Diversity is a worldwide issue that touches nearly every topic. In nursing, it includes all of the following: gender, veteran status, race, disability, age, religion, ethnicity, socioeconomic status, sexual orientation, education, nationality, and physical characteristics. How? Because every day, medical professionals everywhere (especially nurses) encounter people from every race, religion, ethnicity, cultural background, gender, sexual orientation, etc. Every interaction creates diversity and as such the issues that surround the topic are just as vast and as numerous.
The American Nurses Association (ANA) defines diversity awareness as “acknowledgment and appreciation of differences in attitudes, beliefs, thoughts, and priorities in the health-seeking behaviors of different patient populations.” But diversity is more than just a definition. Diversity in nursing means knowing how to respond if a patient becomes violent towards you for your culture, gender, or religion, or what to do next if a medical professional refuses to give you treatment because you identify as LGBTQ. While the ANA urges nurses to grow professionally and personally in their efforts to understanding diversity issues and translating those learnings to quality care for every patient, diversity efforts often involve complex issues that can’t be solved with a simple “yes, we will do better” response. True diversity efforts require action to succeed, so here are some ways to break down diversity barriers like stereotyping and close-mindedness in order to provide better health care for your patients.
Live, Work, and Breathe Diversity in Everything You Do
The number one most important thing you can do to promote diversity and inclusivity in your organization is to communicate everything as clearly as possible. Think about it. Have you ever had a supervisor who did not communicate their expectations clearly to you? Did you ever have a conversation with a patient that was downright awkward or uncomfortable because of the personal or cultural differences between you? Was there a lot of ambiguity in what they asked from you? How well did you work with that supervisor? People get frustrated, scared, flustered, upset, and discouraged. Situations escalate. The key to avoiding miscommunication in the health care space is to incorporate strong diversity efforts. Here’s why:
When diversity and representation is lacking, it’s hard for people to feel welcome. The balance of diversity in the world of medicine starts with culture and beliefs. The best way for health care providers and hospitals to get in on this? By increasing diversity efforts in hiring. Having nurses on staff that can understand the demographics of their patients, communicate, and relate to their individual struggles will improve the lives of patients and the fulfillment of the nurses hired. Why? Because it opens the door to reaching an understanding of your patient’s morals, values, language, religion, and other demographics (i.e., it makes them more comfortable in their environment).
But communication is a two-way street, therefore listening is just as important. When a diverse workforce of nurses exists, they can more effectively listen to what is bothering their diverse population of patients. This is made possible because not one nurse can relate to every cultural background, speak every language, or identify with every gender identity or sexual orientation. Nurses that actually exist in these spaces can make quality suggestions and treat their patient for the best results. In other words, hiring African American, Asian, Muslim, Christian, LGBTQ, transgender, male and female (and many many more backgrounds, religions, identities) nurses are vital to the overall care of every patient.
This communication is not only between health care providers and seekers. It is also along the health care provider plane. Clear and consistent communication among nurses and doctors will help lead to smooth transitions in providing care for a patient. Staffing a diverse workforce will lead to breaking down the barriers of stereotypes and keeping an inclusive and respectful mind when providing healthcare.
Breaking Down Stereotypes
The first major barrier is breaking down stereotypes. Stereotypes are defined as “a widely held but fixed and oversimplified image or idea of a particular type of person.” They have become fatal fallacies in our society, and in the medical profession, they can be a major player in increased discomfort between patients and nurses alike. Categorizing someone into a group or as an image of something they don’t identify with puts a strain on their livelihood and overall health. As a consequence, especially from a nursing standpoint, it can hinder a nurse’s ability to give proper medical treatment and impedes a patient’s ability to recover. No nurse or patient should feel negative pressures from their social environment for their background, especially when receiving medical treatment. Therefore, it is crucial that we attempt to break down stereotypes to help improve the acceptance and abundance of diversity in nursing to advance the openness and inclusivity of treatment and recovery for people of all backgrounds.
Shattering stereotypes is difficult. The Wisconsin Network for Research Support (WINRS) and the Community Advisors on Research Design and Strategies (CARDS) aimed at doing so through the power of “The Personal.” For six plus years, the University of Wisconsin has been funding meetings between these groups. The CARDS were people who were giving advice to researchers who want candid feedback on how they can improve their methods from those who are deemed “hard to reach.” The CARDS were made up of those who come from diverse racial, socioeconomic, and educational backgrounds. At the end of the research, WINRS found two things that can help break down the stereotype barriers:
An open-ended question that has been thoughtfully planned out
Allowing researchers to explain why they personally got into research
The reasoning behind the questions were so they would bring out past experiences in members that provoked positive emotions and reinforced human connection. Establishing an emotional experience makes it easier for people to connect. Justification for the second finding was because CARDS members originally thought they were in it only for the money.
So, what can we learn from this study on stereotypes? The biggest thing we can learn is that disconnect between groups of people is cause for concern. Stereotypes stem from a lack of understanding between groups. At the end of the day, both parties of guest researchers and CARDS members received feedback from those who they didn’t think it was possible. This can be translated into day-to-day care for patients. Finding a common ground between nurse and patient can lead to effective communication and better health care for all. In other words, the key to defeating stereotypes once and for all is with understanding, respect, and compassion.
Creating an inclusive culture in health care is incredibly important in today’s world. Duquesne University explains that inclusive nursing practices begin in the classroom. Madeleine Leininger, a nurse anthropologist, developed the idea of “transcultural nursing,” which is nursing based on a patient’s cultural considerations. Teaching transcultural nursing is a stepping stone to inclusion. Interweaving the idea of providing care based on a patient’s cultural beliefs can help establish an inclusive mindset that is respectful to the patient and will translate over to your coworkers.
Developing an inclusive and respectful mindset starts at building strong relationships and understanding, much like breaking down diversity barriers. While efforts have increased to teach transcultural nursing in the classroom, organizations have been created to help support nurses and patients where they can access resources and communities to help them adjust.
The ANA works tirelessly to be a resource for all nurses of every background so they feel welcomed and comfortable. They offer resources from a number of communities, such as the Gay and Lesbian Medical Association and the U.S. Department of Health and Human Services Office of Minority Health. They also offer resources that help you treat patients that are obese, mentally ill, or the elderly. By providing access to all of these communities in one place, the ANA wants to create an industry that is able to treat patients from every walk of life.
Diversity is the key to providing the best health care possible. Understanding how to break down the barriers of stereotyping patients and creating a culture of inclusion within a practice are the two biggest challenges that nurses face today. That is made even more difficult when it comes to being a traveling nurse. Institutes like ANA and WINRS work so hard to educate nurses and medical professionals to knock down the blockades that hinder diversity in nursing.
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.
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