Men in Nursing
MEN IN NURSING
An inside look why they enter the profession and how they fit into a female-oriented culture
By Richard Krisher
With efforts ongoing within nursing to promote diversity, there's one minority group so under-represented when compared to the general population that it barely shows up on the radar screen. Their absence is often so overlooked that it's almost taken for granted.
So why aren't more men in nursing?
As gender barriers have tumbled in recent decades, women gained strong footholds in the medical, legal and business professions that formerly were nearly exclusive male domains. Although small gains were recorded in enrollment of men in baccalaureate and graduate nursing programs during the 1990s, there has been no similar rush of men into the traditionally female-dominated world of nursing. Men represented just 5 percent of the United States nursing population in 1996, up from 4 percent in 1992, according to the National Sample Survey of Nurses conducted by the U.S. Department of Health and Human Services.
FIRST STEP: MONEY
Men in nursing interviewed by ADVANCE said more money would be a good first step toward building interest among the male population.
"The profession would be better off if half of nurses were men," said Ed Halloran, PhD, RN, FAAN, associate professor of nursing at the University of North Carolina at Chapel Hill. "If the remuneration was competitive enough in society to be attractive to men, nursing would have a different status. We can't look past the economic issue." This investment should extend to nursing education as well, he added.
A visiting professor at Hong Kong Polytechnic Institute since January 1999, Dr. Halloran has noted a growing interest in nursing among men as the Asian economy has slumped. (He estimates that in Hong Kong about 10 percent of nurses are men.) That observation parallels 20th century trends he studied in the United States.
"As the economy went bad, the number of men in nursing increased," he explained. "This was true during the Depression, the '60s and the '80s. As the economy percolates, there is so much opportunity to make money elsewhere that men have less interest."
Van Davis, BSN, RN, a shock/trauma nurse at the Medical College of Georgia Hospital in Augusta, grew up in a rural town in south Georgia. He had graduated college with a biology degree in the late 1980s, but found limited job options. His sister was a nurse, and told him about the sign-on bonuses that were common at that time. Davis eventually decided to attend nursing school.
"When I told them I was going into nursing, some of my friends gave me a hard time," Davis related. "The friends who laughed at me, they're still living there. They don't all have bad jobs, but they don't have much chance for advancement. ... I'm making three or four times the money they are. It's a career move I'm glad I made."
But it's not always about money, said Greg Grevera, BSN, RN, CRNH, an HIV nurse educator at the Institute of Human Virology, which is affiliated with the University of Maryland, Baltimore. "Men who enter nursing, they have to love it," he said. "To take that step, it's not something you do on a whim. ... If you're in it for the money, that won't last."
"Money isn't always the answer," agreed Larry Fine, RN, C, who works in cardiac med/surg at Florida Hospital, Orlando. "Seeing more men in nurse recruiting would be a positive step. When I've gone to job fairs, it seems I've always seen female recruiters. Some guys might think that means they're not welcome."
PATHS TO NURSING
For men, deciding to pursue a nursing career can be a significant departure from societal norms. It often takes a personal experience to open their eyes to nursing's rewards.
Dr. Halloran entered nursing school straight out of high school in 1961. He had been hospitalized with a football injury and was cared for by student nurses from the hospital's nursing school. When he learned that the school was admitting its first male students that fall, he made up his mind to be one of them. He received his diploma from New Britain General Hospital School of Nursing in 1964, one of six men in his class.
"My family was very supportive," he recalled. "My mother even told my brother that he should be a nurse too. ... But as far as the unique nature of my situation, I suppose I was very young and oblivious."
Dr. Halloran worked for a few years in psychiatry and neurology, then entered the occupational nursing field when he got a job at Pratt & Whitney, a large manufacturing company with four plants in Connecticut at the time. The company operated a sophisticated hospital complex where one-third of the nurses were men.
From that point forward, the lack of male role models and mentors was never a problem, Dr. Halloran said. He earned his BSN in 1971 from Southern Connecticut State College, then while pursuing his MPH at Yale University studied under John Thompson, who was instrumental in getting him into the PhD program in nursing at the University of Illinois at Chicago. While in Chicago, Dr. Halloran first met Luther Christman, PhD, RN, FAAN, a legendary figure among men in nursing. The two still correspond today.
A 1990 auto accident led Florida Hospital's Fine into nursing. An especially compassionate nurse who took care of him inspired his interest in the profession. Later, while in college working toward a business degree, he struck up a friendship with a nurse in one of his classes. "She basically talked me into it," Fine said.
Fine graduated from St. Mary's School of Nursing in Huntington, WV, one of 12 men in a class of 60 graduates. "Of the men who started in the program, all of us graduated," he said.
IN THE CLASSROOM
Was the classroom atmosphere different for the men than the women?
"I wouldn't say the instructors babied the men or took care of us, but they did look out for the guys and paid attention to us," Fine recalled. "Maybe that was because the men tended to ask more questions of the instructors."
Grevera had always wanted to enter health care in some capacity. He studied in the emergency health services field, but decided he did not have the personality characteristics required for that arena. Nursing seemed a better fit, and he graduated with his BSN in 1988.
Although quizzed by his father why he did not want to be a doctor instead--a question most men in nursing have answered at least once--Grevera knows he made the correct decision.
"I like the hands-on care aspect of nursing," he said, "versus the disease management that many physicians deal with."
Grevera started his career in HIV nursing, then worked as a travel nurse and moved on to staff positions in intensive care and hospice nursing. He's been in his HIV education role for the past two years.
"That's one of the good things about nursing," Grevera said. "You can do a lot of different things and it doesn't look like job hopping."
Grevera was one of eight men who graduated in a class of 140 nurses. As one of so few men, it was hard to avoid standing out.
"That was a positive, because the professors knew who all the men were," he said. "That spotlight forced you to stay up on things."
A STRONG BACK
During his clinicals, he learned the lesson that most men in nursing discover early on.
"Whenever any of the students had to move somebody, they'd say, 'Go get Greg. He can do it himself'," Grevera said. "I didn't mind, but it made it hard to get my own work done." Finally, a professor forbade him from performing any duties related to his strength.
Being known for a strong back is "just part of the job--it comes with the territory," said Davis, the shock/trauma nurse from Augusta. "Whenever there's a patient to be moved from bed to chair, or there's a big fellow who needs help, I get the call.
"If gang members show up, it's 'Van, would you go out there and talk to them?' But that's no problem, there's a lot of teamwork up here. I volunteer for the heavy lifting."
In Davis' case, unique patient reactions to a man who happens to be a nurse usually are not an issue. "In most cases, they're up here because they've been in a severe accident or have a gunshot wound," he said. "They usually don't know who is providing the care."
Davis said that at his facility, female nurses catheterize female patients and male nurses catheterize male patients. Fine said that is the case at other hospitals in his area, but added that Florida Hospital had no such policy.
Some men in nursing have believed their gender stood in the way of their advancement, even filing grievances with the Equal Employment Opportunity Commission to win the right to practice in areas like labor and delivery. But Dr. Halloran thinks that, if anything, being a man mostly worked in his favor.
"During the early years of my career, I was given support and encouragement perhaps beyond what I had earned," Dr. Halloran explained. "I was made the nursing director of a small hospital in Connecticut. Come to find out, I was the fifth person in that position in five years. They had tried everything else besides someone in pants. But that move turned out very positive for the institution and very positive for me.
"I must say that later in my career, however, I believe I was not getting interviews because I was not a woman."
The relationship between doctors and nurses has always been a source of friction, with nurses occasionally absorbing the brunt of a physician's tirade. Are men in nursing treated any differently?
"If male and female nurses are standing side by side and the doctor asks a question, he always looks at the man to answer," Fine observed. "It's not fair, but that's the way it is."
"I've seen doctors be very condescending," Davis said. "But I won't let one of them get in my face. I cut it off before it happens."
"My first job out of school, doing HIV patient care at Johns Hopkins, I worked a 12-hour shift, and all the nurses were men," Grevera said. "That was one of the best days I've ever experienced in a hospital. No doctors gave anyone any lip."
Dr. Halloran noted that in all of nursing, there are only two groups with a critical mass of men: nurse anesthetists and members of the Army Nurse Corps. About half of nurse anesthetists are men, which he asserts is due to the opportunity for financial reward. Men comprise more than one-third of the Army Nurse Corps, he said.
"That's the only place where a nurse can stand in the OR and outrank the surgeon," Dr. Halloran said. "The nurse can be paid more and have a higher status. ... In that setting, the status of nurses is established independently of gender and the other garbage that society tends to deal with."
Grevera agreed with Dr. Halloran's assertion that nurses would likely enjoy greater societal status and monetary rewards if more men joined the profession.
"It stinks that RNs with 10 years of experience and all of their skills make only $30,000 a year," Grevera said. "The unfortunate reality is that men are going to be listened to more than women. In many ways it's still a man's world." *
Richard Krisher is an editor at ADVANCE.
AMERICAN ASSEMBLY OF MEN IN NURSING
The purpose of the American Assembly of Men in Nursing is to provide a framework for nurses to meet, discuss and influence factors that affect men as nurses.
Its objectives include:
* Encouraging men of all ages to become nurses and join together with all nurses to strengthen and humanize health care.
* Supporting men who are nurses to grow professionally and demonstrate to each other and to society the increasing contributions being made by men within the nursing profession.
* Advocating for continued research, education and dissemination of information about men's health issues, men in nursing and nursing knowledge at the local and national levels.
* Supporting members' full participation in the nursing profession and its organizations.
The assembly's 2000 convention, themed "Diverse Nurses for a Diverse World," is scheduled for Nov. 30-Dec. 2 in Seattle.
For more information, contact AAMN, NYSNA, 11 Cornell Rd., Latham, NY 12110-1499; (518) 782-9400 ext. 346; firstname.lastname@example.org (e-mail); www.aamn.org (Web site).