Would you recommend as a career to men? David Stanley, Tania Beament, Darren Falconer, Margaret Haigh, Rosemary Saunders, Karen Stanley, Peter Wall

Abstract

Objective : The principle objective of this study was to establish a profile and perception of men in nursing in Western Australia. This paper will discuss one sub-objective which sort to explore responses to the question: “Would you recommend a nursing as a career to males that you know?” Design: Main study was a quantitative, descriptive survey design, however the question under review was significantly qualitative in nature and analysed as such. Setting : The study took place across Western Australian public and private sector health care facilities, institutions and non- government providers across rural, remote and metropolitan locations. Main outcome measures: Data was collected through responses to one question (within a larger survey) that related to recommending nursing as a career to males. An online survey instrument was used. Results: 70.5 %( n= 377) said they would recommend nursing to males. Of the respondents that selected “yes” 19.6% were male and 80.4 % were female. Of the 29.5 %( n= 158) respondents that selected “no” 24.7% were male and 75.3% female. Qualitative data reported supports the perceptions in the current workforce. Conclusion : Whilst the majority of respondents in the study would recommend a career in nursing to men, a quarter of respondents felt that a career in nursing was not suited to men. Reasons identified included; poor pay, a difficult job, men’s values were incompatible with care, or that they were using nursing as a spring board to other careers. Identifying the perceptions of men in nursing and if current nurses would promote nursing to males they knew assists in the potential recruitment of a much needed future workforce.

Author details Introduction

Tania Beament (Clinical and RN, BA, MSc Much of the literature about men in International Coordinator / Peter Wall (Lecturer) nursing asserts that nursing remains Lecturer) Murdoch University the dominion of women (White, 2014; Edith Cowan University) RN, BAppSci (Nurs), PeriOpCert Maiolo, 2014; Olson, 2014). However, RN, BN Nurs, Med within the media there is an acknowl- Corresponding Author: edgment that a change is taking place, Darren Falconer (Undergraduate as men are entering nursing in greater Course Coordinator) David STANLEY (Associate Professor numbers and even taking a hand in the The University of Notre Dame */ Adjunct Associate Professor #) recruitment of other men into nursing Australia *Charles Sturt University (Olson, 2014). Within the United RN, BN Nurs, MSc. # University of Western Australia Kingdom (UK), United States of America RN, RM, NursD, MSc HS (USA) and Australia evidence suggests Margaret Haigh (MSc Student) C/o Charles Sturt University that the percentage of men in nursing The University of Western Panorama Ave is increasing (Marsh, 2014; Pratt, 2014; Australia) Bathurst Stanley, 2014; O’Lynn & Tranbarger RN, BNurs, MA(Econ) NSW 2795 2007) and there are claims that nursing [email protected] will have a more sustainable workforce Rosemary Saunders (Associate if nurses are recruited from across the Professor) population spectrum (O’Lynn, 2013). The University of Western Australia There are no conflicts of interest RN, Ba App. Sc, MPH This article offers the results of one Key words: question dissected from a larger study Karen Stanley (Lecturer) Men in Nursing, Workloads, Nursing of the profile and perceptions of men Charles Sturt University Recruitment, Survey in nursing and midwifery in Western Australia undertaken between 2013/2014

Working Papers in the Health Sciences 1:14 Winter 2016 ISSN 2051-6266 / 20160082 1 (Stanley et al., 2014). Addressed below nurses in particular in films is generally impact negatively on men in nursing This instrument was designed and career choice for a man. the span of my career as a nurse/midwife are the results from only one sub-ob- a negative one, with men being shown (McMillan, Morgan, & Ament, 2006). validated following advice and consulta- This presented as strong theme with a and find that they add a positive influence jective that sought to explore respond- as being morally corrupt, effeminate These internal and the external issues tion with experienced nurse researchers. number of respondents commenting on to the team and calm when it becomes ent’s views to the question: “Would you or simply incompetent (Stanley, 2012). faced by men in nursing may also impact Sample: There were 1055 respondents why they saw nursing as a good career very hectic” (Female). recommend nursing as a career to males Portraying male nurses in this way has a on their willingness to recommend a to the survey. However, only 1039 choice. One respondent suggested that you know?” serious effect on the public’s perception nursing career to men they know. respondents answered question 20. that, “you meet lots of people and you 4. Suitable for Both: Nursing is a career of male nurses, which may in turn have Ethical Approval: Ethical approval was get to look after and care for people suited to both men and women. Literature Review: a negative impact on the recruitment Methodology granted from the University of Western which is interesting” (Female). Another It was also clear that respondents saw There is substantial literature available to men in nursing. Positive images of Australia Human Research Ethics commented that nursing offered a “good nursing as suited to both men and related to men in nursing generally. competent, self confident male nurses A quantitative non-experimental, Committee (HREC). stable job with good retainment figures so women. Some respondents indicated However, there is a lack of literature are less common. However, as Stanley comparative, descriptive research design Funding: This research was funded by allows job stability, also would really suit that, “gender makes no difference when it that offers insight into the issues faced (2012) concludes, these are required if was employed, using an on-line survey, the Western Australian Nurses Memorial some caring males and we could do with comes down to sincerely caring” (Male). by men in . The gap barriers are to be reduced and more men with the survey questionnaire being Charitable Trust. their skills and role modelling” (Female). Another added that it was a “good career widens when considering literature that are to be attracted into the profession, distributed via email using SurveyMonkey Data analysis: The qualitative analysis Another respondent suggested that choice for both genders” (Female). One highlights the perceptions of the peers with Meadus and Twomey (2007) to a convenience sample of registered, used to consider the free text aspects nursing was, “a good career with many respondent added, “regardless of sex of men in nursing view them, as well affirming there will continue to be a low enrolled nurses and midwives in Western of question 20 explored the data by rewards” (Male). anyone with a passion for nursing, team as how men view themselves and what representation of men in nursing until Australia. Respondents were invited to examining content for specific words, work and the delivery of healthcare they feel are the major issues that affect these barriers are addressed. complete the on-line survey at a single which were categorised and subse- 2. A Good Career for Men: Nursing is a has something to offer the profession” the recruitment and the retention of the point in time to ensure reliability. This quently created sub-categories. From career men do particularly well in. (Female). current male nursing workforce. From Ekstrom (1999), Hereford (2005), Takase, paper addresses responses to only one this, themes were identified, patterns This was also a strong theme, with a a historical perspective men have had a Maude and Manias (2006) and Bartfay question that asked participants, “Would confirmed and an integrated picture of number of respondents suggesting that 5. Helping Others: Nursing is a career long relationship with nursing, although et al. (2010) support the notion that you recommend nursing as a career to the data content was created. In addition, nursing was a career that men did well in. focused on helping others and serving this has been largely overlooked by nursing is a female orientated profession males that you know?” (question 20). detailed analysis of the qualitative data One respondent said, “we have patients the community. historical texts that in the main focus on and much of this perspective adds to a The question began with a “Yes” / “No” from question 20 took place with the aid with different cultural backgrounds While not a strong theme, a number of the achievements of women in nursing persistent inclination for nursing, as with option before asking for comments on of NVivo10 software program. and having male nurses will assist with respondents suggested that they would (Evans, 2004). Further examination by other female dominated professions e.g. the choice made. providing healthcare” (Female). Another recommend nursing to men because it Brown (2009) indicates that even though primary school teaching (Cushman, 2005) Setting: Western Australian health care Results said, “the men that I know in the profession was a career focused on helping others. the numbers of men in nursing are lower to be seen as ‘low status’ occupations, environments within the public and have done very well - in terms of career One respondent said, “if one wants to than women, the level of achievement by devaluing the contribution made by both private sector, nurse education insti- Of the 1039 respondents to question 20 progression and clinical opportunity. I also make a difference in the community and men is growing as they manage to create men and women and potentially turning tutions and some non-government (Would you recommend nursing as a feel that men within this profession have a feel good and satisfied about oneself, it’s successful careers and are promoted men away from the profession. However, providers across rural, remote and career to males that you know?”), 786 lot to offer the women they work with and a good profession” (Female). Another to leadership positions. In fact, the Roth and Colemen (2008) suggest a metropolitan locations were included in (75.6%) (n=613 female and n=173 male) the patients they care for. I have always added, nursing is a “very satisfying career evidence suggests that male nurses are number of strategies that are aimed the study catchment. selected ‘Yes’, and 241 (24.4%) (n=185 enjoyed my professional relationships with if you want to help others, (offering a) very twice as likely to hold a key management at challenging the public’s perception Survey Instrument: The self-reporting female and n=68 male) selected ‘No’. A the male nurses/midwives I have worked sociable career! Great if you love working position within the UK, than their female of nursing, with one being that the questionnaire consisted of 30 questions higher proportion of females, than males with” (Female). Another respondent with people” (Male). counter-parts (Santry, Gainsbury & Ford, profession critically assess and address in seven sections for all participants, said they would recommend nursing as supported this theme by suggesting that 2010). the image of nursing to ensure that it an additional section with 4 questions a career to males (76.8% compared with nursing offered, “a solid career (with) 6. Only the Right Man: While they would reflects gender diversity. for men only and a final section for free 71.7%), (see Table 1). management opportunities if desired” recommend nursing to men they knew, The theme of masculine identity was text comments. The findings reported in (Male). they would only do so to the ‘right’ men. explored by Fisher (2011), who investi- It appears that it is not solely external this paper are from question 20 of the In addition to the data offered in Table 1, A strong theme was that nurses would gated the differences in perceived gender factors that have presented difficulties study, “Profile and Perception of Men in only 535 of the 1039 who ticked either 3. A Positive Contribution: Men do make recommend nursing to men only if they characteristics between Australian male for men. For men who have contem- Nursing in Western Australia” (Stanley, ‘Yes’ or ‘No’ offered comments. The (or can make) a positive contribution to were the “right” men for the job or “if nurses and Australian male engineers. plated a career in nursing or who are et al., 2014) that considered the issue of majority of those who commented (n = the profession of nursing or midwifery. they are interested” (Female). Another The findings indicated that there were already within the profession challenges “recommending nursing to men.” Validity 377 / 70.5%) said they would recommend Nursing were also recommend because, said, “nursing is a physically and mentally differences in expressive characteris- are evident. Issues, such as communica- of the instrument was confirmed as much nursing to males that they knew. Of the men can make a positive contribution. active job that they might be interested tics between male nurses and male tion difficulties, the lack of acceptance of of the questionnaire content was based respondents who selected ‘Yes’ 19.6% One respondent suggested that, “I have in thinking about” (Male). The following engineers, with the male nurses believing men in nursing by some of their female on a similar questionnaire by Hodes were male and 80.4% were female. Of found working with male midwives, helps view paralleled this opinion, “I would that they had feminine characteris- colleagues and the residual effect of the Research (2005) that sought to explore the responses who selected ‘No’ (n= to balance out the female ratio” (Female), if it was someone with an affinity and tics which enabled them to undertake traditional female orientated profession the image of male nurses in California. 158 / 29.5%) almost a quarter were men and that, “men bring a completely ability to deal with people in vulnerable nursing activities and was essential for (24.7%) with the majority (75.3%) being different perspective and often break up situations and if they were interested nursing. Whereas, the male engineers female. the “oestrogen” fuelled work environment in “caring” for people as opposed to held strongly to the traditional view Table 1: Would you recommend nursing as a career to males that you know? (in a positive way)” (Female). Another someone only interested in being an of masculinity in order to work within The ‘Yes’ responses respondent suggested that, “male nurses expert technical nurse – i.e. possibly in ED/ engineering. It is these types of examples No Yes Total A plethora of reasons were offered in can be caring and also calm under ICU etc” (Female). where the ideology of gender stereo- support of recommending nursing to pressure” (Female), and that in a “female typing needs to be eliminated if more n % n % n % men, with many respondents providing dominated workforce, an increase in 7. Something Different: Because men men are to be encouraged into the Female 185 23.1 613 76.8 798 100.0 more than one reason. Analysis of the male team members aids in allowing the offer something different that adds nursing profession (Fisher, 2011). comments resulted in the identification nursing population to be more reflective value to the nursing profession. Male 68 28.1 173 71.7 241 100.0 of seven key themes. The themes are as of society and adds value to the nursing A number of respondents suggested Stigmatising male nurses creates a barrier, follows: cohort through diversity” (Female). that men added something different to which may prevent men from entering the Combined 253 24.3 786 75.6 1039 100.0 Another said, “I have worked with a the profession with one stating, “men profession. The media’s portrayal of male 1. A Good Choice: Nursing is a good number of male nurses and midwives over have a lot to offer (nursing). They are

Working Papers in the Health Sciences 1:14 Winter 2016 ISSN 2051-6266 / 20160082 2 Working Papers in the Health Sciences 1:14 Winter 2016 ISSN 2051-6266 / 20160082 3 much more readily accepted now than conditions. Discussion those selected by women (11.3% men / larger study, almost twice as many men it is a good career choice, it allows men to in previous times. They see things from Respondents felt nursing offered poorly 10.5% women), the disproportionately (21.4% male / 11.7% female) suggested make a positive contribution to the health male perspective which is valuable when paid work with comments such as “poor While the larger study aimed to establish small number of men in the nursing that a disadvantage of nursing was the care of others and as long as the man is, offering holistic ”care (Female). Another earning capacity” (Female), “allied health a profile and perceptions of men in workforce in Western Australia (8.82% lack of ability to work independently and ‘the right man’ and focused on helping said, “I do think if more men came into positions are afforded better recognition nursing in Western Australia, this paper men / 91.18% women) (NMBA, 2014) significantly more men suggested that others or adding something of value to the profession the perception of nurses and do not have the same stress or has focused on the results from one makes this disparity very significant their morale was poor (39.2% male / nursing they would be welcome” and would change” (Female), and that “I workloads levels, most other professionals question within the study that sought (Stanley et al., 2014). This concept 25.2% female) (Stanley et al., 2014). encouraged to join the profession. About studied with a male midwifery student have a higher level of autonomy, ability to to explore respondent’s answers to was supported by findings from Hodes a quarter of respondents felt a nursing and was provided care by a male midwife set up business or work privately” (Male). the question: “Would you recommend Research (2005), with results pointing Female nurses offered a more emphatic career was not suitable for everyone and with my third baby. I feel they have a Another said, “in a female dominated nursing to a male that you know?” Most toward a general view that many male endorsement of the advantages of in particular, men. As well, the pay was great empathy and provide excellent profession pay is lower, promotional respondents said they would (75.6%), nurses progress in their careers more nursing than did male respondents poor, the job too hard, that men had care” (Female). Lastly, one respondent positions once SRN are very limited and with slightly more women than men quickly than women, or that a greater (Stanley, et al., 2014). This apparently inappropriate values or that men were said, “I always encouraged men to look at often require a move away from patient answering “yes” (76.8% / 71.7%). About proportion of men seek out and attain greater degree of enthusiasm of female using a nursing career as a spring board nursing as I have always felt that this is care. Another respondent said, “males one quarter would not, although more of and senior respondents, for promoting the ‘men in to other careers would not recommend what is missing in the nursing profession” in Mental Health are quite often seen as the male respondents indicated that they positions. nursing’ message, and the fact that fewer a career in nursing to men they knew. (Female). security officer/bully boys to deal with would say “no” (28.2%), compared with men would recommend nursing to males However, it is worth noting, as one person aggressive clients” (Male). the female respondents (23.1). The quarter of respondents who that they knew brings into question the commented, “regardless of sex anyone The ‘No’ responses suggested that they would not level of career satisfaction experienced with a passion for nursing, team work and Twenty four percent of all respondents 4. Too Difficult: Nursing is too difficult Analysis of the comments indicate that recommend nursing as careers to men by the male respondents. the delivery of healthcare has something would not recommend nursing to a for men to do, and too difficult for them respondents suggested that they would said it was because; this was not a career to offer the profession” (Female). male they knew. Many reasons were to enter. recommend nursing as a career to men for just anyone and specifically it was In the wider study, when respondents offered in support of their decisions and Others felt nursing was too difficult they knew because it was a good career not suitable for men; because the pay is were asked, ‘why do you think more men many respondents offered more than a career for men saying, “the study is poor; the work too difficult; because men are not attracted to nursing?’ (Stanley choice, it was a good career for men and Acknowledgements one reason. During the analysis, six key tough” (Female) or that there was a, “low that men could, and do make a positive use nursing as a stepping stone to other et al., 2014). Poor salary was identified themes were identified, these were: benchmark to enter nursing lowering the contribution to the nursing profession. careers; or because men have values as a significant reason and was also standard and there is a lack of male role Comments also supported the notion that are in contrast to the core values of offered as a motivating factor for leaving Western Australia Nurses Memorial 1. Not Anyone: Nursing is not a suitable models or peer support...the work is just that while nursing was suited to both nurses or the nursing profession. the profession, particularly among Charitable Trust, WA Department of job for anyone, not just men. too difficult (find an easier job) / always men and women, respondents hoped male respondents. However, the most Health, Chief Nurse and Midwives Some respondents strongly expressed need to do more study” (Male). the right men, focused on helping others The data offered from this question popular options selected by respondents, Office that nursing was not suitable for men or and who added something different or pointed toward a lower level of career regarding why more men are not attracted women. One respondent said, “I would 5. Wrong Values: Men’s values and satisfaction among male respondents. to nursing, were ‘nurses and midwives an additional value to nursing could be Recommendations not recommend the profession to either interests are not reflected in the nursing encouraged. The results suggested that it This apparently lower degree of are seen as intrinsically feminine’ (64.7% males or females. For the level of education professions. was evident that, “men are very welcome enthusiasm may also be found in the male / 73.2% female), and that nursing is • The message that nursing is a suitable required I feel there is inadequate financial Respondents also said that men’s values in nursing” (Female) and should be responses to other questions in the a ‘traditionally female occupation’ (66.8% career for both men and women needs recompense in comparison to other and interests conflict with nursing and sought or encouraged. study. In one other question of the larger male / 72.4% female). These opinions and to be reinforced. fields” (Female). Another said, “nursing that“ (Men) will go for management study (Stanley et al., 2014), 7.2% of male perceptions of negative stereotypes were • Further study is needed to discover is no longer the profession it used to be. positions and leave less opportunity for In other parts of the larger study it was respondents, compared with only 2.7% popular among the male respondents, if men who are nurses have generally Hospitals are run like a business where it is females in what has always been a female noticeable that for men, a desire to help of female respondents, indicated that highlighting the degree to which the lower morale, and if this is the case, why. all about stats and not patients” (Female). occupation” (Female) or that, “I don’t feel people, the desire to have a stable career they had intentions of leaving nursing, respondents believe society’s gendered, • Further study is required to explore Another respondent added, “it is full of that the males I know would be suited and a secure employment with career or related fields, within the next five even prejudiced views can have a the issue of why about a quarter of an unfortunately high percentage of toxic to a nursing career because it requires a variety, all rated highly as motivating years. This was consistent with Hodes negative impact on recruitment of men nurses (male or female) in WA would middle aged women who perpetuate personality that is not focused on wages forces for choosing a career in nursing Research (2005) study, in which 7% of into nursing (Stanley et al., 2014). not recommend nursing as a career to the stereotype of being overworked, and promotion” (Female) or that, “not (Stanley et al., 2014). These results male respondents indicated an intention others. marginalised and handmaidens” (Male). many males I know have the attitude of were consistent with Hodes Research to leave nursing and related industries Conclusion • Further study is required to gain a compassion and tolerance” (Female). (2005) findings that also suggested the completely. better understanding of the experience 2. Not Suitable for Men: Nursing is not a advantages of being a nurse, included Most nurses would recommend a career of male nurses across Australia. suitable job/ career/profession for men. 6. To Move on: Nursing may be used a suitable salary and career stability as In addition, in another question within the in nursing to men that they know because Some respondents felt it was a job not as a stepping stone to other careers/ being relatively more important for males suited to men, with views such, “males professions. than females. by nature are not nurturers” (Female), or A few respondents also suggested that “most male nurses I have worked with are men used nursing as a stepping stone One of the strongest themes to emerge lazy and appear to have the misconception to other careers or Australian residency. from the question was that nursing is a that female nurses are their ‘lackeys’” Comments supporting this theme good career for men and that nursing is (Female). Another added men are not, included, “it appears that some of them a career men do particularly well in. As “suited for the caring role...OK with (male nurses) are frustrated doctors who such, many comments supported the management or physical hard work, not could not make the grade and nursing is idea that men progress well, moving the emotional caring side” (Female), or their second choice” (Female), or that, into management and senior nursing that men, are just “not caring enough” “the only reason they became nurses was positions. The results in other parts of (Female). because of the 457 visa and nursing was this study (Stanley et al., 2014) showed the only job they could obtain permanent that although the percentage of men 3. A Poor Option: Nursing is not suitable residency on” (Female). that indicated they were in management for men because of poor pay and work positions was only slightly higher than

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