Male Nurses Confronting Stereotypes and Discrimination: Part 1, The Issues

Male Nurses Confronting Stereotypes and Discrimination: Part 1, The Issues

Many people experience some kind of discrimination, stereotyping, or even prejudice against them at some point in their lives because of their race, sex, sexual orientation—and even sometimes because of their jobs.

While more and more men are entering the nursing field, it’s still a profession that is primarily comprised of women. So we asked a number of male nurses what they’ve experienced, how they’ve dealt with it, and their advice for other nurses who may experience something similar.

In this article, we begin with what kinds of stereotypes they’ve experienced.

Are You the Doctor?

Nearly every male nurse we interviewed said that he had, at least at one time, been mistaken for a doctor. They all, though, handle it in their own ways.

“I have walked into an exam room where a patient is waiting, and before I had a chance to introduce myself, they said, ‘I thought I was seeing Dr. Weber.’ I just smile and say, ‘You are seeing Dr. Weber. You just get to see me first. I’m Jonathan. I’m a nurse, and I’m going to check your INR before he comes in,’” explains Jonathan S. Basler, RN, a clinical nurse at West Front Primary Care in Traverse City, Michigan. “Then they usually say, ‘You’re not as pretty as his old nurse.’ When I worked in nursing homes, it was common for me to hear, ‘Thanks, Doc!’ as I was leaving a room—and it didn’t matter how many times I introduced myself as their nurse.”

Keynan Hobbs, MSN, RN, PMHCNS-BC, a clinical nurse on the PTSD Clinical Team at VA San Diego Healthcare in California, says that he is mistaken for a doctor all the time and was even back in nursing school. “It happened even more when I moved into an advanced-practice nursing role and wore a white lab coat every day,” he says. Because he works in psychotherapy now, he is often called “doctor.” His response is, “I’m not a doctor; I’m an advanced-practice nurse, and you can call me Keynan or Mr. Hobbs.” Although he doesn’t find this now in psychotherapy, he says that when working in a hospital, “People would look right past me when I told them I was a nurse because some see nurses as less powerful in that setting.”

Sometimes, nurses use humor. Jeremy Scott, MSN, RN, CCRN, a resource pool nurse at Penn Presbyterian Medical Center in Philadelphia, Pennsylvania, says that patients will sometimes be on the phone, and when he walks into a room they say to the person they’re talking to, “My doctor is here. I have to go.” He then tells them that he is their nurse. “People have asked, ‘When will you go back to become a doctor?’ and I jokingly tell them, ‘I’m not interested in all those loans. I enjoy being a nurse.’”

It’s Not You, It’s Me

Sometimes, patients or their family members don’t want a male nurse—simply because he’s a guy.

“I’ve experienced stereotyping as a male nurse. I’ve had patients tell me they don’t want me to be their nurse. I’ve been called gay. I’ve been told by family members that they don’t want me to care for their loved one,” says Carl A. Brown, RN, BSN, director of patient care services for BrightStar Care of Western Riverside County in Sun City, California. “As a nurse—but especially as a male nurse—you need to have a strong outside to let those comments bounce off. But you also need to have a warm heart for those who hold the prejudices. I think it is important for people to know that my gender does not prevent me from providing quality care to each of my clients.”

There are instances in which patients will request a female nurse because of religious reasons. “I respect patients’ wishes because they are in control of the management of their health, so I simply switch assignments. I’m never offended by this,” says Donnell Carter, MBA, MS, CRNA, a clinical staff nurse anesthetist for Northstar Anesthesia at Saint Vincent’s Hospital in Worcester, Massachusetts.

Robert Whigham, RN, a staff nurse at Doctors Hospital in Augusta, Georgia says that it’s common for patients to have preconceived notions about his level of compassion because he is a guy. He’s found that patients in maternity wards and pediatrics may ask for someone else. “They are sometimes uncomfortable with a male nurse helping them,” he says.

In the psychological setting, Hobbs says that “someone who has experienced sexual trauma and doesn’t feel comfortable talking to a man about it” may ask for a female therapist. If they later want to talk with a male, he says that he will be available for them.

Specific Stereotypes for Male Nurses

Les Rodriguez, MSN, MPH, RN, ACNS-BC, APRN, clinical nurse specialist/clinical education specialist pain management at Methodist Richardson Medical Center in Richardson, Texas, says that while in his more than 30-year career as a nurse he hasn’t experienced discrimination, he has come across stereotypes that people think regarding male nurses. They are: all male nurses are gay, men only get into nursing so they can see women naked, men who become nurses are failed doctors, and men go into nursing because it’s easy.

Rodriguez disputes all of them: “In my experience, the number of male nurses who identify as gay is not greater than that reported in the general population. [Re: Seeing women naked] That is an expensive and long, drawn out way just to see what you could see in magazines or strip bars. [Re: Failed doctors] This has to do with relegating the physician to a higher order of professional…Yes, there are some individuals who were in medical school and didn’t survive the program for various reasons, and so they took their academic credits and directed them towards nursing. That does not make them ‘failed doctors.’ It makes them very knowledgeable nurses. [Re: It’s easy] That nursing is easy is a major myth. You are required to learn a lot of detailed information in a very short time…Nursing is not an easy profession, and many males that I have encountered go into nursing because they have a caring disposition.”

Now that we’ve outlined what some of the prejudices and/or stereotypes are regarding male nurses, the next step is to educate them on what they can do. Stay tuned for part two of our series next week where we’ll explore the actions that male nurses can take.

Am I The Picture of Health? Confessions of A Stressed Out Nurse

Am I The Picture of Health? Confessions of A Stressed Out Nurse

I had never received the backhanded compliment of “oh, she has such a pretty face” until recently. That was a compliment reserved for fat women. I did not consider myself fat at all. I would describe myself as overweight, but never fat. If I could still purchase clothing out of regular department stores, I did not believe myself to be obese. Even when I was hospitalized last year and the doctor’s notes said “…obese, 47yrs old female,” it did not truly register. However, once my vanity was attacked it hit home.

Sometimes, I see myself in the mirror and wonder how did it get to be this way. I am 5’4″. I weigh 210 lbs and am a Registered Nurse! Euphemisms like “thick,”” full-figured,” and ” healthy” only mask what I know to be the truth. This body that I live in is well on its way to diabetes and hypertension. Thankfully, in this moment I do not have any of those diseases, but it is just a matter of when, not if.

Being overweight has affected my self-esteem, my sense of self-worth, my self-love. It feels like a self-inflicted punishment. When I think back to when I was slim and feeling good, it almost brings me to tears. I start asking myself how did I let it get this out of hand? Why didn’t I just get up from the table? Stop eating at fast food restaurants? Continue to exercise? I am not a fat person who does not know how I got fat. I know exactly what I did, which I think makes it all the worse.

There are times I find it difficult to teach my patients about health and wellness. I wonder if they are looking at me and finding me a hypocrite. Or are they realizing that I, too, understand how hard it is to walk that path.

The heavier I became, the more crap I accepted from the men I dated. I no longer felt I that should be respected or loved entirely. Glad that they were in my life was enough. Trust me, when you do not love you, no one else does either. I stayed with a man who told me that he did not usually date “big girls.”  So, I sat wondering, should I feel special that you chose me? I found myself always trying to overcompensate for not being thin, for not being his ideal of beauty. I was showing him that my love was not worth it because it did not come in a perfect size 4, 6, or 8. I was depleted walking out of that one.

So now at this juncture, I am ready to lose the weight. I mean do what is necessary to get to where I feel comfortable in my skin. This is not simply about my vanity, but about my life, my health, and self-love. So, I am inviting you on this journey with me. Come along.

Hi, I’m Erika.

Ciao Bella!

The Presidential Election: How to Be Less Stressed

The Presidential Election: How to Be Less Stressed

This year’s presidential election is affecting just about everyone. It’s causing so much stress, arguments, and overall negativity, that we couldn’t even get any nurses to go on record with tips on how they remain less stressed in this crazed political time and help their patients remain so as well. Many were concerned that if they gave their opinions—even about how to help others—that because it had to do with politics, they may be reprimanded or even possibly lose their jobs.

That says a lot. Most nurses love to help other nurses. But in this case, the fear was tangible.

Instead, we contacted professionals in the mental health field to get their advice on what you can do to reduce your stress in this final week before the presidential election and how to keep it reduced after it’s over.

Use the Oxygen Mask First

If you’ve ever flown on an airplane, you know that the flight attendant always instructs people that in case of an emergency, to put your own oxygen mask on first. You won’t be any good to others, if you can’t breathe yourself.

The same case applies with lowering your stress. “In ‘helping’ professions, it is common for providers to ignore their own needs. Focusing on self-care, though, is critical during high-stress times like election season,” says Lisa Long, PsyD, a licensed psychologist, executive coach, and interventionist as well as owner of a private practice in Charlotte, North Carolina. “Taking a personal inventory of one’s stress level and well-being is a good start. Paying attention to yourself is a major aspect of doing and feeling your best. If you notice changes in yourself and how you are feeling, make the time to get connected with people you can talk to. Keep a list of things that make you feel relaxed, and make time to do at least one—even when you feel you have the least amount of time for it. Listen to your own body and needs—just like you do with your patients.”

Laura Dzurec, PhD, PHMCNS-BC, ANEF, FAAN, a dean and professor of the Widener University School of Nursing in Chester, Pennsylvania, says that recognizing that an individual, emotional response is not going to change the election is an important first step in lowering your stress. “The stresses accompanying the debates, deliberations, discussions, and arguments surrounding the presidential election have encouraged emotional responses,” she explains. “One important tip to use in lowering stress is to pay attention to personal responses. Are they defensive? Angry? Anxious? By backing away from pointless debates and thinking through responses that are immediate, nurses can lower their own stresses regarding what’s happening with the election.”

Tips To Help You Reduce Your Stress

Let’s face it—although we’ll get some relief after Election Day, there will still be fallout for some time no matter which candidate wins. Now that you have been reminded to take care of yourself first, what can you do?

“Humor is a fantastic coping strategy when it comes to situations that seem out of our control. Think of all the political parodies at the current time. Turning to humor helps reduce the experience of stress,” says Marni Amsellem, PhD, a licensed psychologist with a private practice specializing in health psychology. “Another great strategy—regardless of the stressor—is trying to tune out or take some time away from the stressor. For example, if the negativity of the conversation happening around you is becoming overwhelming, temporarily remove yourself from the situation, turn off the TV, take a social media holiday, and the like.”

One of the easiest things you can do is just breathe. “My tip for all nurses is to set the alarms on their watches or cell phones to remind themselves several times per day to perform two activities—breathe and practice mindfulness. Three nice deep breaths several times a day can do a world of good to clear the mind and refresh the body. As for mindfulness, take a few seconds, clearing the mind of all thoughts except for noticing the temperature in the room and being mindful of all safely and calmness,” recommends Mary Berst, PhD, the associate program director of Sovereign Health Group in Palm Desert, California.

Amy Oestreicher, a PTSD peer-to-peer specialist, health advocate, and speaker for TEDx and RAINN, suggests deep breathing as well and agrees that humor works. “Humor creates a common language the breaks barriers,” she explains.

Oestreicher also suggests that nurses try a couple styles of management with themselves, two of which are Active Management and Calming Management. With Active Management, she says, you take all of the energy that’s fueling that stress and use it—exercise, run, shout, or scream. Do whatever makes you feel better.

With Calming Management, you do just that—take actions that will work to keep you calm. That might be breathing deeply, meditating, getting a massage, or even taking a warm bath.

Finally, A.J. Marsden, PhD, a former Army surgical nurse and current assistant professor of psychology and human services at Beacon College in Leesburg, Florida, suggests that nurses encourage optimism and refute negative thoughts. “Smile! Research shows that people who smile really will feel better,” says Marsden. “Focus on all of the good work you’re doing. When we feel that our work is making a positive difference and an impact on the world, we feel more positive and happier.”

Nurses Battle to Fight Opioid Addiction

Nurses Battle to Fight Opioid Addiction

It seems like we see articles and hear news reports about opioid addiction on a daily basis. Unfortunately, many of these stories are no exaggerations.

According to the United Nations Office on Drugs and Crime’s 2015 World Drug Report, it is estimated that 32.4 million people around the world struggle with opioid abuse. Additionally, results from the Substance Abuse and Mental Health Services Administration’s 2014 National Survey on Drug Use and Health estimate that 1.9 million Americans struggle with addictions to prescription opioids and 435,000 more have addictions to heroin, an illegal opioid.

Opioid abuse is clearly a problem in the United States and abroad. Different organizations, institutions, and agencies have taken different approaches to combat this problem, as have individual rehab centers across the country. Several of these approaches involve nurses.

Treating Addictions

If the opioid epidemic is a war, nurses are serving on the front lines. Emergency room nurses often treat people who have overdosed or are suffering from the ill effects of opioids, other drugs, and alcohol.

Nurses work at rehab centers to treat opioid abuse and other forms of abuse. They work at clinics and hospitals that provide medication-assisted treatment (MAT). They work in a wide variety of health care settings to help people recognize and treat their addictions. They also work to educate others about substance abuse and hope that such preventative measures can help people avoid addiction in the first place.

State Efforts

At Boston Medical Center, doctors do not administer programs that treat opioid abuse. Instead, nurses administer such programs. This tactic allows the clinic to see more patients (and ultimately treat more patients). Other health centers in Massachusetts and across the United States are utilizing nurses to administer such programs.

Other programs might provide specific training that relates to addiction. In 2016, the U.S. federal government awarded a grant to train student nurses at the College of Nursing at the University of Massachusetts in Amherst, Massachusetts. This program trains nurses in SBIRT, which stands for screening, brief intervention, and referral to treatment. The program aims to diagnose addictions early and help people find treatment for them.

National Efforts

National organizations are also tackling addiction. The American Nurses Association (ANA), the American Association of Colleges of Nursing, and others have pledged to provide more training for people who prescribe opioids. The ANA has also pledged to encourage more health care providers to register with their states’ drug monitoring programs.

The ANA has also pledged to launch a campaign to raise awareness of opioid addiction. It has already established resources about opioid addiction and other forms of substance abuse. Additionally, ANA provides resources that can help nurses with their substance abuse problems if they are addicted themselves.

Government Efforts

The government has also joined nurses in the fight against opioid abuse. The U.S. Centers for Disease Control and Prevention (CDC) created and published guidelines regarding the prescription of opioids. Several nursing schools across the United States have pledged to teach these CDC guidelines, many of which address the use of opioids for long periods of time.

State boards of nursing have also created similar recommendations. The Michigan Board of Nursing, for example, has issued guidelines for nurses in regards to using controlled substances to treat pain. These guidelines recognize that nurses need to effectively treat pain. They also recognize the potential danger of certain medications.

There are also other government efforts relating to opioid abuse and nurses. The Comprehensive Addiction and Recovery Act of 2016 is a federal law that permits nurse practitioners and physician assistants to prescribe buprenorphine to patients who are addicted to opioids. It also allows doctors to see higher numbers of patients who need such drugs.

Speaking of government action, the U.S. Drug Enforcement Administration (DEA) sponsors National Prescription Drug Take-Back Day. During this event, people bring unneeded prescription drugs to designated areas. DEA agents and other law enforcement agents take these drugs and educate the public about drug abuse. During one such day in April 2016, authorities took back almost 447 tons of prescription drugs.

Nursing Efforts

Nurses educate the public about Prescription Drug Take-Back Day. They also play a vital role in other government efforts to end addiction by participating in community-based opioid overdose prevention programs (OOPPs). As their name indicates, OOPPs work to prevent substance abuse problems from ever occurring. Other nurses and nursing organizations are interested in government matters as advocates. They encourage other nurses to take political action or support candidates who take particular views on health care matters.

These efforts demonstrate that while the opioid epidemic is huge, different organizations, institutions, government bodies, rehab centers, and people are committed to helping fight it. Nurses have played—and will continue to play—a vital role in this battle.

Why Women in Healthcare Are An Endangered Species

Why Women in Healthcare Are An Endangered Species

Women represent nearly 80% of the healthcare workforce, and they represent 77% of hospital employees. Also, 26% of hospital and health system CEOs were women in 2014. Statistics show the number of women in healthcare is rising, but there are still challenges. One of the most widely talked about challenge is gender inequality, including the lack of women in leadership positions. While gender inequality is important, this issue is not why women in healthcare are an endangered species.

Women in the healthcare industry are just as likely (if not more) to suffer from anxiety, stress, depression and other mental and emotional issues. Like most healthcare workers, women who are physicians, registered nurses, home health aides and more enter the field with a passion to help others. But if you fall into these categories, how many times have you neglected your own needs? Shouldn’t you treat yourself with the same care as a patient?

While the term endangered is normally used in reference to animals, you’re surrounded by just as many threats as a leopard in the wild. For decades, women in healthcare have suffered from stress, fatigue, strain due to schedule, insufficiency in internal training, and injuries from physical tasks. According to the American Foundation for Suicide Prevention, female physicians die by suicide at a 400 percent higher rate than women in other professions. One article posed the question “who takes care of the caregivers?”

The answer is YOU!

There are some issues in healthcare that is a work in process, but you have the power to positively influence your well-being today. Your patients need you. Your family needs you. And, you need you. So, treat yourself with proper rest, prayer, stress management techniques, supportive relationships, and be the first thing on your to-do list by adhering to your discovery checklist.

 

 

African American Women and the Stigma Associated with Breastfeeding

African American Women and the Stigma Associated with Breastfeeding

August marks national breastfeeding awareness month, and although overall national breastfeeding rates are on the rise, breastfeeding rates for African American mothers are significantly lower than other racial groups. The benefits for both mother and baby are numerous, yet some new mothers are hesitant to do so, especially in the African American community. Why are African American women less likely to breastfeed compared to their white counterparts?

A persistent discrepancy exists between African American mothers and mothers of other races who breastfeed. African American mothers have been lagging behind their white counterparts for years when it comes to breastfeeding.  According to the Centers for Disease Control and Prevention (CDC), the initiation rate of breastfeeding among African Americans is 16% less than whites. Multiple factors in the African American community may play a role in these discrepancies.

Lower breastfeeding rates among African American women begin with education, or lack thereof. “You can never have too much education and information,” says Joycelyn Hunter-Scott, a mom of two young sons. When asked about a stigma in the African American community Hunter-Scott replies, “I don’t think it’s a stigma; I believe it may have something to do with the lack of education and information the mothers receive during and especially after pregnancy—especially the younger mothers.”

Hunter-Scott, who was a mother who extensively researched breastfeeding when she was pregnant, is correct regarding the lack of education during the perinatal period affecting overall breastfeeding rates. According to the CDC, some hospitals within African American communities are failing to fully support breastfeeding. In a CDC Morbidity and Mortality Weekly Report, ten indicators that show hospitals are supporting breastfeeding were evaluated showing that hospitals in zip codes with more than a 12.2% African American population were less likely to implement three specific indicators. These indicators include: helping mothers initiate breastfeeding early on, having infants “room in” with their mothers after birth, and limiting what infants eat or drink in the hospital to only breast milk.

Renee Bell-Eddings, MSN, RNC-OB, whose main job function is to educate staff nurses within the Women, Infant, and Children’s (WIC) department in a community-based hospital in Houston, Texas, also knows education is the key for new mothers, but also attributes a social component to breastfeeding. “I believe the reason there is a stigma is simply [because of] the lack of education and support from family and friends. Often times we see that she is the only woman in her family that has chosen to breastfeed. We also have to understand that the family plays a big role in the choices that a mother will make concerning breastfeeding—that’s where we see the cycle of breakdown because she doesn’t have the support she needs to continue.” A new mother needs support from those closest to her when taking on the challenges a breastfeeding mother may face.

A two-time mother, Hunter-Scott breastfed both of her sons—the eldest for one year and the youngest for seven months. She credits the support of her mother, sisters, and husband during that time. “This [support] made an enormous impact on my decision to breastfeed for the timeframe that I did,” she says.

Although Hunter-Scott had the support of her family (and nearly six months of maternity leave), she can see how a mother not having support or having a short maternity leave can negatively affect breastfeeding rates in the African American community. “I think it is important that the health care staff initiate breastfeeding after birth and make sure not to give pacifiers or artificial nipples to infants. I also believe many African American women don’t have the luxury of staying home after they have their baby. Some have to go back to work within a few weeks, some a few days, so it’s quicker and easier to send the baby off to childcare with formula.”

Negative cultural influences in the African American community about breastfeeding can also play a role in breastfeeding rates. Breastfeeding has been seen by some African American women as reverting to “slavery days” when feeding a child by breast was the only option. Baby formula as we know it was developed in the late 1800’s and soon gained popularity when feeding a baby with formula was seen as something only “elite and sophisticated” mothers do, regardless of race. These advertising campaigns led many women to believe breastfeeding was a choice only for lower income mothers.

Another issue that faces a breastfeeding mother is public breastfeeding and the potential shaming from others. Feeding a child in public from the breast is often seen as indecent and given a perverse sexual connotation. Being able to feed on demand is crucial for the continued production of breast milk in a lactating mother. The shaming some women endure is enough to discourage them from continuing to breastfeed even if they have chosen to do so initially. The indecency claims of public breastfeeding generalizations make it hard for any woman, let alone an African American woman, to nurture her child through breastfeeding. Negative portrayals by the media and in our own communities have a profound effect on the initiation and continuance of breastfeeding.

The societal and commercial pressures to not breastfeed or stop breastfeeding altogether before six months of age are evident through aggressive marketing campaigns of formula producers. Societal pressures include: not having a national maternity leave law, the shaming of breastfeeding in public, and not having enough dedicated breastfeeding areas in public establishments to encourage breastfeeding. Many mothers do not have the ability to stay home for extended periods of time after birth, further encouraging them to stop exclusive breastfeeding in exchange for formula. Working mothers in the United States need support to continue breastfeeding before their baby is even born by means of national legislation for established maternity leave, breastfeeding or pumping breaks when they return to work, and a willingness from their employer to provide a conducive environment to support a mother’s wish to continue to breastfeed.

With all racial and societal factors aside, breastfeeding offers both mother and baby numerous benefits—and this is why it’s vital that mothers attempt to breastfeed for at least six months. When formula was introduced it was touted as the “perfect food” for a growing baby, but nothing compares to a mother’s milk. Breast milk has everything needed to sustain an infant and promote lifelong health. Nurturing a newborn with a mother’s milk offers baby rich nutrients that have proven benefits for both mother and baby, not to mention the money saved from not purchasing formula.

Infant mortality rates are twice as high for African American babies than white babies, and breastfeeding is the key to saving infant lives. Health benefits of breastfeeding for baby include decreasing the risk of common childhood illnesses, such as upper respiratory infections, ear infections, and asthma. It also provides long-term benefits for obesity and future diabetes risk, high cholesterol, and high blood pressure. Mothers benefit from breastfeeding by helping get back to pre-pregnancy weight sooner (breastfeeding burns up to 500 calories per day!) as well as decreasing risk for diabetes and breast, uterine, and ovarian cancers.

Education, education, and more education is the key to increasing breastfeeding rates in the African American community. Education has to start during the prenatal period and continue through birth and thereafter. Bell-Eddings knows knowledge is power: “Education is a big key in changing the mindset of all and allowing mom to make an informed decision.”

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