MEN NURSES AND MASCULINITIES: EXPLORING GENDERED AND SEXED RELATIONS IN NURSING SY Joan Alice Evans Submitted in partial fulfillrnent of the requirernents for the degree of Doctor of Philosophy Dalhousie University Halifax, Nova Scotia August, 2001 O Copyright by Joan Alice Evans, 2001 National Library Bibliothèque nationale du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395, rue Wellington Ottawa ON KIA ON4 Otbwa ON KlAûN4 Canada Canada The author has granted a non- L'auteur a accordé une licence non exclusive licence allowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distnbute or sell reproduire' prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la fome de microfiche/film, de reproduction sur papier ou sur format électronique. 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This research is dedicated to my father Maxwell James Evans who instilled in his three daughters the value of education the importance of independence and the rewards of hard work TABLE OF CONTENTS Abstract ....................................................... ix Acknowledgments ............................................... x Prologue ....................................................... 1 Thepurpose .............................................. 3 The Structure of the Thesis ................................... 4 Chapter 1: Men Nurses and the Gendered Nature of Nuning ............ 6 Tokenism and Masculine Privilege ................... 9 Nursing as a Status Contradiction for Men ............ 11 Specialization and Mascufinization ................. 13 SexRoles ..................................... 17 Institutional Career Advantages for Men ............. 19 Summary ..................................... 23 Chapter II: Men's Historical Association With Nursing: 'Setting the Scenen . 24 Introduction .................................... 24 Early History ................................... 24 The Feminization of Nursing ...................... 27 Early Segregation of Men Nurses .................. 28 Feminization as a Barrier to Men's Participation inNursing ..................................... 31 The Rote of Nursing Associations .................. 34 Recruiting Men lnto the Profession ................. 36 Men in Nursing: Implications for Women Nurses ....... 38 Summary ..................................... 42 Chapter III: Methodology and Method .............................. 43 Postmodern Considerations ....................... 43 Masculinity as Problematic and Political ............. 44 Hegemonic Masculinity .......................... 45 lmpetus for Change ............................. 47 Alliance Politics: Combining Masculinity and FeministTheory ................................ 48 Ferninist Standpoint ............................. 50 My Own Situatedness ........................... 52 Participants in This Study .............................. 54 Interviewing as the Method of Data Collection .............. 55 Data Analysis and the Written Account .................... 57 Ethical Considerations ................................ 59 The Organization of the Written Account .................. 59 Chapter IV: Men's Lives. Nurses' Lives ............................. 61 Xavier ...................................... -61 Robin ........................................ 62 Bruce ........................................ 64 George ....................................... 65 Camillus ...................................... 66 Nikki ......................................... 68 Mateo ........................................ 69 Patrick ....................................... 70 Chapter V: Men Nurses as Anomalies: "What's a Real Man Like You Doing in a Job Like Thisn? ............................. 73 Introduction .................................... 73 Participant Dialogue ............................. 73 Reactions of Clients ........................ 73 Reactions of Others ........................ 75 Defending Nursing as Men's Work: Challenging Stereotypes .................... 78 ldentifying and Defending Men's Unique Contribution to Nursing ..................... 81 Managing Masculinity ...................... 84 Living With the Suspicion of Homosexuality ..... 86 Discussion .................................... 91 Going Against the Grain: Spoiled Masculinity .... 91 The Labeling of Men Nurses as Gay ........... 93 The Homosexual Role Trap .................. 95 Nursing as a Status Contradiction for Men ...... 98 Maintaining Hegemonic Masculinity .......... 102 Surnrnary .................................... 104 Chapter VI: Caring Men. Cautious Men: rouch at Your Own Riskn ...... 105 Introduction ................................... 105 Participant Dialogue ............................ 106 An Affirmation of Caring .................... 106 Gendered Expressions of Caring ............. 106 Humor as Caring Practice .................. 108 Touch as an Expression of Caring ............ 109 The Problematic Nature of Men's Touch ....... 110 Assessing When it is Safe to Touch .......... 112 Strategizing to Protect Oneself From Accusations 115 Discussion ...................................118 The Hegemony of Caring ................... 118 The Feminization of Caring ................. 119 Maintaining Masculinity and Caregiving ....... 122 Men Nurses' Sexualized Touch .............. 124 Nursing's Caring Image: Double Edged Sword . 127 Men Nurses as Failed Caregivers ............ 129 Summary .................................... 131 Chapter Vil: Masculinity Ernbodied: "Where Are All The Big Strong Men When You Want Them?" ............................. 132 Introduction ................................... 132 Participant Dialogue ............................ 133 Men Nurses as Movers and Lifters ........... 133 Men Nurses as Enforcers of Safety ........... 135 The Association of Masculinity With Violence ... 138 Discussion ................................... 139 The 'He-Mann Role Trap ................... 139 "He-Mann Practices as Practices of Masculinity . 142 The 'Enforcer" Role Trap ................... 143 The "Enforcer" Role as Contradiction ......... 145 Promoting Images of Hegemonic Masculinity ... 146 Hegemonic Masculinity and the Failed Caregiver Trap ........................... 149 Surnmary .................................... 150 Chapter VIII: Segregated Relations: "Boys Will Be Boys and Girls Will BeGirlsn .......................................... 152 Introduction ...................................152 Participant Dialogue ............................ 153 An Affirmation of Teamwork ................ 153 Men Nurses' Relationships With Women Nurses 154 The Sexualized Nature of Men Nurses' Social Interactions ........................ 156 Social Risks and Accusations of Sexual Harassrnent ....................... 157 Social Segregation as Gender Differentiation ... 158 Relations Between Men Nurses ............. 159 Men Nurses as Special and Privileged ........ 161 Men Nurses' Relationships With Men Physicians 165 Discussion ................................... 168 Social Distancing as Gender Practice ......... 168 Male Bonding ............................ 171 Maintaining "Erotic PeaœnThrough Social Distancing ......................... 172 Social Distance and Masculine Privilege ....... 174 Women Nurses' Practices of Nurturing MenNurses ............................. 175 Men Nurse Men Physician Relationships ...... 178 Social Distance as Disadvantage ............ 180 Summary .................................... 183 Chapter lx: Analysis of the Findings .............................. 185 Men. Nursing and Masculinity: Making the Link ....... 185 MenYsPain ................................... 186 Managing Masculinity: Measuring Up .............. 191 Conclusion ........................................ 194 The Challenge for Nurses ....................... 195 Implications For Future Research ................. 196 Epilogue: More Thoughts on Thoughts ........................... 200 Appendix A Initial Interview Guide ................................ 204 Appendix B Second Interview Guide .............................. 207 AppendixC ConsentFom ...................................... 209 References ABSTRACT Men's experience in the nursing profession is profoundly shaped by notions of masculinity and gender - notions which constitute a pervasive factor in struduring different work lives and unequal opportunities for women nurses and men nurses. The importance of gender as a fundamental and organizing factor of daily life is evidenced by the stigma of hornosexuality or spoiled masculinity which is associated with men who defy prevailing gender nom. For men nurses, gender noms and gender inequality also interact with group proportions to create unique patterns of interaction that create complex and contradictory situations of advantage and disadvantage. These patterns of interaction which are piayed out in nurses' socialization and caring practices and in the work roles and tasks they assume, reflect the ways in which men nurses' and women nurses' practices support hegernonic