroes, and role models. The study by Rajacich, found many men suggested nursing promoted as
role models, If we get a show like Scrubs or something like that where theres an influential
man who is a nurse or to highlight historical figures who have been influential in nursing, can

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change the view of male nurses (2013, p.77). Rajacichs survey also found that if male nurses
were seen as firefighters, heroes, it may be more a accepted profession for men. Changing the
stigma and developing a schema that nursing is not just a profession for women will enhance the
care of patients and allow for men to be more accepted into nursing.

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