More Men in Nursing: Strategies for Support and Success

More Men in Nursing: Strategies for Support and Success

Community colleges are experiencing an increase in the number of men pursuing nursing as a career choice. The National League for Nursing’s Annual Survey of Schools of Nursing for the 2010-2011 academic year indicated that 15% of associate degree students were males. At 15%, men enrolled in basic RN programs remained at the historic high reached at the beginning of the current economic recession. Across all levels of nursing education, approximately one in seven nursing students was male in 2011. This represents a 2% increase in the male student population since 2010.1These statistics are encouraging and provide a possible solution to the worldwide nursing shortage.

From Fall 2001 until Fall 2012, the Borough of Manhattan Community College (BMCC) enrolled 504 male nurses in their associate degree program. This increase in the number of male students has provided impetus for further examination of the reasons why more men are pursuing nursing as a career in the 21st century, and what faculty can do to support and facilitate the integration, progression, and success of male students in nursing programs.

A structured survey consisting of ten key questions was sent to 68 male students currently enrolled in the associate degree nursing program at BMCC. The survey questions were framed from general to specific in order to draw conclusions. A total of 52% responded and provided answers to questions such as:

  • The motivating factors for deciding on a career in nursing;
  • Influencing factors, such as type of work in the military and their decision to enter the health care field;
  • Personal reasons for choosing nursing, such as: job stability, better pay, career flexibility, and opportunity for advancement;
  • Work placement preference after graduation;
  • Resources that would be most beneficial to their success in nursing programs.

 

It’s a Man’s Opinion

Results of the first half of the survey have shed light on male student nurses’ view of their place and future in the profession. Demographic data related to male students indicated that 54% of respondents were in an age group of 35 to 44. Seventy-five percent (75%) of male students entered nursing after another career; 33% of male students had an associate degree in a field other than nursing; and 25% had a bachelor’s degree from a field other than nursing. Seventy percent (70%) had no previous health care experience. And 87% had no military medic background.

The second half of the survey focused on male students’ view of their place in nursing. Categories ranged from strongly disagree to strongly agree. Findings indicated that 70% of respondents expressed a desire to help others; 66% of male students had no knowledge about the history of men in nursing; and 45% believed that male nurses choose to work in specialized areas. These findings confirm the literature’s viewpoint that most male nurses tend to gravitate toward specialty areas.

Results of the last area of the study addressed the importance of having adequate resources to facilitate progression and positive outcome for male students. Most respondents felt that career counseling/internships (80%), academic tutoring in nursing content (74%), faculty mentoring (65%), personal counseling (60%),  and financial aid (60%) would be beneficial to students’ progression and success in the nursing program.

            Career Counseling/Internships. Career counseling is abundant in most colleges and universities, primarily for retail industries. Counseling for nursing students, however, focuses on how students can best prepare for graduating, passing the NCLEX exams, and achieving licensure.

With a drastic change in today’s economy, health care institutions have felt compelled to focus on creative ways of meeting staffing needs and cutting costs for orientating new graduates once hired. Due to the economic recession, nursing jobs are more difficult to secure. In addition, most hospitals require at least one-year of bedside nursing experience before hiring a new graduate. How will a new graduate acquire the experience necessary to land a job? The American Association of Colleges of Nursing reported that 88% of graduates from baccalaureate programs had jobs within six month of graduation.2 However, associate degree program graduates are not as fortunate. In order to adequately prepare for the workforce, associate degree graduates are counseled on the need to continue their education and to participate in an internship program during their final year of school or an externship program after graduation.

Colleges often apply for and receive grants in collaboration with hospitals to provide externship programs that will facilitate training and mentorship for new graduates. Most programs are limited to 10-15 students, depending on the cost for six weeks of training and mentorship. In this program, students are often given additional training in EKG, venipunctures, and physical assessment skills. Students must successfully complete the training program, at which time they receive job placement either at the institution of training or a sister institution within the same conglomerate.

Most faculty in nursing programs serve as counselors to nursing students and have an ongoing relationship with health care institutions to provide internships, externships, or volunteer residency programs. In these programs, students acquire more hands-on experience, which tend to be limited during the school year. All students, regardless of gender, receive career counseling and the opportunity to apply for internships or externships during the summer months. Students are also counseled to continue their nursing education, whether from an ADN-to-BSN or a BSN-to-MSN program. Most colleges and universities offer a free NCLEX review course to prepare students for the licensure exam. This serves as a win-win situation for students since most public colleges, including the City University of New York, pay for the cost for the three-day review session.

Tutoring in Nursing Content. Tutoring, mentorship, meditation, and relaxation have been categorized as stress-reducing resources that can be offered to students.3Students who are relaxed and adequately prepare perform better on exams. At BMCC, tutoring is offered each semester for all nursing students. A schedule is usually posted outside the tutoring room so students can plan to receive extra help with course content. At times, students who lag behind are placed with the more outstanding students in study groups, which form a basis of support for struggling students.

Additionally, course faculty is available during office hours to clarify content and to discuss any issue students may have. Male students are informed of the availability of our male faculty mentor, if they so desire to meet with him instead. Tutoring is also available through the e-tutor website. Students follow specific guidelines for submitting electronic questions and are required to be specific as to what help they need. Communication via e-tutor requires students to convey information such as assignment, textbook, edition, page number, and any other relevant materials that will help facilitate the process. Students provide a valid email address for ongoing communication and feedback.

Mentoring Opportunities. Addressing the need for faculty mentoring of male students focuses on the benefit of having professional role models. Ideally, male faculty can fulfill this role. However, only about 5% of full-time teachers in nursing school today are men.4One strategy that could provide mentorship for male students is to pair male students with male graduates of the program. For example, the American Assembly for Men in Nursing (AAMN) has initiated a chapter within the greater New York area aimed at providing networking and collaboration among the 17 colleges within the City University system. In other colleges and universities, developing bonds with non-traditional older male student mentors via establishment of mentorship programs is another means to foster a supportive environment for male nursing students.

Personal Counseling. Schools of nursing should readily refer male students to counselors to discuss problems that may impinge upon their educational experience. It’s preferable to assign a male counselor who can relate to the student’s issues. Faculty should look for red flags that may indicate a student’s need for counseling referral or a need for help with problem-solving issues. Implementation of counseling should be done early in the semester when problems first surface to avoid a point-of-no-return situation. The lead faculty could meet individually with the student after the first exam if the student does not pass, and the student can be given a choice to discuss the issue at hand with the faculty or see a counselor. The student should also be asked if they would prefer a male or female counselor.

Financial Aid. Obtaining a nursing education is expensive. The average annual cost for tuition, room, and board for the 2010-2011 academic year ranged from $8,085 at public two-year colleges to $32,617 at private four-year universities.5This does not include the cost of books, lab fees, equipment, and supplies. Additional expenses may include uniform, transportation to and from school, testing, and malpractice insurance fees. Financial concerns are some of the main reasons students struggle in or leave school.Students often are able to qualify for work-study, which provides extra cash for personal expenses. It is also possible to apply for grants and scholarships to offset the cost of tuition. Overall, some means of financing a nursing education is always available whether through state or federal funding. From time to time, small nursing incentive scholarships become available as well, which serves as additive means for helping students through a financial crunch.

 

Where Do We Go From Here?

A review of the literature has pointed to other areas in which faculty can have significant input in changing the culture of indifference towards male students in nursing programs. One such area is in the planning of clinical rotation experiences. Male students often begin their clinical rotation eager to apply theoretical concepts to clinical learning experiences. Sometimes, however, their emotions may overshadow their ability to learn. One such example is the maternal-child clinical rotation. Research suggests that male students are uncomfortable and have feelings of not knowing what to expect in the post-partum area. A beneficial strategy by faculty that could mitigate the situation is first being cognizant of students’ feelings and identifying male students’ concerns before starting the clinical rotation in any setting.

Male students may also have difficulty with the concept of caring and expressing emotion. Use of vernacular, which is broad and encompassing, would challenge misconceptions of male nurses as non-caring providers. Encouraging the use of gender-neutral language during discussions of concepts around caring would be beneficial to male students.6 Faculty can recognize that male students are able to demonstrate caring in a different way, such as touching a patient’s shoulder and providing words of encouragement—and they could show the same act of caring as holding a patient’s hand, which is so often done by female nurses.

A 2005 study published in the National Student Nurses’ Association’s magazine, Imprint, indicated that men considered nursing a “calling” and that they enjoyed “making a difference.” BMCC’s recent survey reveals similar findings. Clearly, there is a need for a change in faculty perspective of malestudents in nursing programs. Addressing the needs of male students calls for implementation of strategies that promote diversity and integration within the profession. There also must be a challenge to the public’s perceptions of males in nursing that create barriers for male students. Nursing leaders and administrators need to implement recruitment strategies that emphasize gender and racial diversity in brochures, nursing magazines, billboards, as well as in the media.7 Just as historically traditional male professions—such as medicine and law—have been altered over time by the entry of women and minorities, integrating more men into nursing programs allows the profession to proactively address the problem of gender imbalance within nursing.

 

 

 

References

1. Kaufman, KA. Findings from the Annual Survey of Schools of Nursing Academic Year 2010-2011. National League for Nursing. June 2012. www.nln.org/researchgrants/slides/exec_summary_1011.pdf.

2. American Association of Colleges of Nursing. Employment of New Nurse Graduates and Employer Preferences for Baccalaureate-Prepared Nurses. Research Brief. October 2011. http://www.aacn.nche.edu/leading_initiatives_news/news/2011/employment11

3. Moscaritolo LM. (2009) Interventional Strategies to decrease nursing student anxiety in the

clinical learning environment. Journal of Nursing Education 48, 17-23.

4. National League for Nursing. (2011). Re health affairs and the nurse educator shortage.

Retrieved from http://www.nln.org/aboutnln/blast/blast_health_affairs_response.htm

5. U.S. Department of Education, National Center for Education Statistics. (2012). Digest of Education Statistics, 2011 (NCES 2012-001), Chapter 3. Retrieved from http://nces.ed.gov/fastfacts/display.asp?id=76.

6. Patterson J, Morin KH (2002) Perceptions of the maternal-child clinical rotation:

The male student nurse experience. Journal Nursing Education 41, 266-272.

7. Roth, JE, Roth, Coleman CL. (2008) Perceived and real barriers for men entering nursing:

Implications for gender diversity, Journal of Cultural Diversity 15, 148-152.

 

1st Annual Salary Survey

1st Annual Salary Survey

While there is a range in how much nurses earn, nurses reported making more money this year than they earned five years ago. Respondents to the first annual Minority Nurse salary survey reported an overall current median salary of $67,000 and said they had a median salary of $60,000 five years ago. Further, many, though not all, employers also offer benefits, most commonly health insurance and a retirement plan.

However, those values encompass all regions of the United States as well as a variety of specialties and other factors, including ethnicity and education.

For example, respondents living in the West reported the highest median salary, $74,250, while respondents living in the Midwest reported the lowest median salary at $63,000.

To gather all this data, Minority Nurse and Springer Publishing emailed a link to an online survey that asked respondents some 18 questions to characterize their educational backgrounds, main roles as nurses, and employer type, as well as to ascertain their current and past salaries. More than 3,000 nurses responded to this survey, representing every US state and the District of Columbia. The respondents also correspond to a broad swath of the profession, with nurses working in administrative roles or performing research as well as nurses tending to patients at their bedside in the NICU or in a psychiatric clinic.

Breaking the data down reveals some key differences in salary levels.

Median salary also varied by ethnic background. People of white/non-Hispanic backgrounds earned a median $71,119, followed by people of Asian descent making a median $64,000 and African Americans reporting a median $60,500. Hispanic or Latino/Latina nurses reported a median salary of $58,000 and Native American nurses earned a median salary of $60,000. Additionally, people who identified as multiracial reported earning $50,000, as the median.

Education also affected salaries as respondents with higher levels of education reported earning more in income. For instance, nurses with a bachelor’s level degree commanded a median salary of $65,000, while nurses with a master’s level degree said they earned a median salary of $70,000.

In addition, nurses with an advanced practice nursing specialization reported a median salary of $84,000. However, nurses with a medical-surgical specialization said they made a median salary of $55,000.

The good news, nearly all respondents reported earning more than they did just five years ago.

Highlights

  • 23.2% of respondents have a PhD or other doctoral-level degree
  • 43.7% work at a college or university
  • 50.0% have been at their current job for five years or longer
  • 63.2% received a raise within the last year
  • 54.3% left prior job to pursue a better opportunity
  • 45.2% do not expect a raise this year
  • 49.1% are looking to leave their current job in coming years

Five Most Common Specialties

  • Critical care (NICU, PICU, SICU, MICU)
  • Certified Nurse Educator
  • Medical-surgical
  • Advanced practice nursing
  • Psychiatric/mental  health

Highest Paid by Employer Type

  • Private hospital
  • Private practice
  • University or college
  • Public hospital
  • Walk-in clinic

Most Common Benefits Provided

  • Health insurance
  • Retirement plan (401(k), 403(b), pension, etc.)
  • Dental insurance
  • Paid time off
  • Sick leave

 

 

Standing Up for the Right to Be Ourselves

How do gay, lesbian, bisexual and transgender (GLBT) nurses handle the issue of their sexuality in the nursing workplace? Are they “out” at work? Do they encounter discrimination from patients and co-workers, and if so, how do they deal with it? Is their sexuality an asset, a liability or a non-issue when it comes to being a nurse?

As a gay man who is also a nurse, I am very interested in exploring these issues. I recently spent some time searching Internet nursing forums and came across a very enlightening thread. I’d like to share some of the posts with you.

The discussion began with a gay nurse asking other gay nurses for advice on how they deal with questions from patients about their home life, such as “Are you married?” The conversation quickly turned to more general comments on the broader issues of acceptance of gays in the workplace and being “out” versus “in the closet” at work.

From a nursing assistant and Army medic: “There is NOTHING wrong with keeping your personal life (whatever that may be) COMPLETELY apart from your work life. That’s what professionals do.”

A nurse in Texas responds: “That’s not the real world, professional or not. Keeping my personal life completely apart from my work life is what I attempted to do many times over, but. . .it only leads to more questions, more probing and just as much if not more gossip and stories about you. Not that gossip in the workplace should rule how you react to it, but in my experience it just ends up making things worse when you act vague and mysterious about your personal life.

“For me, it has always been a struggle between [how to deal with] the ‘if you’re gay I don’t want to know about it’ straight co-workers and the ‘inquiring minds want to know’ types,” the post continues. “For the latter types, fine. Here’s my oh-so-interesting gay life. Pretty ordinary and not much different from yours. For the former types, I’ve always found it interesting that the same nurses who fall into the ‘keep your private life to yourself’ category tend to be the same ones who constantly talk about their [spouses] and children at the nurses’ station all day.

“Can all of you [nurses] out there who insist that your private lives are completely separate from your professional lives honestly say that you never make any mention of a spouse or love interest to your co-workers, whether voluntarily or [in response to] questions from your peers? [Or that you] only discuss professional work-related issues with them?”

Another poster argues, “When I am at work, I am a nurse. I leave my personal life where it belongs— at home, not work! I would never engage in discussions about my personal life at work, because I am there solely to ensure that my patients receive the best quality care.”

A critical care nurse in Texas comments at some length: “I disagree that you can work in such close environs and not share some personal information with your co-workers. Establishing professional relationships requires some personal disclosure. [People] don’t live in compartments— professional here, personal there. If you withhold all [information about] personal relationships, you will have a problem with being considered aloof or cold—and that would affect your professional relationships.

“It has been my experience that most nurses’ stations are literal Peyton Places of personal information. I couldn’t see how you could hide who you are for long. The effort to do so would seem to me to just cause too much dang stress—. “Will some people be comfortable with [your sexuality] and others uncomfortable? Of course. You have to read each individual and [then decide to give or not give] details of your life based on [how accepting you think that person would be]. That’s not the same as saying that you should remain ‘in the closet’ to co-workers who would have a problem [with your being gay], but you can certainly de-emphasize your conversation [about that aspect of your life when you’re working with them]. The bottom line is: as co-workers we have to work together, which means some give and take on lots of issues, including this one.

“I would think that [in this day and age] most of your co-workers would have come to terms with this issue anyway. It is my experience that there is either a higher percentage of gays in nursing [than in other professions] or at the least, a higher percentage of gay nurses who are willing to be ‘out’ about it. As such, most of your co-workers should have had ample opportunity to ‘get [used to] it.’

“As far as patients go, your relationship with them is far more temporary. I would think it would be, if not appropriate, then certainly more convenient to not bring it up and only disclose that information rarely, [especially if you are working with older patients]. The older generation is much more fixed in their [biases and stereotypes], and a few days’ exposure to a challenge of those stereotypes is not going to change them, [especially if] they are sick enough to be in the hospital or a family member who is stressed over their loved one being in the hospital.”

What an interesting and revealing conversation! These posts shed light on some important issues that are all too often overlooked in discussions about the need for more diversity in the nursing workforce. Above all, they show that while GLBT nurses face many of the same biases and barriers to acceptance as racial and ethnic minority nurses, we must also deal with a whole set of other challenges that are uniquely our own.

To Thine Own Self Be True

As a gay RN who is now in his 40s, I have seen the incidence of homophobia in the workplace decline quite a bit in recent years. Of course, that’s partly because I moved from Georgia to more liberal California to escape some of that. But all in all, it’s a more accepting workplace.

Like other groups who are perceived as “different” by the majority population, GLBT people have had a tough time as a minority in society. I remember when I was in my 20s and saw my first gay bashing. Then, when [21-year-old gay college student] Matthew Shepard was beaten to death [in Wyoming in 1998], it put homophobia in the national spotlight.

Since then, many states and organizations have taken action to protect GLBT people from various kinds of discrimination, including employment discrimination. While it’s still legal in 26 states to fire someone because of his or her sexuality, another 25 states have laws on the books protecting homosexuals from workplace discrimination. Some of the gay participants in the abovementioned Internet nursing forum say they rely on their hospital’s code of ethics to protect them from harassment in the workplace.

As for myself, I’m out at work. I have a partner of six years and I find (some) men attractive. That’s who I am. I have a sexuality and while it’s not really part of my work life, I am not going to hide it in fear. It is just as beautiful and worthy of respect as any other part of me or anyone else. We owe it to the next generation to leave this world in better shape than we found it. I do that, in part, by fighting homophobia and promoting tolerance. I perform my nursing care in a nonjudgmental fashion and I don’t expect to be judged if my sexuality is revealed in casual conversation.

Nursing is, by its nature, a very personal profession. We perform embarrassing and sometimes painful procedures on people, and so our patients sometimes want to know a little bit about us. Accepting who I am allows me to better accept other human beings for who they are. Some people are in a mindset that requires some personal growth before they can be accepting of gays— or blacks, or Indians or any other minority. It’s not for me to shelter them from my sexuality and stunt their growth nor to judge them. I owe it to the world to be a good person and a worthy nurse who, among many other things, is an unashamed homosexual. I don’t accept intolerance and I point it out when I see it.

Based on those Internet forum posts, it would appear that the main concerns on the minds of today’s GLBT nurses are about disclosure— whether to hide or downplay their sexuality at work or to stand up for their right to be accepted as who they are. That this is still an issue clearly shows how laws against equality for gay people—such as the recent Proposition 8 in California, which took away same-sex couples’ right to marry—can be passed in this modern age. If gays are afraid to stand up and be counted in the workplace, then people who are on the fence regarding GLBT rights will never know who we are and what great people we are. They will never know what positive role models we are as nurses and as minorities fighting for acceptance in society. And most importantly, they will never know about the unique qualities, knowledge and insights we bring to the nursing profession and to patient care.

We bring compassion and a special advocacy for the underdog. We have known discrimination and the fear that comes from being different. GLBT nurses turn this into an ability to strive harder to meet the needs of minority patients and the underserved. We know what it’s like to have to work twice as hard as other people to reach the same goals. We cherish the things it takes us more effort to achieve, such as marriage, children and equal rights under the law. We respect people for who they are as individuals, regardless of skin color, gender, age or affliction. That’s what GLBT nurses bring to the nursing workplace. Now it’s time for us to step up and be recognized for those contributions. I urge all GLBT nurses to bring one more very important thing to the work we do: the willingness to stand up and be proud of who we are.

Wounded by Words

Entering the patient’s room, I immediately took note of the look on the elderly woman’s face. There was no way I could look past her grimacing. As an African-American male nurse, I had seen this look before and knew it was in response to my gender, my race or both. Pulling away from the side of the bed where I was standing, she demanded: “Where are all the white people?”

Busy and rushed for time as most nurses are, I was not sure how to handle this situation and still get my medication pass done in a timely manner. I did not think therapeutic communication or touch would work in this particular case. She would not let me get that close to her, either physically or emotionally. Acting as if I could not comprehend her, I offered her the medications that were ordered. She looked at the medicine cup and abruptly said, “I’m not going to take that!” Now the dilemma had evolved into how to distribute medication to this patient.

Who knows what was going through this woman’s mind? Maybe she thought that my being alone with her in her room was a perfect opportunity for racial retaliation: Here was this black man who was finally going to pay her back for centuries of racial injustices. More than likely, she felt I was not intelligent enough to follow the physician’s orders and that the meds I was offering her were incorrect. At this point, it was all irrelevant. My intention was to help her, but in her mind I only represented someone from a race she considered inferior and had spent a lifetime hating.

This patient may not have known the date, or what the name of the health care facility was, or even her own name, but she could and did hold on to racial intolerance. Years of other life training may have abandoned her, but the training she had received about race remained intact. I saw in her face what could only be described as a mixture of hate, fear and anxiety. The year was 2004, but in my mind this incident transported me back to our nation’s past and gave me a taste of how ugly and complicated life must have been for past generations of black and white Americans.

Frustrated with my inability to administer medications to this patient, I exited her room and searched for the other nurse on duty. She was also African American, but I thought there was a chance she would fare better because she was female. This nurse was not new to the ward and she was not surprised by the patient’s reaction to me. When I asked her how I should handle this matter, she replied, “She won’t take medications from me either.”

Needless to say, this patient did not receive her medication that particular shift. I documented the incident and continued to care for the patients who would allow me to.

Unfortunately, it seems the only repercussions that resulted from this incident of racism were the painful feelings that have continued to stay with me. Nothing was ever addressed on any other level that I was made aware of. My employer’s apparent reluctance to acknowledge the problem disappointed me. It seems that even the most liberal and up-to-date facilities fall short when it comes to addressing this issue.

 

“Get Over It”

Another of my notable experiences involving racism in a patient care situation was an encounter I had with a veteran. This incident affected me deeply for two reasons. First, I am a veteran myself, having served eight years in the U.S. Air Force. Veterans usually feel a kinship toward other vets, regardless of their background, branch of service or duration of service. Secondly, I had taken care of this particular patient for some time and thought that our relationship had somehow transcended race. Until this incident occurred, our interactions had always been very cordial and respectful.

This was a patient who needed total care. He was paralyzed on his left side from a stroke and needed another’s help for even his most basic needs. The incident occurred on evening shift. Because of our limited staffing, once the total care patients were put to bed for the night it was our practice to leave them in the bed until morning. But on evenings when bingo was being played, I would help this patient get dressed again, put him in a wheelchair and push him to wherever the game was located.

He was prone to fits of yelling and anger, but in the past I had always been able to calm him down. Entering the room this particular night, I could tell that he was not in the best of moods, but I was not expecting the encounter that ensued. All of my attempts to calm him failed. In fact, they seemed to just heighten his anger. And at the apex of his anger, he yelled, “N- – – – -, get out of my room!”

Many emotions ran through me at that moment-certainly too many to count. What I did next escapes me. I assume I must have straightened his blankets and did what I thought would make him comfortable. I do know that I exited his room angry and told the charge nurse about the encounter.

The nurse in charge was totally sympathetic but at a total loss as to how she should handle the situation. I was sitting in the staff break room obviously angry and frustrated, with my arms crossed on top of my chest. She under- stood that she could not just let this incident go without some intervention on her part. Her decision was to call the house supervisor.

I had what I thought was a decent working relationship with the house supervisor, so I was not against discussing this incident with her. When the evening supervisor arrived on the ward, I was still in the break room fuming from the incident. She came in and asked me to explain what had happened; I gave her my interpretation of the incident. Her reply did nothing to soothe my anger. She basically said, “Get over it.”

She then began to relate some incidents of disrespect she had encountered in her own journey through nursing. Being called out of her name, having her level of intelligence questioned and being touched inappropriately were all situations she described. She seemed to indicate that this was part of our job and we had to take it.

I sat there listening, refusing to believe what I was hearing. I also refused to accept her personal doctrine that this type of treatment was “normal” and that nurses should accept it. I sat there respectfully, but her words did nothing to redeem my dignity or help repair my relationship with this patient.

The incident did send some minor ripples toward the higher-ups at the facility. They never spoke to me directly, but their messages found a way to me somehow. The messages consisted of blaming the occurrence on the patient’s condition, saying that stroke patients sometimes react that way. The patient’s medication was also increased, especially his psychiatric medications.

 

A Gesture of Healing

The one person who truly seemed to understand how much this incident had hurt me was the patient’s wife. His wife, who was a volunteer at the facility, was tireless in her efforts to continue caring for him and many other veterans. She seemed to be his exact opposite in terms of temperament. She volunteered mainly on the day shift, but our paths crossed as the day shift ended and the evening shift began. She too had always been very cordial and respectful to me. The day she confronted me about this incident was no different. I did not intentionally avoid her, but I was not looking forward to encountering her either.

Our discussion took place in the doorway of the patient dayroom. She had always been very direct and that part of her personality was very much in evidence now. She looked me straight in the eyes and said, “I heard about what happened between you and my husband, and I would like to apologize for the awful word he called you.”

I immediately dropped my head and was silent, not because I was ashamed but because I was so full of anger. She continued, “My husband was not a man who used that type of language when he younger, and we did not raise our children to use that type of language either.”

I was still silent, but now we were staring into each other’s eyes. We could both see how deeply this incident had touched me. “I have offered an apology and I can not force you to take it,” she said, “but I hope that you will and that you will continue to care for my husband in the same manner as you have always done.” That was her last statement to me as she gently patted my hand and walked away.

We did speak again after that, but the subject of what happened that day was never touched on. Our conversations were genuine and honest, but I believe we both felt that enough had been said on the subject. Even though I never said anything to her about the incident, she comprehended the depth of the damage her husband had caused by uttering that offensive word.

 

Emotional Scars

As much as I would like to say that my treatment of that patient did not change, the truth is that it did. I was still very professional and considerate to him. But all of the things one would describe as “extras” ceased. I never got him up for bingo again and my conversations with him held brevity in my tone.

Time passed and I was transferred to another unit at the facility. But I never forgot that patient or that painful incident. Any time I visited that unit to see past co-workers, I would always peek into his room just to see how he was managing.

I began to hear that his health was declining. By the time I had gathered enough courage to actually step into his room, he had deteriorated to the point where he was alert only to himself and being fed by a nasogastric feeding tube. I stood at his bedside and asked him how he was doing, but all he could do was gaze up at the ceiling and mumble incoherent words. He continued to steadily decline until a co-worker notified me of his death.

Later that week I read his obituary. I was surprised at the sterility of the announcement. There he was in an old picture from his military days, hat cocked to the side, smiling. The obituary mentioned a lifetime of loved ones and military service. It was brief and to the point. He existed, but now he was gone.

I was not sure of my feelings then and I am still not sure of them now. All I knew was that he was dead and our joint legacy of pain had died with him. But it still lives in me.

The point of this personal reminiscence is that we in the nursing profession must ask ourselves how to handle the issue of racism in the nursing workplace, and more specifically, how to handle racism when it is expressed by patients. I guess the first step is to admit that the problem exists. Even when they are in a hospital receiving care for the effects of diseases, aging or traumatic physical injuries, there will always be some individuals who will put their racial ideology above anything they are confronted with. That is their right.

But we professional caregivers of color also have the right and the obligation to stand against such behavior and demand to be treated with respect and dignity.

Men in Nursing School

Increasingly, men are pursuing careers in nursing, attracted by the same benefits that have traditionally drawn women to the profession: abundant job opportunities, good salaries and, above all, the opportunity to make a difference in people’s lives.

Even though men account for 50% of the population, only about 7.9% of registered nurses in the U.S. are male (up from 5.8% in 2004). That’s a smaller percentage than in other developed countries, such as 10% in the United Kingdom, 18% in Germany and 23% in the Netherlands. But those numbers are beginning to rise as nursing schools around the country keep reaching out to recruit more male students into their programs. According to the American Association of Colleges of Nursing, as of December 2008 the percentage of men enrolled in baccalaureate and master’s degree nursing programs was 10.4% and 8.9%, respectively.

In previous generations, most men who made the pioneering decision to go to nursing school had to overcome significant barriers, such as gender discrimination from female instructors and students, unequal access to clinical training in areas like obstetrics and gynecology, and lack of support from family and friends who perceived nursing as strictly a women’s career. But what is it like to be a gender minority nursing student in the 21st century? Do today’s men in nursing school still face these same challenges? If so, how are they dealing with them? And do male students of color feel that being both a racial/ethnic and gender minority puts them at a double disadvantage compared to other nursing students?

Here’s what seven current or recently graduated male students have to say about their experiences in a female-dominated educational environment—including their man-to-man advice for other guys in nursing school and their recommendations for how nursing programs and instructors can maximize their male students’ chances for success.

Stuart Davidson

Senior, BSN Program
University of Pennsylvania School of Nursing (Philadelphia, Pa.)

Both of Stuart Davidson’s parents work in health care—his mom is a nurse anesthetist and his dad is a health care administrator—so nursing was a natural career choice for him. “Nursing is a good route to get into health care quickly,” he explains. “I wanted to get immersed in the field early to make sure it was indeed what I wanted to do.”

The choice hasn’t come without challenges. And as president of the Male Association of Nursing at the University of Pennsylvania (MAN-UP), Davidson has heard his share of similar stories from other male students on campus. “[Men] who tell you they haven’t faced challenges [in nursing school] are either ignoring it or choose not to [talk about it],” he says.

Some of the barriers male nursing students face as gender minorities are subtle, such as the pressure put on them by some female instructors who are skeptical of male students, Davidson notes. “[Some of them] will give men a harder time—challenge us because they think we shouldn’t be there.” Other roadblocks are more obvious, like encountering female patients in obstetrics clinicals who don’t want to be examined by a male student.

Davidson’s advice for other men in nursing school is simple: Be positive and have a strong support network. “Attitude makes all the difference,” he emphasizes. “I’ve embraced my role as a male in a predominately female profession.”

Joining a support group like MAN-UP can also be an important success strategy, he adds. It helps to have someone to talk to—especially other male students who are going through the same thing. But Davidson also knows men “who have all females in their support structure.”

Seeking out a supportive faculty member, preferably male, can be helpful too, Davidson says. “Otherwise, it’s easy to be passive—one of five guys who sit in the back of the room and don’t speak up. You need someone to encourage you to speak out, to hash out your goals and find your niche.”

In addition to sponsoring social events to give members an opportunity to connect with other male students informally, MAN-UP also invites practicing male nurses to speak to the group about their specialties. “They’re good role models,” Davidson says. “Some guys [in the group] have matched up with speakers for mentorship.”

Spencer Stubbs

Freshman, BSN Program
University of Pennsylvania School of Nursing (Philadelphia, Pa.)

Like most first-year students entering the University of Pennsylvania School of Nursing, Spencer Stubbs’ greatest challenge is getting the hardcore science classes out of the way and preparing for clinicals. But as an African American male, he also deals with the stress of being both a racial and gender minority in the classroom.

“I’m one of only 18 males [in my cohort],” he says. “[Some female] instructors make little comments like, ‘for you nurses—and you males who are preparing for pre-med…’ They think that we males are in here only because of the bad economy.”

Penn offers a dual-degree program in nursing and health care management that attracts many male students. “But some, like me, do want to work in a clinical setting, not management,” says Stubbs.

Although he initially feared experiencing both sexism and racism in nursing school, so far the latter hasn’t been a problem for him. “I haven’t encountered [racism from professors or classmates—at least not yet],” he reports. Still, he can’t help noticing that “I am the only African American male in my nursing class. It’s a little sad that even today, in the class of 2013, there’s only one.”

Stubbs has a peer advisor and a nursing instructor who are both African American men. These two role models have eased his prime anxiety about starting nursing school: Will there be people like me? They’ve also given him several pieces of valuable advice: Step back before a bad situation escalates. Don’t lose your cool. Let ignorant comments pass. Reach out to others. “At the end of the day, you have to make sure you attain your goal,” Stubbs says.

He has also gained support and guidance from several student groups on campus, including MAN-UP, Minorities in Nursing Organization (MNO) and the Black Students League.

Stubbs was urged to consider a nursing career by his physician sister, Aisha. “I chose nursing because, as they say, ‘doctors focus on treating diseases and nurses on treating people.’ I definitely want the patient interaction.”

Ashley Vasnaik

Junior, BSN Program
University of Portland School of Nursing (Portland, Ore.)

“Some people give me looks like, ‘what are you doing here?’ I don’t know if it’s because I’m a male, or I’m not Caucasian, or what,” says Ashley Vasnaik, a nursing student of East Indian ancestry.

One of seven men in a cohort of 145 students, Vasnaik hasn’t encountered gender bias directly, but he’s heard stories from other male students who have. It usually comes from female instructors, he says. “Their attitude is ‘what do you think you’re doing here? Go back to engineering or business, where a man belongs.’ They think that nursing is a woman’s field and that care needs to be given from a female point of view. Sometimes there’s an assumption that any male who enters pediatrics or labor and delivery has an ulterior motive.”

Vasnaik’s support network includes his family—his mother and sister are nurses—and classmates, both male and female. He advises other men in nursing school to befriend women students, too. “[Female students] come up and introduce themselves to me all the time,” he says. “As one of the few males in the program, I stand out.”

As for man-to-man networking, Vasnaik adds, some male students belong to a Facebook group called M.U.R.S.E. (Males United to Redefine Society’s Expectations [of Male Nurses]. The word “murse” is also a combination of “male” and “nurse.”) And on campus, “we kind of mentor each other,” he says. “Younger guys will stop me in the hall and we’ll talk for 10 to 15 minutes. They might say, ‘I’m worried about my anatomy exam,’ and I’ll give them my best advice.”

Vasnaik believes that persistence and a positive attitude are the keys to success. “Don’t think ‘I’m going into a difficult profession and will have problems [because of my gender],’” he advises. “Instead think, ‘I have my study habits down and my coping mechanisms in place.’”

Paul Dominguez

Senior, BSN Program
University of Texas Health Science Center at Houston School of Nursing (Houston, Texas)

The biggest barrier for Paul Dominguez, a Hispanic BSN student, was adjusting to taking classes on a major university campus. “I had a tough time the first semester,” he recalls. “But the school is really accommodating, and things started to click.” He did so well, in fact, that he is scheduled to graduate in January 2010—from a class that comprises about 10% men.

Dominguez was encouraged by his mother, an LPN for 30 years, to transfer from business administration to a nursing major. He initially felt hesitant in the nursing program. “[Being accountable for] people’s health and safety was an enormous responsibility,” he says. “But it was OK once I gained some confidence and got over my self-doubt from being new to the medical field.”

While some male nursing students of color might view their status as a double disadvantage, Dominguez does not. “Here in Houston, it’s a double plus,” he explains. “The county hospital I’m interested in working for is looking for Hispanic nurses who speak Spanish. And male nurses are always in demand.”

He aspires to become an emergency room nurse after he graduates. Ever since he saw a male Hispanic nurse working in the ER during rotations, “that’s been my role model.”

For the most part, Dominguez says, people today are more accepting of male nurses. Still, he did experience some occasions in clinicals where “some patients [were] hesitant [about having] a male nurse, especially female patients, because they aren’t used to it. It’s unusual.” But his friends, family and classmates have been supportive. And the environment at the school has been male-friendly, with posters of men as nurses hanging in the hallways.

“The only class that we male students had trouble with was OB, because guys don’t have [the first-hand] experience with female physiology and babies [that women do],” he adds.

Dominguez does have one piece of advice for female nursing professors: Be sensitive to the uniquely male communication style. “Guys really just want to know how something is working, how to fix it and then get on to the next thing,” he says. “We don’t want fluff. We’re not interested in hand-holding.”

Dennis Niekro

Graduate Entry MSN Program
Ohio State University College of Nursing (Columbus, Ohio)

Dennis Niekro, a student who is making a career change into nursing, is enrolled in a master’s entry graduate program for people who have completed a bachelor’s degree in a major other than nursing. (His undergraduate degree is in psychology.)  He previously worked for 15 years in education, medical research and at a hospice. Now he is pursuing an MSN in the adult nurse practitioner program.

Niekro says he hasn’t encountered any gender bias problems in nursing school. “Maybe I’m in a unique place, but I haven’t experienced difficulties. No issues at all. There’s a diverse population at OSU and the environment at the university is one of tolerance. The College of Nursing has also done a tremendous job of recruiting male students.”

According to Niekro, 17% of the 58 students who started in his cohort in fall 2008 were male. The percentage of men in the 2009 cohort was almost 19%. “In all [clinical] areas, the male students have been well received,” he adds. “Our OB clinical instructor was especially sensitive [to our needs].”

Niekro’s friends and family members have also been very supportive, viewing his choice to enter nursing as a natural and logical career progression. “My parents have not been vocal [about it] with their friends,” he admits. “[They’re not] boasting ‘my son has gone back to school to be a nurse practitioner!’ But that just speaks to the older generation’s view of nursing.”

For Niekro, being a gender minority in nursing school has been a learning experience in itself. “It’s interesting, as a man, to immerse myself in a profession that has been dominated by women,” he comments.

He sees the recruitment and retention of men in nursing school as a system-wide issue. “Schools should try to recruit more men into clinical faculty positions,” Niekro says. “It is important to have more of a gender balance in nursing leadership positions [on campus]. That helps to normalize things a bit for [male students] who may have their own internalized issues.”

He recognizes that the nursing faculty shortage and the low representation of men in nursing make it extremely challenging for many schools to recruit male instructors. But he’s seeing some encouraging trends. “Here at Ohio State,” he says, “a grad student who recently completed his PhD in nursing assumed the role of interim director of the women’s health and nurse midwifery programs.”

Steve Wooden, CRNA

Doctoral student, DNP Program
Duke University School of Nursing (Durham, N.C.)

Steve Wooden, an advanced practice nurse specializing as a certified registered nurse anesthetist (CRNA), has been working in the nursing profession for 30 years. He is now continuing his education by pursuing a Doctor of Nursing Practice (DNP) degree in nurse anesthesia at Duke University School of Nursing, where he says his gender is not an issue. But back in 1979, when he first graduated from nursing school with his BSN degree, he was the only man in a class of 80 students.

“Maybe I was naive, but I didn’t consider it a problem,” he recalls.

Although Wooden had no trouble being accepted by his undergraduate instructors and fellow students, some of the physicians and administrators objected to his presence. “Their attitude was that because I was a man and in nursing school, there was something wrong with me,” he says. Having the support of classmates and professors helped him cope, as did “my ambition to be the best nursing student I could be.”

What advice does he have for how nursing schools can ensure that male students have an equal opportunity to succeed? “Establish non-discriminatory guidelines for both male and female students,” Wooden recommends. “My biggest experience of bias [in my undergraduate program] was when male physicians asked that I not be allowed into certain clinical areas [such as obstetrics].”

Fortunately, he says, some of the doctors he had to work with were more tolerant than others. For example, in one of his clinicals he was able to successfully assist a physician at a shopping mall breast exam clinic, because the patients were first asked if they were comfortable having a male nurse.

Wooden notes that some of the gender-based challenges he faced 30 years ago continue to be an issue for male nursing students today, such as avoiding any perception of inappropriate touching with female patients or classmates. “When we took turns being clinical models, for instance, I made sure everyone was comfortable with that,” he says. “But if a female classmate was not comfortable with the idea of being examined by a male student, I took it as matter of [her personal] feelings, not overt discrimination. I didn’t let it bother me. Most of the students were mature and understood the context.”

Lopsang Sakya, RN

2008 graduate, ADN Program
Portland Community College (Portland, Ore.)

When Lopsang Sakya became a registered nurse a year ago, it marked the pinnacle of an 11-year journey. Sakya, who is of Nepalese and Tibetan ethnicity, immigrated to the U.S. in 1997 and worked a series of grueling jobs in New York City.

“I worked 12 hours a day, six days a week for $250 a week,” he says. “For four years I did bike delivery , riding as fast as I could to deliver food hot. It was the hardest job I ever had.” But tips doubled his earnings and he was able to save almost his entire pay by sleeping on a cot at his employer’s premises.

Sakya’s oldest sister was studying nursing in Oregon, and she encouraged him to do the same. The job security and the salary appealed to him. Still, his decision to become the first man within Portland’s small Tibetan community to enter nursing brought him up against some cultural barriers. “In my [native] country, most people think nursing is only for women,” he explains. “They make fun of men [who want to be nurses]—‘That’s a woman’s job!’”

As a student nurse at Portland Community College, he initially felt awkward as one of only two Asians in the class, and the only Asian man. “I felt a little different from everyone else in the beginning, but I acted [like all the other students] and it was fine.”

Even though he was one of only five men in a class of 40 nursing students, Sakya doesn’t remember ever being singled out because of his gender—or rather, he didn’t at first. Prompted a little further, he recalls, “oh, yeah, obstetrics. A lot of women [patients] didn’t want a male nurse, but I didn’t want to [work in] obstetrics anyway, so that didn’t bother me.”

Today Sakya is a medical-surgical nurse at Legacy Mount Hood Medical Center in Gresham, Oregon. Although he is the only Asian male nurse in a staff of approximately 130 on his floor, three of his fellow nurses are Asian and six are men. And he gets along well with both co-workers and patients.

“Work is fabulous; everyone is just great,” he reports. “The patients are curious [about my background]. They’ll ask me ‘where are you from?’ and ‘how long have you been here?’ When I tell them, they always say, ‘oh, that’s nice. You came to the United States to go to school, and you’ve stayed to help people.”’

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