Abstract

Review of Literature

Methods

Results

Discussion

Conclusions

References

Table A

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Perceptions Surrounding Men in Nursing

Kimberly Stoltenberg RN, BSN, Deborah Behan PhD(c), RN-BC, and Mark Frame PhD
The University of Texas at Arlington

 


Abstract

Providing individualized care to an increasingly diverse population is a daunting task for nurses who are primarily white females. The small percent of men in nursing, despite recruitment efforts directed at the male population, prompted an exploration of the prevailing perceptions surrounding male nurses. A survey was administered to 216 adults of varying ages, careers, and ethnicities. The majority of participants showed favorable perceptions of nursing, but certain gender barriers still remain with the images of nursing and nurses.  Barriers included the lack of knowledge surrounding available nursing education levels, work hours, work locations, and perceptions surrounding working as a male nurse.

Review of Literature

The Nursing Shortage

 

As of 2004, the American Hospital Association reported a vacancy rate of 8.1% for registered nurse positions in hospitals. According to the same study, 40% of hospitals found it more difficult to recruit nurses in 2004 than in 2003. This shortage is only projected to get worse. By 2020, it is estimated that there will be a shortage of over 1 million nurses (American Hospital Association, 2006). Hecker (2005) predicts a shortage of over 1 million nurses by 2014. Not only is the nursing shortage expected to grow in size, but the effect of it is also expected to intensify as the baby boomer generation ages. With generational aging, the demand for registered nurses will increase (Buerhaus, Staiger, & Auerbach 2000). US Census Bureau (2005) reports that 12.4% of the population in 2000 was over 65 years of age. That number is expected to increase to about 20% by 2030 (US Census Bureau, 2004).

 

Declining Interest in Nursing by Women

 

Over the last 30 years there has been a large expansion in careers available to women. With this growth in opportunity, there has been a decline in interest in nursing as a career by women (Buerhaus et al., 2000; Kimball & O’Neil, 2002; Meadus, 2000; & Staiger, Auerbach, & Buerhaus, 2001). Staiger et al. (2001) tells us that the peak interest in nursing occurred for women graduating high school around 1973. It is important to note that interest in nursing by women rose again briefly in 1992 when publicity regarding nursing was positive. That interest quickly diminished (Staiger et al., 2001). According to the American Hospital Association (2004), enrollment in health education has declined as more career opportunities have become available to women. Women have become less interested in nursing as a career, and men continue without interest in nursing (Andrews, 2005).

 

Men as a Minority

 

Kimball and O’ Neil (2002) identify the need to make the nursing population more reflective of the diversity of the population of the United States. This country is experiencing a growing minority population. As of 2004 (US Department of Health and Human Services and Health Resources and Services Administration), 88.4% of registered nurses were white, leaving only 11.6% of registered nurses who identify with minority groups. This same report estimated the current US population to be 67.9% white and 32% minority groups.

 

This disparity is wide; however, the disparity between the percent of men in nursing and the percent of men in the US population is much larger. The US Department of Health and Human Services and Health Resources and Service Administration reported in 2004 that only 5.7% of nurses are men. A U.S. Census Bureau report issued in 2005 estimates that 49% of the US population is male. This gap disserves attention.

 

According to Johnson and Johnson (2002), only one man in ten would consider nursing as a career. Those men who are interested in nursing tend to be older and looking for new careers (Nelson & Belcher, 2006; Buerhaus, Staiger, & Auerbach, 2004). There is a gap in knowledge regarding why men are entering nursing at low rates despite recent recruitment efforts. This study sought to understand the prevailing perceptions surrounding men in nursing today.

Methods

This study used a descriptive design. The questions were: (a) “How do men perceive men in nursing?” (b) “How do women perceive men in nursing?” and (c) “How do personality types play a role in how a person perceives men in nursing?” Institutional Review Board approval was obtained through the University of Texas at Arlington.

The Instrument

Subjects’ responses to questions were elicited using a survey entitled “Nursing as a Career Survey.” The survey consisted of 97 questions broken into four sections: 50 personality typing questions from the Goldberg survey (Goldberg, L. R., 1999), 31 statements about nursing, 11 statements about men as nurses and a final question asking if the respondent would consider nursing as a career for him or herself, and four demographic questions.

The tool was adapted from questions used in previous nursing research as well as from issues addressed in articles written by male nurses. The tool was reviewed and modified by a nursing faculty member at the University of Texas at Arlington and a psychology faculty member at the University of Texas at Arlington.

Data Collection


Anyone, male or female, age 18 or over, was permitted to take the survey. The survey was posted online through a professional survey site. Respondents were made aware of the survey in one of two ways. Students in the University of Texas at Arlington Psychology courses that require participation in research could select to take the survey as partial fulfillment of their course requirement. Other respondents came to know about the survey through word of mouth.

Results

Responses were looked at in terms of percents which were broken into groups based on the gender of the respondent and the personality type of the respondent. There were 216 participants. Of those, seventeen did not complete the survey. Their responses were used when present. Responses left unanswered were not included in the calculations. Respondents ranged in age from 18 to 40 years. Two hundred and five respondents indicated their gender: 63 (about 29%) were male, and 142 (about 66%) were female.

How do Men and Women Perceive Nursing?

Overall men in general rated the statements slightly more negatively than women (see Table A). The key values that stand out for both gender groups are as follows. Only 30% of the male respondents believed nursing provides flexible schedules. Of the female respondents, 42.3% agreed. Nursing offers several levels of education, but only 27.12%, 43.33%, and 61.67% of the male respondents believed that a nurse can get a doctorate, masters, and baccalaureate degree respectively. For females the numbers were 36.96%, 63.23%, and 59.85% respectively. Over half of the males, 53.33%, and half of the females, 50%, believed nurses have to work in hospitals. Only 46.67% of men and 59.12% of women view nursing as financially rewarding. Only 49.15% of men and 65.2% of women believed nurses have the opportunity to travel with their career. When asked if women like dating men who are nurses, only 23.33% of males and 18.84% of females agreed.

How do Personality Types Play a Role?

Subjects were ranked in five personality areas: agreeableness, conscientiousness, extroversion, narcissism, and openness. The survey results from the ten subjects scoring the highest and the lowest in each area were compared to responses for the overall population.

Agreeableness. Agreeableness made a large difference in the subjects’ responses. For those who were most agreeable, responses were much more positive than the population. For those who were least agreeable, responses were much more negative.  

Extroversion. Extraversion made a difference in the subjects’ responses. Those who were most extroverted rated nursing very highly in every response. They also believed there to be greater gender barriers for men then the rest of the population did. Those who were least extroverted rated nursing similarly to the rest of the population with the exception of a few areas. These respondents rated nursing very low for prestige, being financially rewarding, using current knowledge and technology, and managing patient care.

Narcissism.  Narcissism affected the subject’s responses in a few areas, but the responses were similar for the rest of the survey. Those who rated as high for narcissism rated nursing as more rewarding and more involved in new technology than the general population. Those who rated high for narcissism also held stronger negative views of men in nursing than the general population. Those who rated low for narcissism rated nursing lower for prestige and needing to keep up with new information than the general population.   

Discussion

Limitations

This study was bounded by three major limitations. The first was the population age range. The majority of participants were of college age. This is beneficial because persons in that age range are making or have recently made their career choices. The limitation comes in this survey’s inability to measure the perceptions of high school students. Because of the difficulty of obtaining approval to survey minors, this group was not invited to participate.

Secondly, the survey was too lengthy. The first section of the survey that measured the respondent’s personality type consisted of 50 questions. This tool has been effectively reduced to 20 questions (Goldberg, 1999). Using a shorter survey would likely have reduced testing fatigue and promoted completion of the survey.

Finally, this study was highly time bounded. Because this study was done as partial fulfillment of requirements for graduating with an honor’s degree, the study had to be completed prior to specified deadlines. This limited the amount of time allotted for background research, survey formulation, data collection, and data analysis.

Recommendation for Future Research

The authors recommend that a similar study be conducted with high school age students. Understanding their perceptions is important to reach male students entering into higher education. More research should be done evaluating personality types and the effect on choosing nursing as a career. With this understanding, marketing can be directed at males whose personality types have the highest tendency to select nursing as a career.

Implications for Nursing

Perhaps when nursing is being marketed to the high school groups the following ideas would further promote nursing as a more male friendly career.  All nurses will profit from focusing on overcoming the stigmas and lack of knowledge surrounding nursing.

Teaching potential nursing students about the wide variety of work schedules available may entice more students to enter nursing.  Only 30% of male respondents agreed that nursing offers flexible schedules. With the wide variation in shifts available to nurses (two day alternatives, twelve hour shift, eight hour shifts, night shifts, day shifts, etc.), this is a misconception that needs to be corrected.

The availability of many diverse programs of higher education is another important area in which respondents hold a misconception. Of participants 27.12%, 43.33%, and 61.67% believed that a nurse could obtain a doctorate, masters, and baccalaureate degree respectively. The image of nursing being shown to the public should include the many opportunities available when practicing nursing with higher degrees.

Of the male respondents, 53.33% believed that nurses have to work in hospitals. Other career roles, such as community nursing or military nursing, should be made visible to men. This may also include the ability to travel as a nurse. Less than half (49.15%) of male respondents realized that traveling is available to nurses. Educating the public on the different roles and travel abilities of a nurse may prompt more interest in nursing.

Nursing needs to continue to raise the bar for pay. Only 46.67% of male’s rated nursing as financially rewarding. Though the starting wage comparable to starting wages for graduates holding other four year degrees, there is little opportunity for pay increase and advancement. According to the Bureau of Labor Statistics (2008) the median annual earning for a registered nurse was $57,280, but only the highest ten percent of registered nurses earned more than $83,440.

Nursing needs to be marketed to those males whose personality traits predispose them to being interested in nursing. By matching personality types with proper knowledge of the benefits of nursing we are sure to see more people enter in to nursing.

Conclusions

This survey highlighted several areas in the current perception of nursing that present opportunities for consideration of ways to draw men into a nursing career. Through further research, modification in marketing strategies, and changes in the culture of nursing itself, more men may be encouraged to seek the benefits inherent in a nursing career; a career which, as of 2004 (US Department of Health and Human Services and Health Resources and Service Administration), consisted of only 5.7% males.

References

American Hospital Association. (2004). Trend Watch. Retrieved June 5, 2006, from http://www.ahapolicyforum.org/ahapolicyforum/trendwatch/twjune2001.html

American Hospital Association. (2006). Trend Watch. Retrieved June 5, 2006, from http://www.ahapolicyforum.org/ahapolicyforum/trendwatch/chartbook2006.html

Andrews, K. E. (2005). Perceptions of high school boys toward nursing as a career choice (Doctoral dissertation, University of Missouri, 2005). UIM number 3167305.

Buerhaus, P. I., Staiger, D. O., & Auerbach, D. I. (2000). Policy response to an aging registered nurse workforce. Nursing Economics, 18(6), 278–284, 303.

Buerhaus, P. I., Staiger, D. O., & Auerbach, D. I. (2004). New signs of a strengthening U.S. nurse labor market? Health Affairs (web exclusive). Retrieved June 5, 2006, from http://content.healthaffairs.org/cgi/content/full/hlthaff.w4.526/DC1

Bureau of Labor Statistics, U.S. Department of Labor. (2008) Occupational Outlook Handbook. Retrieved April 9, 2008, from http://www.bls.gov/oco/ocos083.htm

Goldberg, L. R. (1999). A broad-bandwidth, public-domain, personality inventory measuring the lower-level facets of several five-factor models. In I. Mervielde, I. J. Deary, F. De Fruyt, & F. Ostendorf (Eds.), Personality psychology in Europe (Vol. 7, pp. 7–28). Tilburg, The Netherlands: Tilburg University Press.

Hecker, D. E. (2005). Occupational employment projections to 2014. Retrieved June 5, 2006, from http://www.bls.gov/opub/mlr/2005/11/art5full.pdf

Johnson & Johnson. (2002). Nursing shortage: Johnson & Johnson campaign aims to increase awareness, general interest. Nursing Economics, 20(2), 93–95.

Kimball, B., O’Neil, E. (2002). Healthcare’s human crisis: The American nursing shortage. Retrieved June 5, 2006, from http://www.rwjf.org/files/publications/other/nursingreport.pdf

Meadus, R. J. (2000). Men in nursing: Barriers to recruitment. Nursing Forum, 35(3), 5–12.

Nelson, R., & Belcher, D. (2006). Men in nursing: Still too few: Discrimination and stereotypes still keep many from joining nursing ranks. American Journal of Nursing, 106(2), 25–26.

Staiger, D. O., Auerbach, D. I., & Beurhaus, P. I. (2001). Expanding career opportunities for women and the declining interest in nursing as a career. Urologic Nursing, 21(3), 185–190, 195.

US Census Bureau. (2005). We the people: Women and men in the United States. Retrieved March 20, 2007, from http://www.census.gov/prod/2005pubs/censr-20.pdf

US Census Bureau. (2004). U.S. interim projections by age, sex, race, and Hispanic origin. Retrieved April 9, 2008, from http://www.census.gov/ipc/www/usinterimproj/

US Department of Health and Human Services and Health Resources and Services Administration. (2004). The registered nurse population: National sample survey of registered nurses March 2004. Retrieved June 5, 2006, from ftp://ftp.hrsa.gov/bhpr/nursing/rnpopulation/theregisterednursepopulation.pdf

Table A

 

Table A:

Comparison between Male and Female Positive Responses (%)

Statement

Male

Female

Difference

Nurses have to know a lot to do their job well.

88.33

95.65

7.32

Nurses are respected.

80

76.09

3.91

Nurses do challenging work.

86.67

94.2

7.53

Nurses manage patient care.

88.33

94.93

6.6

Nurses are kind people.

71.67

76.09

4.42

Nurses have a positive public image.

84.75

81.67

3.08

Nurses positively affect healthcare.

95

92.03

2.97

Nurses are professionals.

94.92

97.83

2.91

Nurses are skilled.

98.31

96.38

1.93

Nurses work hard.

86.44

97.1

10.66

Nurses have to keep up with new information in their field to do well.

88.33

93.48

5.15

Nursing is rewarding.

74.58

79.56

4.98

Nursing involves using new technology.

80

86.23

6.23

Nursing provides flexible schedules.

30

41.3

11.3

Nurses can get a Baccalaureate Degree in Nursing.

61.67

59.85

1.82

Nurses can get a Masters Degree in Nursing.

43.33

62.32

18.99

Nurses can get a Doctorate in Nursing.

27.12

36.96

9.84

Nurses have to work with sick people.

71.67

68.84

2.83

Nurses have to work with dying people.

70.00

64.23

5.77

Nurses have to work in hospitals.

53.33

50

3.33

Nursing is a prestigious job.

70

73.72

3.72

Nurses have opportunities for advancement.

63.33

83.33

20

Nurses can only do what doctors tell them to do.

15

15.22

0.22

Nurses work in a safe environment.

35

42.34

7.34

Nursing is financially rewarding.

46.67

59.12

12.45

Nursing offers job security.

68.33

79.71

11.38

Nurses make important contributions in patient care.

98.33

99.28

0.95

Nurses make important contributions in the medical field.

76.67

86.76

10.09

Nurses have the opportunity to travel with their career.

49.15

65.22

16.07

Nursing is a career for intelligent people.

78.33

86.23

7.9

Nurses work in partnership with physicians.

81.67

89.78

8.11

I know a man who is a nurse and I respect him.

58.33

68.61

10.28

Men who are nurses are stereotyped.

71.67

84.78

13.11

Men who are nurses have to prove themselves.

31.67

46.38

14.71

Men who are nurses face gender barriers.

61.67

71.53

9.86

Men who are nurses do not have an opportunity to work with other men.

10

5.84

4.16

It is okay for women to work as nurses, but it is weird for men to work as nurses.

13.33

2.19

11.14

Most men who are nurses are homosexual.

6.67

0

6.67

Men who are nurses are wimps.

6.78

0

6.78

Women like dating men who are nurses.

23.33

18.84

4.49

It is embarrassing to be a man who is a nurse.

8.33

4.35

3.98

Male physicians do not respect men who are nurses.

10

8.76

1.24

I would consider nursing as a career choice for myself.

36.67

51.45

14.78

 

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