In an earlier life, I graduated from the Federal Bureau of Investigation?s Training Academy in Quantico, VA, and became a special agent of the FBI. I was never just a special agent, however. I was always a female agent. Back then, all of the women were called female agents. So I know, in a small way, what it?s like to be a male nurse.

Some nurses are still called male nurses instead of nurses. It?s a not-so-subtle way of setting someone apart from what we consider usual. In a recent episode of the NBC show, Scrubs, the hospital residents used the term ?murse? to describe a male nurse. In spite of those backward and unfortunate missteps, there are men in nursing who are welcomed, accepted, promoted, and who serve as role models for men and women alike. The good news is that just as women have persevered and proved themselves in previously male-dominated professions, men are making positive inroads and changing the face of nursing. Although only about 6% of the nation?s 2.7 million nurses are male, that number is double the percentage of 20 years ago. In 1980, there were only about 45,000 men in nursing; by the year 2000, the number increased to 147,000.¹

Ramon Garcia, RN, Critical Care, at Passaic Beth Israel, Passaic, NJ, has witnessed the changes. ?Nursing has changed dramatically since I started in 1987,? Garcia remarks. ?I was one of two men when I graduated, but I knew this was what I wanted to do. I always enjoyed taking care of people.?

We?re starting to appreciate that gender does not determine the qualities of caring and compasion in a person. Men like Ralph Ferrer, RN, nurse manager of ED and CCU at Passaic Beth Israel, Passaic, NJ, have known that all along.

Ralph Ferrer, RN, BSN, nurse manager of the ED and Critical Care at Passaic Beth Israel, agrees, adding, ?I?ve been in nursing for 26 years. Initially I was uncomfortable,? he admits. ?There are stereotypes about male nurses. You may have to work a little harder to prove yourself, but I have been accepted as an equal. The nursing profession has been very good to me.?

Should We Stay or Should We Go?

Nurse leaders know that men could go a long way in helping to solve the growing nursing shortage. Current figures predict a deficit of half a million nurses in the US by 2020. According to the National League for Nursing and the American Association of Colleges of Nursing, men today make up 10.2% of the students in four-year-college nursing programs and 16.1% in two-year associate-degree programs. Even with these increased numbers, men remain an untapped resource for the nursing profession. A national poll found that only one in 10 men would even consider nursing as a career choice.¹

More troubling are the statistics uncovered by a University of Pennsylvania researcher. Julie Sochalski, RN, PhD, studied data from the National Sample Survey of Registered Nurses collected by the Division of Nursing of the US Department of Health and Human Services (HHS) in 1992, 1996, and 2000. The study, which was published in the Health Affairs journal in 2002, found that 7.5% of new male nurses left the profession within four years of graduation from nursing school compared to 4.1% of female nurses who left within the same time period. Job satisfaction statistics also reflect gender differences. Seventy-five percent of new female nurses and 67% of new male nurses report that they were satisfied with their jobs, and among experienced nurses, gender differences still show up, with 69% of women and 60% of men reporting job satisfaction.

Image Isn?t Everything

Why the confusion about the Beretsky?s professional careers? Oleg is the nurse and his wife the computer programmer. Aren?t we a ?tad? too quick to jump to conclusions?

?You say nurse,? says Oleg Beretsky, RN, coordinator of care, Visiting Nurse Service (VNS) of NY, ?and people expect a female. My wife is a computer programmer, so when we introduce ourselves and our professions in social situations, we do get weird looks.? Even in the healthcare setting, Beretsky says old perceptions and stereotypes exist. ?When I call a physician?s office or a lab to get results,? he adds, ?the staff assumes that I?m a doctor.? Beretsky never let other people?s attitudes get in his way, however, and while working for seven years in high-risk antepartum and labor and delivery, served as a prototype for a nurse in an episode of the NBC show, Friends.

Gilbert Oakley, RN, Patient Services Manager (left) and Paul Schneider, RN, Grant Manager for VNS NY, talk about balancing the pressures and the rewards of nursing.

?It can be a conversation stopper,? Gilbert Oakley, RN, Patient Services manager for VNS of NY, agrees. ?I sometimes feel that people would be more interested if I did something else.? And Oakley admits that his two children were happy when he got his managerial position. ?That way,? he explains, ?they said they didn?t have to say that their dad is a nurse.? Paul Schneider, RN, MPH, grant manager for the LPN Transition to Home Care Program at VNS of NY, had some role models to follow when he decided to pursue nursing. ?I started nursing school when I was 32,? Schneider reports, ?and I knew three other men who had been nurses since the 1970s, including the captain of my high school football team.? In spite of his experience, Schneider realizes that there are still social taboos against men being seen as caring or compassionate. ?Some men still don?t feel that they can express that image,? he adds. ?They hide that side of themselves.?

Reality Is

There?s the image of nursing and then there?s the work. When we asked these men why they think men leave nursing, their answers had little to do with gender and a lot to do with the work of nursing. ?If a man is going into nursing for the money,? says Garcia, ?he has the wrong attitude. You can?t just go in with a degree and expect to succeed. Nursing is hands-on work, and you have to have that human component. It?s a hard job. I think that the men who don?t stay at the bedside find nursing frustrating, overwhelming, and unpredictable. It?s not what they expect.?

The men we talked with emphasized the importance of not taking patients?, family?s, or the public?s reaction too personally. ?When I get resistance, especially from a female patient,? says Schneider, ?I make it a point to never take it personally. I say I?m a professional nurse. I wish you?d give me a chance, and then if you?re uncomfortable, I?ll get a female nurse to do the procedure.? Schneider reports that he has rarely had to ask someone else to step in. ?Sometimes men can react better to a particular problem,? adds Ferrer. ?We can intervene in a different way, or maybe have a different sense of compassion. There?s room in the nursing profession for many different approaches to caring.?

Beretsky has found that the way to gain acceptance is with confidence and competence. ?Your success in nursing depends on you as a person,? he adds. ?You must demonstrate that you?re a caring and professional nurse. Other nurses may choose not to like me as a man on the unit, but they have to respect my skills.?

Oakley finds that working as a male in a predominantly female profession has rarely been a problem. ?I?ve always felt very welcome,? he says, ?and in some ways I think it?s easier to be a man; I?m not judged as harshly.? But that doesn?t mean nursing has been an easy career choice. ?My problems with the job have to do with the job,? Oakley says. ?Nursing is difficult to do well, and there are so many really good nurses out there. Maybe that?s why men leave, because they can?t be the best. If I had any fantasies about being King of the Hill, they?d have been dashed by now.?

Check It Out First

So what are the answers? How do we keep men in nursing? ?Check it out first,? suggests Schneider, who volunteered at a local hospital. ?I hung out with the nurses and asked myself ?Would I be comfortable here??? Schneider says men need to know what they?re getting themselves into. ?Do you have an understanding of the pressure and demands of the job, the shift work, the weekends, and the holidays?? he asks, ?and maybe most important: are you comfortable working with women?? Oakley and Garcia both worked as orderlies before they became nurses. ?Check it out first,? says Garcia. ?Take a job in the hospital and learn more about the job.?

And if one type of nursing doesn?t work out, there are many other options. Schneider left the hospital after one year. If one thing doesn?t work,? Schneider suggests, ?try something else. But don?t give up; there are so many other opportunities in nursing.?

Why do men leave nursing? Maybe it?s the work; maybe it?s the image; or maybe, as some nurse leaders have speculated, men are less willing to deal with the lack of respect that nurses receive from the public, physicians, and each other. ?As nurses,? Garcia remarks, ?we don?t always get the respect that we should and we?re not always helpful to each other. We need to be kinder to ourselves and kinder to each other. Dealing with human lives should command more respect.?

Carol Dunbar, APRN, BC, is a frequent contributing writer to Nursing Spectrum.

References

1. Silver S. Men who dare to care: Hospitals reach out to recruit men to the nursing profession. Available at: http://www.dailynewstranscript.com. Accessed August 9, 2003.