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