Nine years ago, I was so happy to have my first article published in Minority Nurse. The article was a discussion on whether or not it’s OK to be out at work as a gay person. Looking back at the changes I’ve seen over this time period, I decided to put together a few thoughts.
The county hospital where I work is rolling out some new intake questions for our electronic health record system. The impetus is to better serve our LGBTQ patients. A transgender person with residual breast tissue did not know he could still get breast cancer. An MTF person developed prostate cancer. These patients slipped through the cracks because they lived their true self but had body parts susceptible to illness that the caregiver was not aware of. By next month, we hope to have 10% of our patients properly classified using our new Sexual Orientation and Gender Identity (SOGI) questions. As the program rolls out, we will capture more and more of our population so caregivers can better serve them.
As a gay man in my 50s, I have seen great changes in my lifetime on LGBTQ issues. There was a time when just being out was a danger. But we bring some unique perspectives to our job that shouldn’t be overlooked. We know what it’s like to be the underdog. We cherish family because we worked so hard to have our families recognized. Respect for minorities come easily to us because we have suffered discrimination. Fairness in treatment under the law was not free for us or other minorities so we always strive to protect our patients’ rights. We know that being gay does not give you AIDS, but we also know what those risk factors are and we are able to educate our patients on the facts without judgement.
Now that we are rolling out a campaign to identify our patients’ unique needs regarding sexual health, reproductive issues, and mental health, we are working to destigmatize these issues in our community. Just asking these questions can be a litmus test of our own feelings. When the program was being explained in an employee meeting, there was pushback. “Our patients will be insulted.” Or, “Our patients won’t understand the terms.”
It occurred to me that we might be projecting our own feelings and, in some cases ignorance, onto our patients. Of course, there are what seem like valid issues when trying to tease this information out of patients in the geriatric clinic. My feeling is that you just throw the questions out there and you get what you get. The elderly are just as much part of the world as the young (and in between).I can’t wait to get some real world experience in asking these questions:
- What is the sex on your original birth certificate?
- What is your gender identity?
- What is your sexual orientation?
Some explanation might be needed with some patients. Sexual identity is not your sexual orientation. Sexual identity cannot be inferred from your birth certificate. We are looking forward to the rollout but with a bit of trepidation because we are not used to asking such personal questions. But,if you want to better serve this population, you have to identify them. The FTM person who never got a breast cancer screening because his caregivers never informed him of the risk—that can be preventable with better understanding of our patients. More information is better than less.
I take away two points from the SOGI questions that excite me. The first is that caregivers are going to be more aware of the disparities in health care that can occur with our LGBTQ patients. We are charged with the care of all our patients, not just the ones that fit into neat boxes. Just being aware of the differences makes us stop to weigh implications that might have been missed in the past. The second is that by normalizing this conversation, both patients and caregivers can talk openly about a subject that was once taboo. It’s OK to be gay or lesbian, FTM, MTF, something in between, or nothing at all. We all have health care needs.
Annette Smith, a nurse and coworker with 35 years of experience, has insight into changes in practice like the new SOGI questions: “At the beginning, there is a lot of pushback. The sky is falling, the sky is falling. But after a while, the process becomes normalized and it’s not a big deal anymore. We end up wondering what all the fuss was about!”
There was a time when just talking about sexual orientation was not even considered. Now we are required to ask! This destigmatizes the whole subject. To revisit my first question: It should never be a question of whether it’s right or wrong to be out at work. It’s just a question of you being comfortable enough in your own skin to let other people know.
The nursing program at MidAmerica Nazarene University, with the help of Digital Third Coast, created an infographic depicting data on the perceived stigma of male nurses. Through their research, they gleaned quite a lot of interesting information.
For example, while it’s well-known that mainly men served as nurses in the past, their research indicates that “Due to associations with the military and religious orders, there was significant male representation in the nursing profession through the late 1800s.” The visual even shows a photo of famed poet Walt Whitman with his male nurse, Fritzenger.
When did this all change? According to the graphic, legal barriers in the early 1900s contributed to the scarcity of male nurses. In fact, many nursing schools would not even admit men. This didn’t officially change, though, until 1981 when the U.S. Supreme Court ruled that not admitting men to nursing schools was unconstitutional.
As a result, during the 1930s and 1940s, the percentage of nurses who were male decreased to its lowest point, which according to the U.S. Bureau of Labor was 1%. Not surprisingly, that percentage has risen over the years. As stated in the 2013 Census, out of the 3.5 million employed nurses, 78% are Registered Nurses (9.6% of these are male); 19% are Licensed Practical and Vocational Nurses; 3% are Nurse Practitioners; and 1% are Nurse Anesthetists (41% of these are male).
From these statistics, it can be concluded that men are more likely to become nurse anesthetists—which is the highest paid role in the nursing field. With women making up the majority of the nursing field, one would assume that they tend to make more in terms of salary, right?
Wrong. Female nurses make only 91 cents per every dollar that male nurses make.
For more fascinating facts about the perceived stigma of male nurses, check out the infographic here.
In the past, most nurse roles on television were played by women. Just as the number of men in the nursing profession in real life is increasing, we’re likewise starting to see more men in nursing roles on television.
We chose some of our favorites—because we either loved or could barely tolerate them or they made an impact during their time on the small screen. Here they are, in no order of preference.
Fictional Character: Thor Lundgren
Played by: Stephen Wallem
Show: Nurse Jackie
Everyone loved Thor—he was smart, strong, and funny as heck. And he tried to help Jackie. If he wasn’t shooting the breeze with Jackie in the chapel, he was dealing with Zoey. But in a moment’s notice, he was right there, saving patients. We’d want him as our nurse.
Fictional Character: Peter Petrelli
Played by: Milo Ventimiglia
With all the challenges they face, nurses in real life may often feel like they need superpowers. In the TV show Heroes, the nurse actually had them. Peter Petrelli, played by Milo Ventimiglia (who’s now starring on the hit show This Is Us), was working as a hospice nurse when he realized that he was evolved and could absorb the powers of other humans who were evolved. Wouldn’t that be great to do when working a double shift?
Fictional Character: William Dell Parker
Played by: Chris Lowell
Show: Private Practice, a Grey’s Anatomy spinoff
While he worked as a receptionist, Dell Parker was a qualified nurse and began training to work as a midwife. Unfortunately, his character was killed off in a car crash. But the time he had on the show, he made quite an impression
Fictional Character: Rory Williams
Played by: Arthur Darvill
Show: Dr. Who
As a nurse in a coma ward, Rory Williams is a close companion to the 11th Dr. Who, played by Matt Smith. Hey, he gets to help people and go in the TARDIS? What’s not to love?
Fictional Character: Clark Beavers
Played by: Jonathan Slavin
Show: Dr. Ken
Clark Beavers is hilarious. He calls Dr. Ken (played by Ken Jeong) his “work husband,” walks with a group at the mall, and really loves shrimp. But the reason we love him is because he makes us laugh.
Fictional Character: Jesus Velasquez
Played by: Kevin Alejandro
Show: True Blood
When he comes to work as a nurse for Lafayette’s mom, Jesus Velasquez ends up becoming the fabulous one’s boyfriend. He then introduces Lafayette to witchcraft and being a medium. While they worked well together, Jesus gets killed off, although he did return in a future episode as a ghost.
Fictional Character: Paul Flowers
Played by: Ricky Schroder
Even though he only graced us with his presence for a few episodes, nurse Paul Flowers made a big impression. He put up with Dr. Kelso’s nasty remarks, “That’s a woman’s job, son.” But he also dated Dr. Elliott Reid, played by Sarah Chalke. While she gets embarrassed by being with a male nurse who has been known to wear pink scrubs, Paul tries to show her the error of her ways. Unfortunately, she dumps him, and Paul was no more. But he showed how male nurses could be comfortable with their masculinity while they cared for patients.
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.