How Does Gender Bias Negatively Impact the Role of Men in Nursing - Essay Example

How Does Gender Bias Negatively Impact the Role of Men in Nursing As d by Trossman (2003), the word "nurse" often conjures the image of a female,wearing a white cap, following a male doctor's orders. With this image, now a stereotype, it is not surprising that few men consider becoming nurses. Most men do not want to enter a profession considered "female" where they are "subservient" to physicians, generally men. This gender bias, that nursing is for women and that men should be in positions of more power, is a significant detriment to men in nursing. Not just male nurses in practice, but those in often-biased nursing education programs, likely inhibiting young men and adult men from considering entering the nursing field. Gender bias negatively impacts the role of men in nursing by: Violating basic rights (ethical principles) to which men are entitled, as human beings and afforded to members of the nursing community Discouraging them from entering the nursing field at all Making it more difficult for men to complete educational programs because of biased literature and classroom structures Making it more difficult to advance, with fewer mentors and peer supports to provide necessary guidance Not all male nurses believe gender bias has had a negative impact on their career. But, fewer than 6% of the Registered Nurses in the United States today are men (U.S. Department of Health and Human Services). Considering approximately 49% of the population is male, the 6% figure indicates that bias may be impacting the entry and retention of men in the nursing field. Furthermore, Wilson (2005) in a study of Australian nursing students, found that in a three-year period, the average attrition rate for males in a university-based nursing program was 55.5% but only 45% for females. This, too, raises concerns about what is keeping men from entering or staying in the nursing field. One answer is gender bias. What is Gender Bias Gender bias, most succinctly defined by the higher education company McGraw-Hill, is "Behavior that results from the underlying belief in sex role stereotypes." (McGraw-Hill Education Company). Entire dissertations have been written defining sex role stereotypes. Sex role stereotypes, in the most basic terms, are stereotypes ("conventional, formulaic, and oversimplified conceptions, opinions, or images") ("Stereotypes") based on the roles ("characteristic and expected social behaviors of an individual") ("Roles") based on sex/gender, traditionally male or female. Vogel, Wester, Heesacker, & Madon's (2003) finding that women and men act in accordance with social roles which are often segregated along gender lines helps summarize how sex role stereotypes are perpetuated. They continue, "Popular culture has embraced the idea that women and men are different. Self-help books, talk shows, and magazine articles routinely acknowledge large gender differences" With popular culture stressing distinct differences and roles for men and women, it is understandable that a career traditionally considered female would not be considered attractive to some men. To assess biases and the status of Men in Nursing in 2005, the research firm of Bernard Hodes Group performed an on-line survey, open to male nurses and nursing students, from October until December 2004 and received almost 500 responses (N=498) (Bernard Hodes Group, 2005). Of note were the men's responses to the question regarding their perceptions about nursing before entering the field. The top four responses, with percentages responding, to what they had as perceptions of men and nursing: Traditionally female dominated field (85%) Other professions perceived "more appropriate" (62%) Nursing salaries are not competitive with other careers (33%) Nursing is not an autonomous, decision-making profession (27%) The next most popular response, "Nursing doesn't provide much upward mobility" garnered only 16% of responses. It is evident that the perception - or stereotype - of a subservient female is still in place. The media does not aid efforts to get men in nursing, presenting highly stereotyped images of men who enter nursing. Doucette (2006) noted that "Movie characters such as Gaylord Focker in Meet the Parents and Jack McFarland in Will and Grace aren't exactly role models that help encourage more men to enter the nursing field." Nursing2005 in the article "Why so few male RNs" published the following findings from male nurses on the topic of difficulties in the workplace: Male nurses are seen by female nurses as muscle (71%) Difficulty in being a minority in terms of gender (49%) Communication issues with female counterparts (48%) Men are perceived as "not caring" (34%) The next response, difficulty with physician relationships, garnered 11% of responses. Indeed, Kepshire (2006) commented, "Though I've had major rewards, I've also experienced some negative attitudes toward men in nursing, from the bias against assigning a female patient to a male nurse student, to the assumption that I was only a nurse because I couldn't get into medical school (though, I never had a desire to be a physician!)." The survey results and the input from other nurses reflect biases the men encounter as a function of their gender (e.g., male nurses are seen by female nurses as muscle, male nurses are men who couldn't 'make it' to be a physician) that hurts the entry and retention of men in the nursing field. It should be noted that James Derham, the black slave who is fabled to have worked as a nurse in 1783 in New Orleans to save the money for his freedom, later studying medicine and becoming the first African American physician, did not remain a nurse. Was this is an early precedent that nursing was not "good enough" for men and they "should" be doctors Gender bias also appears to inhibit the growth rate for male nurses in the United States. The U.S. Department of Health and Human Services' 2004 National Sample Survey of Registered Nurses provides the source for the commonly cited 6% figure for the percentage of Registered Nurses in the United States who are male. However, that figure is rounded, the actual figure is 5.7% for 2004, but notably, it has only grown .3% from 2000, when the figure stood at 5.4%. (United States Department of Health and Human Services). Sherrod (2006), writing on the need to increase diversity in nursing, noted, "we should produce a registered nurse workforce that reflects the diversity of the population we serve. With that goal in mind, we'd need to increase the proportion of med in nursing by more than nine times from the current 5.7% to 49%" matching the United States population." He continues, "An increase of 900% may seem unobtainable, but we're actually making some progress, albeit slowly, since 1980, when men made up only 2.7% of the workforce." However, if the current growth rate of .3% every four years (2000-2004) were to hold, the next 24 years (2004-2028) will see only 1.8% growth, compared to the 3.0% growth between 1980-2004. Growth is critical, yet in the Bernard Hodes Group survey, 73% of current male nurses indicated that they felt stereotypes were a special challenge as were other gender-based concerns. The stereotypes may be keeping men out of nursing, and inhibiting nursing's diversity to better represent the population served. Gender Bias and Ethical Considerations Nurses must operate within an ethical framework to guide them in making clinical, administrative, and personal decisions. Few persons question the importance in nursing care of the six major ethical principles: autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity. Yet the principles are often not considered in matters relating to the nurse per se, not specifically the care the nurse gives. For example, consider the ethical principle of autonomy. Johnstone (1999), in Bioethics: A Nursing Perspective writes, "When the concept of autonomy is used in moral discourse, what is commonly being referred to is a person's ability to make or exercise self-determining choice - literally, 'self-governing'." When a male nursing student has no male mentors or preceptors to which to turn, if he is not afforded the same opportunities as a female, or sees no male role models in the literature and history of his profession, he still may have his autonomy and right to choose, but the environment is such that his choices may be reduced before he graduates. His autonomy is constrained, though not completely stripped, by gender bias when conceptions or decisions are made, such as that men have not contributed to nursing, based solely on gender. The question arises, would a female nursing student have the same experience If not, then one must consider if gender biases are in force. Ethical issues arise when considering the rights of a nurse, a male nurse, and matters that may constrain him. Nonmaleficence, doing no harm, is a basic tenet of nursing, yet gender bias some shown by some female and/or male nurses subtly or overtly does harm. Another closely related principle, beneficence, is not upheld when a nursing school structures its program with literature and studies that are not inclusive to men, in some instances doing them harm by discouraging them from staying in the nursing program. Justice, seeking fairness or treating equals as equals, is also jeopardized with gender bias in the nursing field. Certainly men and women are not equal per se, but Brown vs. Board of Education of Topeka (1954) overturned the doctrine upheld in Missouri's Plessy vs. Ferguson (1896) of "separate but equal." It was agreed that segregation - at least on race - was inherently unequal. This issue became pertinent to male nurses in Mississippi University for Women v. Hogan (1982), which overturned the school's previously all-female admission policy. Treating male nurses justly has been recognized as important by the Supreme Court, and is a fundamental right of any nurse, male or female. Veracity, telling the truth, is a complex principle when a nurse is concerned for a patient's emotional well being if a delicate question were asked, but an imperative for interacting with peers and supervisors. A male nurse should expect his peers and supervisors to relate to him openly and honestly, yet stereotypes and biases often are in play without ever being mentioned. Male nurses should be able to expect truthfulness, and to be truthful, with any patient, staff, peer, or faculty they encounter without wondering if the other person has hidden biases that may taint the interactions. Fidelity, keeping promises, is fundamental to trust, which is necessary in any job or school setting. The International Council of Nurses' Code of Ethics expects, "that inherent in nursing is respect for human rights, including the right to life, to dignity and to be treated with respect." (International Council of Nurses, 2006). The American Nurses Association Code of Ethics uses similar language, "The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems." (American Nurses Association, 2001) For one nurse to treat a male nurse differently, or act according to stereotyped expectations, would clearly violate the message of the codes, and violate the principle of fidelity to oneself and one's profession. Above all, when gender bias is evident in the education or medical setting in which a man operates, as a student, hands-on practitioner, or administrator, the ethical principles are, on the whole, violated. These principles, according to the rights-based, deontological theorists, are rights of every man and woman, and bias interferes with the man's ability to exercise the rights he is due. As Johnstone (1999) summarized when discussing the principle of autonomy, probably the most basic right, "What this basically means is that people should be free to choose and entitled to act on their preferences provided their decisions and actions do not stand to violate, or impinge on, the significant moral interest of others." Gender bias precludes this and has a negative impact on men in nursing on a practical basis and a theoretical basis. Barriers to Men in Nursing Sherrod (2006), summarizes several major barriers to increasing the numbers of men in the nursing field, most related directly or indirectly to gender bias. These include: Social isolation - There are few male nursing faculty members, or even other male students for male nursing students to turn to for direction or assistance. Male nursing students rarely receive mentorship or guidance as they progress through their programs. Little recognition of men's role in nursing history. While Florence Nightengale's Nightengale Training School for Nursing which opened in 1860 was the benchmark for nursing education both in the United States and the United Kingdom, some believe (Sherrod 2006) it reinforced the view that nursing was women's work and set a precedent that may still be in place. Health care-givers have been both female and male since antiquity, whether doctors, nurses, deacons/deaconess, priests, shamans, midwives, faith healers, or in the role as the head of the family and caretaker. A complete history of the historical contribution of men in nursing is beyond the scope of this paper; Male Nurse Magazine published a concise and informative summary on this topic by Lucas (2003). It should be noted, though, that the contributions of men are often identified as "contributions by male nurses," highlighting the differences in gender, rather than accepting the contribution of men as the norm. Anthony (2004) summarizes the representation of males in nursing literature, writing, "Contemporary nursing literature, both research-based and popular press, is replete with examples of gender bias and its impact on males seeking to pursue a nursing career." Subtle forms of bias, such as literature bias, can be as detrimental to the movement to increase the number of males in nursing as outright discrimination. Sherrod (2006) also mentions "Refusal to address individual learning needs" as a barrier to men in nursing school, stating, "Professors use a lecture format exclusively in class, and the program doesn't prepare male students for work primarily with women." Sherrod's concerns have merit, but learning needs are not necessarily gender-based. Nor do men need to be "prepared to work primarily with women," a statement that may represent bias in and of itself. Not All is Negative Not all nurses, male and female, agree that gender differences are problematic. It would be difficult for a woman to write an article discussing whether gender differences and stereotyping in nursing do or do not have a negative result for male nurses. However, Doolan (2006) a male nurse, wrote an uplifting and encouraging article for Men in Nursing discussing how gender differences have worked for him, not against him. He commented "Being one of relatively few men in nursing creates opportunities." He noted certain factors that were vital including: The nurses own view of themselves and their importance. He wrote, "our perceptions about being a man in a predominantly female profession will greatly affect our experiencewith a chip on [your] shoulder, [you] always read into interactions with the expectation that [you] are unwelcome." Remembering that he [Doolan] may make more of an impression on a patient, in a positive way, than a female nurse, "People don't see as many men in nursing, so when they interact with a male, this experience may stand out to themthe advantages of this increased scrutiny will always far outweigh the disadvantages." Appreciating the differences between men and women, "Female colleagues have told me that they appreciate having a male perspective on various scenarios or dilemmas." The advantage of his size, "if a patient is having a really bad dayHe or she tends to be less likely to snap at me than to snap at others, which mighthave something to do with my being 6'4" and weighing over 200 pounds." One of the few to publicly celebrate his gender differences, Doolan closed that he had overwhelmingly found being a man in nursing to be a positive experience - consistent with results of the Bernard Hodes Group survey where 83% of respondents said they would encourage their male friends to become nurses. Furthermore, 57% of respondents indicated they had been successful in recruiting male friends into nursing. (Bernard Hodes Group, 2005). Looking to the Future Respect for human rights are the foundation of a society. If the rights of men wanting to enter nursing are overtly or covertly violated by gender biases and stereotyping, then society must revisit priorities and actions. Beginning before the 20th century, the woman's rights movement began elevating the negative impact of biases and stereotyping of women to a national level. With attention and hard work, gender bias against women was de-institutionalized and women gained more rights. Though not on the same scale as the women's rights movement, the movement for men to be accepted in "traditionally female jobs" such as nursing needs to take hold. The absence of men in nursing furthers stereotypes and biases that may keep highly motivated, qualified men from pursuing nursing. This is detrimental not only of the potential nurse, but his patients and others he might influence. Several articles discuss ideas and exciting ways the nursing community is reaching out to men, including Trossman (2005), Doolan (2006), and Anthony (2004). In addition, first person accounts of positive nursing experiences continue to be beneficial in letting other males know the diversity and the many positive experiences of being a male nurse (see Murphy, 2006 and Hilton, 2001). Efforts to depict male nurses as diverse, "masculine," competent, as well as caring may go a long way toward Sherrod's (2006) goal of a 900% growth rate for men in nursing in the next several decades. References Peer-reviewed Nursing Journals Anthony, A.S. (2004). Gender bias and discrimination in nursing education: Can we change it Nurse Educator, 29, 121-125. Doolan, D. (2006). Answering the clarion call for nurse educators. Men in Nursing, 1, 9-10. Doucette, J. (2006). A man's world: Nursing is a genderless word. Men in Nursing, 1, 56. Kepshire, B. (2006). Editorial: Men in nursing: An untapped resource. Men in Nursing, 1, 4. Murphy, P. (2006). From paramedics to process improvement: Consider allied health. Men in Nursing, 1, 52-55. Nursing2005 (2005). Clinical rounds: Why so few male RNs Nursing2005, 35, 35. Sherrod, B. (2006). Wanted: More men in nursing. Men in Nursing, 1, 34-49. Trossman, S. (2003). Caring knows no gender. American Journal of Nursing, 103, 65-68. Wilson, G. (2005). The experience of males entering nursing: A phenomenological analysis of professionally enhancing factors and barriers. Contemporary Nurse, 20, 221-233. Other Nursing References and Supporting Sources American Nurses Association (2001). ANA Code of Ethics With Interpretive Statements, Washington, DC: American Nurses Publishing. Bernard Hodes Group (2005). Men in Nursing Study. Retrieved April 3, 2006, from: http://www.hodes.com/industries/healthcare/pdfs/MenInNursing2005.pdf Hilton, L. (2001). A few good men: Male nurses defy stereotypes and discrimination to find satisfaction in a female-dominated profession. NurseWeek, May 14, 2001. Retrieved April 3, 2006, from http://www.nurseweek.com/news/features/01.05.men.html International Council of Nurses (2006). ICN Code of Ethics. Retrieved April 4, 2006 from http://www.icn.ch/ethics.htm. Johnstone, M-J., ed. (1999). Bioethics: A Nursing Perspective. Sydney, New South Wales: Harcourt Saunders. Lucas, J.R. (2003). Letter to the press. Date: October 2003. Male Nurse Magazine, October 2003. Retrieved April 6, 2006, from: http://www.malenursemagazine.com/dear_editor_1003.htm McGraw-Hill Higher Education. "Gender bias." McGraw-Hill Online Learning Center. Retrieved April 3, 2006, from: http://www.highered.mcgraw-hill.com/sites/0072486694/student_view0/glossary.html "Roles" (1992). In The American Heritage Dictionary of the English Language, Third Edition. Boston: Houghton Mifflin. "Stereotypes" (1992). In The American Heritage Dictionary of the English Language, Third Edition. Boston: Houghton Mifflin. U.S. Department of Health and Human Services. Preliminary Findings: 2004 National Sample Survey of Registered Nurses. Retrieved April 5, 2006, from: http://bhpr.hrsa.gov/healthworkforce/reports/rnpopulation/preliminaryfindings.htm University of Missouri Kansas City (no date). Exploring Constitutional Conflicts. Retrieved April 6, 2006, from http://www.law.umkc.edu/faculty/projects/FTrials/conlaw/sepbutequal.htm Vogel, D.L., Wester, S.R., Heesacker, M., & Madon, S. (2003). Confirming gender stereotypes: A social role perspective. Sex Roles: A Journal of Research, 48, 519-528. Read More