From 2002 to 2009 the nursing profession has grown by 62% (Macwilliams, 2013). Bowman (2020) reported that from 1960 to 2020 men in nursing increased from 2% to 13% of all U.S. nurses. The Bureau of Labor and Statistics reports a need for 3.19 million nurses by 2024. Men have historically been underrepresented in nursing, including roles in nursing education. With the increased demand for RNs, health care providers and academia must ensure an inclusive environment for everyone, no matter the gender. This article will explore the data on male nursing school enrollment and strategies to enhance recruitment of men into nursing. Also, this article includes the personal journey of one male nurse leader.
The challenge of recruiting and retaining a diverse popula-tion of men in the nursing profession begins in the nursing academic environment. According to the American Association of Colleges of Nursing (AACN) (2020a), during the period of August 1, 2018, to July 31, 2019, only 47,309 (12.7%) males were enrolled in undergraduate nursing programs. In graduate nursing programs during this time period, there were 17,608 (12%) males enrolled in master’s, 4,993 (13.8%) enrolled in doctor of nursing practice (DNP), and 509 (11.1%) enrolled in a research-focused doctoral degree program. Of the graduates from August 1, 2018, to July 31, 2019, 18,308 males (12.7%) earned an undergraduate baccalaureate degree, 5,894 (11.8%) earned a master’s degree, 1,043 (13.1%) earned a doctorate of nursing practice, and 79 (9.8%) earned a research-focused doctoral degree (AACN, 2020a).
The male nursing enrollment and graduation data may be reflective of the challenges reported by male nursing students. As a minority within the profession, Macwilliams and Bleich (2013) reported that male nursing students experience higher rates of attrition than female nursing students, experience higher levels of role strain, and loneliness and isolation (Macwilliams & Bleich, 2013). Researchers have identified barriers such as frequent references to “she” in lectures and textbooks; lack of male nurses in textbooks; little to no content on male contributions to the history and profession of nursing; gender-related bias in obstetric rotations; anti-male remarks made by nursing faculty and practicing nurses; and lack of male role models and mentors (Macwilliams & Bleich, 2013; O’Lynn, 2004). Male nursing students have expressed fear of “suspect touch” when caring for female nursing students, with little to no nursing content in lectures or textbooks addressing this. Negative influences on gender diversity in nursing are evident when nursing faculty place males under closer scrutiny, do not understand or accept the manner in which males engage in caring behaviors and express emotions or the ways in which men self-reflect on their practice. Men in nursing can be reluctant to seek support and sometimes engage in a less expressive form of self-reflection that may be assumed as non-caring by female colleagues. Men may be reluctant to engage in caring touch due to concerns about the touch being interpreted as inappropriate. In addition, faculty sometimes have the expectation that male nursing students should be assertive, act as leaders and take on the lifting tasks for the female students (Macwilliams & Bleich, 2013).
African American male nursing students experience similar challenges to white male students; however, some challenges are attributable to race. Patterson (2020) reported additional challenges experienced by African American male students such as being the only Black male in the class, clinical group or sometimes in the hospital setting (feelings of alienation, loneliness and social isolation), overcoming financial struggles, being excluded from study groups and social events, experiencing insensitive racial jokes and implicit biases, and lack of black male faculty.
Male academic faculty can experience a “glass ceiling” within the predominately female nursing academic environment. AACN (2020b) reports of the 783 nursing school deans in the country, only 46 (5.9%) are males. The largest number of male deans reported was in 2014, but that number amounted to only 6.2%. Male faculty also are underrepresented in nursing academia. Of the 21,622 faculty reported, 1,528 (7.1%) were male (AACN, 2020b).
Men in nursing academia have similar experiences to male nursing students. Male academic faculty report feeling isolated, desire more male role models in nursing academic administration and need mentors to assist with navigating the unfamiliar environment and culture of academia. Mott and Lee (2018) reported that male nursing faculty enter academia for the same reason as females—the desire to teach, motivated by the ability to shape the future of nursing. Male nursing faculty have a limited peer group and lack of male mentors to understand practices such as promotion, tenure and securing a program of scholarship and research. Male faculty also express concerns with interacting with female patients and female nursing students due to the “hidden thread of sexual conflicts” (Mott & Lee, 2018). Male faculty reported feeling the need to leave the door open when meeting alone with female nursing students. Male faculty experience unconscious and implicit gender bias within academia. Male nursing faculty report that differences in communication and the manner in which men think may not be appreciated for their diversity (Mott & Lee, 2018). Males may engage in a manner of direct communication that is succinct and expressive with minimal wording. This can be interpreted as aggressive communication by some individuals.
Recommendations for recruitment of men in nursing:
About the Authors
Demetrius J. Porche, DNS, PhD, FNP, FAAN, is dean and professor, Louisiana State University Health – New Orleans, School of Nursing.
David Beasley, MHA, RN, NE-BC, FACHE, is director of nursing at Novant Health Kernersville Medical Center in North Carolina.