At Charles R. Drew University of Medicine and Science, the number of male nursing students seeking a master’s degree is reason to celebrate.
“At the beginning of this semester, a faculty member said, ‘I just did an assessment of our new cohort and 15% of the incoming class are men, and it’s the most we’ve had in a cohort,’” says Sheldon D. Fields, PhD, RN, FNP-BC, AACRN, FNAP, FAANP, dean of the Mervyn M. Dymally School of Nursing.
But gender diversity is just part of the story at the historically black and Hispanic graduate institution based in South Central Los Angeles. “Not only is our male student population up, I also only have minority male students in my program,” says Fields, who previously served as an assistant dean and codirector of the Doctor of Nursing Practice Program in the Nicole Wertheim College of Nursing and Health Sciences at Florida International University. At that Miami school—a historically Hispanic institution—the male nursing enrollment is much higher at 30%.
Such historically diverse schools of nursing are key to getting more men of color into the nursing pipeline, says Fields. “Minority-serving institutions, I think, stand a better chance of attracting men because we are more flexible and we don’t have those historically traditional ways of looking at who should and who could be a nurse.”
Increasing Gender Diversity
Today, one out of 10 nurses is a male. And while more men are resisting stereotypes and increasingly pursuing a career in the most trusted health profession, many more are needed not only to achieve gender parity, but also to reflect the nation’s demographics, says William T. Lecher, RN, DNP, MBA, NE-BC, immediate past president of the American Assembly for Men in Nursing (AAMN).
AAMN has aligned its goals to improve gender diversity with the recommendations of the Institute of Medicine nursing report, which stated that to improve the quality of patient care, more efforts are needed to increase the diversity of the nursing workforce, especially in the areas of gender, race, and ethnicity.
“Our patients and families know the important role men in nursing play in meeting their nursing and health care needs. For example, The DAISY Award is provided by almost 2,000 health care facilities and celebrates and honors the extraordinary compassion and direct care nurses provide to patients and families every day,” says Lecher, senior clinical director at Cincinnati Children’s Hospital Medical Center.
“The DAISY Foundation has found that men are recognized by patients, families, and health team members two to three times the rate they are employed. Or, in other words, the patient and family experience benefits by having men in the nursing workforce. As such, our patients, families, and health care administrators should demand our nursing schools do a better job recruiting and retaining more men in nursing school. It is hard to believe that, in this day and age, men in nursing school only account for 12% of students [as of 2012] and their attrition continues about twice the rate of women in nursing programs,” says Lecher.
According to a report by the American Association of Colleges of Nursing, 2014-2015 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, men comprised 11.7% of students in baccalaureate programs, 10.8% of master’s students, 9.6% of research-focused doctoral students, and 11.7% of practice-focused doctoral students. One of AAMN’s goals is to have men make up 20% of nursing student enrollment by 2020.
To encourage schools of nursing to support its male students, AAMN has created the Excellence in Nursing Education Environments Supportive of Men program, a recognition designed to provide evidence to stakeholders that a specific program is gender-inclusive. Recognition symbolizes excellence in providing male students a positive and equitable educational environment as determined by AAMN.
The program’s goals include increasing awareness of issues that may challenge the success of male student nurses, fostering the recruitment and retention of men as nursing students, and recognizing nursing education programs that have achieved excellence in supporting male students. Recognition is valid for eight years. Schools interested in applying can do so at AAMN.org.
Increasing the gender diversity of students to create a workforce prepared to meet the demands of diverse populations requires schools of nursing to do a better job of recruiting and retaining male students, says Marianne Baernholdt, PhD, MPH, RN, FAAN, professor and director of the Langston Center for Quality, Safety, and Innovation at Virginia Commonwealth University (VCU).
“You won’t find a school of nursing today… that wouldn’t say we do everything we can to increase minorities in nursing and that includes men. If you are not going to put money or specific actions behind [these goals] well, you will just keep doing what you are doing,” Baernholdt says. At VCU, men are 12.5% of the undergraduate nursing school enrollment, she adds.
VCU offers several entryways into nursing, including the RN-to-BSN program, and an accelerated bachelor’s degree program. “Because we have that mix, I think we have a higher proportion of male students. But VCU is known for its diversity, so that’s another reason we also have as many African Americans as we have males. Does that mean we could do better? Of course, we need to do even better,” says Baernholdt.
From 2010 to 2013, the number of male RNs increased from 8% to 10.7%. During that three-year period, an additional 70,000 male nurses entered the workforce, increasing their number to over 300,000. Since the 1970s, the percentage of male nurses has more than tripled.
The profession’s low unemployment, a desire to make a difference, and a shift in how male nurses are viewed are among the reasons men are entering nursing, experts say.
“The increased visibility of AAMN and men in other nursing organizations make it easier for men to see themselves as nurses,” says Lecher. “Furthermore, the recent recession has helped men choose nursing as a way to help others, have purpose and meaning in their work, and earn good income for their families.”
Alexandra Robbins, author of The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital, agrees. “I think they are increasingly drawn to the profession as the stigma and stereotypes wane and as more men realize just how hands-on a nursing career can be,” she says.
Fueling the growth of male nurses are innovative initiatives, including programs that train foreign-educated physicians—who cannot practice in this country—to become nurses, says Fields. The number of returning military veterans is another factor. “There are several medic-to-RN programs around the country, and the VA has put money into continuing education for vets, and a large number of them are coming into nursing,” says Fields, noting that the military is disproportionately higher in men.
While male nurses are the minority, they still earn more money than women in the same role.
A report published earlier this year in JAMA: The Journal of the American Medical Association, found that the average female nurse earns about $5,100 less than her male counterpart—even when researchers controlled for factors such as race, age, marital status, and specialty. The uneven wages also varied significantly by specialty. The highest salary gap was for nurse anesthetists, a role held by many men.
“I don’t think what we’re seeing should surprise anybody because we live in a country that has a pay disparity between men and women, with men making more money,” says Fields. “In nursing, there is a slightly larger number of men who pursue an administrative role, and they tend to work in critical care roles, which requires more credentials and pay more money,” he adds. Men seemed to be promoted quicker, too.
The bottom line? “In America, we have a patriarchal society that says men are worth more,’’ says Fields.
The salary gaps are dismaying but may not be as widespread as the study suggests, says Peter McMenamin, PhD, senior policy fellow and health economist at the American Nurses Association.
The challenge is in the data, which included information that stretched back more than 10 years, when there were fewer male nurses. Also, the wage differences are not explained but may include women who took time off to have children and, so, lost their place in the labor force and never caught up. Or, the data could include male nurses who worked two or more jobs, which meant their total compensation increased, explains McMenamin.
“So there are all these little things that suggest it’s not as simple as taking the average wage for men and women in the same category” because of other issues, including training and experience, says McMenamin. Still, he is dismayed that the differentials exist. “We’d like to live in a world where experience and education were the primary determinant of compensation…but gender alone should not.”
Gender diversity may help to resolve the uneven wages, says Lecher. “Gender occupational segregation does not promote wage advancement in nursing or any other occupation. A more gender-diverse workforce will benefit the wage potential for all nurses.”
While that remains to be seen, gender diversity improves culture competence and outcome for patients, says Elliot Brooks, senior vice president of human resources at MJHS, one of the largest health systems in the greater New York area.
“New York is one of the most diverse cities in the world. At MJHS, we believe that our employee population should reflect, understand, and respect the diversity of this great city. That doesn’t just extend to gender; it also means culture, faith, tradition, ethnicity, sexual orientation, et cetera. Our anecdotal qualitative research shows that our patients, of any background, appreciate receiving care from nurses who are culturally sensitive. This enhances care management, goal setting, and having difficult conversations. But, the benefits go beyond those important things,” Brooks says.
Patients are more likely to open up “about their personal lives, dreams, hopes, and challenges,” Brooks continues. “By extending compassion, dignity, and respect to our patients, we are able to help provide care to the whole person—physically, socially, emotionally, psychologically, and, of course, culturally.”
The nursing community, health care stakeholders, and the public must work together to improve gender opportunity in nursing. “There’s been a huge cultural expectation and assumption shift in the past 40 to 50 years,” says Brooks. “It used to be that most people assumed all nurses were women. Today, fewer people make that assumption. I think the Millennials and future generations will help continue to push for greater gender opportunity in all professions, not just nursing.”
Lecher agrees that more vocal support is needed, particularly from fellow nurses. More men and women nurses need to demand that the profession become more gender diverse and inclusive, he says. “It would be a mistake to think that men can solve gender recruitment and retention by themselves when women dominate the profession,” he adds.
“We have many women in nursing advocates for gender diversity. There are presently five women serving in the role of AAMN chapter presidents. A lot of nurses believe our membership is limited to men, but that is not the case,” says Lecher. “The truth is our women in nursing colleagues need to take a leadership role for such change, or our progress will continue to be glacial.”
Robin Farmer covers health, business, and education as a freelance journalist. Based in Virginia, she contributes frequently to Minority Nurse magazine and website. Visit her at www.RobinFarmerWrites.com.
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