Two recent papers by UIC College of Nursing faculty found that microaggressions – common, subtle indignities – can be just as harmful as a major discriminatory event, contributing to negative mental and physical health outcomes in bisexual women.
Associate professor Wendy Bostwick, PhD, MPH, and assistant professor Ariel U. Smith, PhD, RN, were co-authors on both papers, one published in the Journal of Bisexuality and the other in Psychology of Sexual Orientation Gender Diversity, a publication of the American Psychological Association. Both relied on findings from the Women’s Daily Experience Study of 112 ethnically and racially-diverse bisexual women.
Bostwick is principal investigator on a National Institute on Minority Health and Health Disparities grant which funded the Women’s Daily Experience Study, one of the first ever to focus on bi-identified women and mental health. Participants completed a baseline survey, followed by 28 days of e-diaries to capture microaggressions that they may have experienced during the previous 24 hours.
“The old saying goes, ‘sticks and stones may break your bones, but words can never hurt you,” Smith says. “But you look at the data and realize that’s simply not true. Microaggressions that someone has experienced over a lifetime are correlated with mental and physical ailments they experience even today.”
The researchers looked at microaggressions related to sexual orientation, race and gender. Microaggressions could include denying a person’s bisexuality—suggesting it’s “just a phase”—or a rude or insulting comment about lesbian or gay individuals. A comment minimizing or denying the existence of racial discrimination is an example of a racial microaggression.
Participants reported an average of eight microaggressions of any type in the previous month, with almost all women—97%—reporting at least one microaggression throughout the duration of the study.
Gender-based microaggressions were reported the most frequently. Women reported being sexually objectified on more than 15% of the days recorded.
The papers also found microaggressions were associated with poor mental health and binge drinking, smoking and marijuana use. The most consistent finding was an association between microaggressions and anxiety.
“Our findings suggest that for bisexual women, the weight of denigrating comments about their sexual identity, gender and race can contribute to poor health outcomes—whether such comments happened last year or yesterday,” Bostwick says. “Of course, these comments are situated in a larger context of systemic inequities, which may render bisexual women with fewer resources to cope when confronted with dismissive and disparaging comments about core aspects of who they are and their own lived experiences.”
Bisexual women of color were a majority in the study—57%—a group that is notably absent in the literature, the researchers say. Latina bisexual women reported worse health outcomes than Black and White bisexual women in their daily diaries. Smith says the impact of microaggressions on bisexual women of color is an area where further research is needed.
“So often we focus on the large discriminatory events, like being denied housing or being fired from a job,” Smith says. “These subtle comments and slights can be just as harmful. That’s why it’s important to address it through education – understanding and recognizing what a microaggression is and then adapting policies to raise awareness.”
Co-authors included UIC Nursing visiting research specialist Larisa Burke, MPH, Amy L. Hequembourg, Alecia Santuzzi and UIC Nursing professor emerita Tonda Hughes, PhD ’89, RN, FAAN.
One year ago, I would have taken any opportunity to write, advise, or lecture on the inequalities of being a black nurse in health care. I could’ve complied a novel of complaints, stories, examples, and tears from the countless nurses that have described horrific scenarios of discrimination and bias feelings of being undervalued and overlooked for coveted leadership roles. Today, my paradigm has shifted and my perception of reality has moved from fractured to healed. How did this happen? Am I drunk on the liquor of white America, am I not “woke”? Have I forsaken my people and joined the other side? No. I’m still very much an advocate for equality in health care.
Here’s where I’m at: there are many individuals who subscribe to a methodical and intentional belittling of those who do not look like them and they come in every shade, even black. I may have heard a metaphorical gasp, but the truth is we focus so much of our attention on those individuals, working to receive their approval, waiting for a nod, anticipating some sort of compassionate act to help us succeed. Here’s the truth. They are not enlightened and they don’t care and until they plan to become self-aware their behaviors actions will never change. They are disconnected from the pillars of nursing compassion, empathy, human connection, and healing. Create a path to success using your knowledge and passion. Channel your energy and focus on yourself.
I have countless stories of inequality, being undervalued, and overlooked, feeling inadequate, not good enough, not included. Many of my colleagues have the same stories, we have collected so many stories that we could build a library of hate, but why? Why waste energy on what’s unimportant? Why not channel that energy and create something new, innovative, and intentionally inclusive? Achieve the highest degrees or certifications possible, build a nurse framework that cannot be torn down, that cannot be destroyed, that lasts lifetimes. Not just something for the moment.
Here’s a truth: my move to corporate America opened my eyes to a reality. Nobody, I mean nobody eats for free. It’s time for Black America to open its eyes to the truth and learn the transparency of human behaviors. What you fear is created in your mind, so change the narrative. Move your mind to a positive paradigm and see the opportunities in every task that you are asked to complete, instead of complaining why not focus on self-awareness and success. Yes. It’s OK to be selfish. Don’t just complete an objective. Execute it. Put all your hurt and pain in your work and watch how your outcome changes. Change how you eat, what you eat, include exercise, meditation, and whatever it takes to move you to a healed space. We have over 400 years of shackles to break, take pride in breaking your own chains and contribute to the evolution of history. Don’t just read the news; become the news.
Over the past half a century, the number of
men in the nursing industry has increased exponentially. In the sixties, only 2% of men were nurses. Today, the percentage has
climbed to 13%. That’s an 85% increase, which is huge!
However, if 13% of nurses are men, that means that 87% of nurses are not. There is an extremely disproportionate number of men in the nursing field, and there’s no real reason for it, other than stigma. But today you’re going to learn just how senseless this stigma is, and why it must be stopped.
Originally, men were nurses. In 250 B.C., the world’s first nursing school opened its doors, for men only. Yes, nurses were originally all male! But times have changed. Nowadays, women make up the bulk of this once male-dominated industry
Why? Because of the stigma. What’s the stigma,
you ask? The stigma is that nursing is a caregiving position, and therefore,
such a job should be reserved for women. Now, here’s the fallacy of such a
statement. Today, women are doctors, accountants, and policewomen, jobs which
were once considered to be for men, and no one thinks twice, because gender
bias deserves no place in a country as morally advanced as the US. But for some
incomprehensible reason, there is a significant amount of gender bias. Pay
attention to the nursing industry, and you’ll notice it there.
But this has to stop. We need male nurses; they’re just as capable, strong, and intelligent as their female counterparts, and add a much-needed balance to the industry.
How Can We Stop the Stigma?
Never belittle the concept of someone becoming a male nurse. Being a nurse is something to be proud of, regardless of gender! It shows you’re a caring, kind person who wants to help others and has the ability to accomplish goals.
Respect men in the nursing industry. These men are people who don’t care what everyone else is doing. They do what should be done, regardless of what others will think. And that is something to look up to.
Spread the word about the benefits of becoming a male nurse. The pay is fabulous, the line to the bathroom door is moot, and promotion is likely (since men are more likely for promotion overall, and there are so few men in the field to begin with). There are many more positives about this career; perhaps we’ll get into the details another time, but even just the aforementioned benefits can be enough to show guys you know that this is a field worthy of their consideration.
Become a nurse! It’s a great career choice for men, and every additional male nurse makes a difference in the percentage.
Tips for Men in the Nursing
Industry
Being a male nurse isn’t always easy, but it’s
wonderfully rewarding, both financially and emotionally. Here are a few tips
for you to get the most out of being a guy in scrubs.
The same way men prefer male nurses, women often want to be cared for by a female nurse. This is nothing personal; don’t take it to heart. There will be many a man who will be really happy to find out you’re being his nurse.
There are many organizations, such as AAMN and The Brotherhood of Nursing, which can help you connect with other male nurses.
Does it bother you that most scrub stores are so feminine focused? Then you may prefer to shop at Murse World, which exclusively provides guys with a full selection of male scrubs from all the best nursing uniform brands.
Stay confident and proud. You’re helping so many patients, and simultaneously breaking gender barriers in the nursing industry.
Whether you’re a nursing student, a nurse, a patient, or anyone else, you can have a part in stopping this unnecessary stigma
In part one of this two-part series, we illustrated the types of prejudice and stereotypes that male nurses can often face. What happens, though, when male nurses experience it? What can or should they do?
What to Say
If confronted by someone who believes that men don’t belong in nursing, you should be professional and take the opportunity to educate them. “I would tell them to check the data,” says Donnell Carter, MBA, MS, CRNA, clinical staff nurse anesthetist at Saint Vincent’s Hospital in Worcester, Massachusetts. “Many men are turning to nursing because it is a secure and rewarding profession with plenty of opportunities for personal growth. Nurse anesthetists, in particular, practice with a high degree of autonomy and professional respect. They carry a heavy load of responsibility and are compensated accordingly.”
Tell them to walk the walk. “I would ask them to join me for 12 hours and see if they could do what I do. Walk a mile in my clogs,” says Jeremy Scott, MSN, RN, CCRN, a resource pool nurse at Penn Presbyterian Medical Center in Philadelphia, Pennsylvania.
Look into history. Kody Colombraro, LPN, EMT-B, a hospice care consultant at Regency Hospital in Augusta, Georgia, suggests that you give them a history lesson. “If it hadn’t been for the crusades, males would still be the dominate sex in nursing. The first nurses were the Knights of Hospitaller, also known as the Order of St. John. They were believed to have been the medical caregivers to the Knights of Templar. It wasn’t until Templar numbers decreased that they were militarized and sent to battle.” When that happened, women began filling the need for nurses.
Ask Why? Les Rodriguez, MSN, MPH, RN, ACNS-BC, APRN, clinical nurse specialist/clinical education specialist pain management for Methodist Richardson Medical Center in Richardson, Texas asks them why they think that way. “Men are just as capable of being nursing as women are in being physicians. Men are just as capable at being nurturing, compassionate, empathetic, and caring as women are,” he says. “We have females in the battlefield, flying planes, and running corporations. Why can’t and shouldn’t a man be a nurse?”
Enlighten Them. “When you consider the aging and declining health in America, I firmly believe that we will need every man and woman who aspires to to be a registered nurse,” says Dave Hanson, MSN, RN, ACNS-BC, NEA-BC, regional director of nursing practice, education, and professional development at Providence Health & Services Southern California in Burbank, California. “According to the 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, men provide a unique perspective and set of skills that are important to the profession and society. The IOM report also noted that the nursing profession needs more diversity—in gender as well as ethnicity.”
What Action to Take
If you’re a male nurse and dealing with stereotypes, prejudice, and/or discrimination, there are actions you can take. “Discrimination is a big problem. If any nurse is being discriminated against, he or she should contact human resources, their union representative, and, if needed, a lawyer,” advises Basler.
“The first stop should be their nurse manager—unless that is an issue. Then, human resources—unless that is an issue, with the next stop being an attorney on the way to a new job,” says Scott. “I personally would not deal with nonsense.”
Regarding stereotypes, they still exist, and, for some people, always will. But male nurses can do their part to help eliminate them. “One way to dispel stereotypes is to understand that it’s typical to have variations within any group, including the nursing profession. Recognizing and respecting the diversity that exists within the nursing workforce is what will strengthen and grow our profession,” explains Hanson. “It’s essential for the larger community of registered nurses to stand together to advocate for ongoing education, research, policy, and dissemination of information about men’s health issues and men in nursing.”
And be all that you can be. “Do an outstanding job and go above and beyond for their patients and team members,” says Carter. “I would also recommend seeking leadership, teaching or mentoring experiences to help change public perceptions. It’s important for men to actively seek to change the face of nursing by highlighting their diversity.”
Carter continues: “My career has rewarded me with many opportunities. The face of nursing has truly changed over the last two decades. I expect that more men will decide to pursue a career in nursing in the future.”
Concentrate on the job at hand. “Just keep your nose to the grindstone and surpass all negativity,” says Robert Whigham, RN, a staff nurse at Doctors Hospital in Augusta, Georgia. “Watch your life flourish.”
“You decided to join a profession that has been dominated by women for generations,” says Jonathan S. Basler, RN, a clinical nurse at West Front Primary Care in Traverse City, Michigan. “Choose your mentors wisely and be the best nurse you can be. Let your knowledge, skills, and compassion define you as a nurse—and not your gender.”
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.
