Introduction
Females have always been the underdog in many professions as well as in social settings. They had to struggle, along with color, to have their proper place in society without harm and discredit to their person or group of association. Gender bias, discrimination, and inequality have always been a contention in the workplace, although in most instances, it was the female gender who experiences the imbalance or inequality. Likewise in many forms of mass media, gender bias is always seen, such as the use of the female body in many announcements or advertisements that target male audiences or consumers. Gender bias and challenges, however, are not limited to the female gender. In work environments where the majority of staff or even superior levels are females, there is a high possibility for gender problems.
This paper will focus on the problems and issues that male nurses and student male nurses encounter in the workplace or clinical setting. It will also explain how and why this issue is important to the profession and new practitioners and will specify the type of issue in the context, whether it be ethical, legal, economic, social, or political. The paper will further describe the factors that make this issue important and significant at this time, discuss how this issue should be approached or resolved specifically by (1) new nurses, (2) nursing organizations, (3) consumers/patients, (4) other health professionals, (5) hospitals and health agencies, (6) taxpayers, and (7) the federal and state governments. It will base its discussion on peer-reviewed journal articles and studies with relevance to the issue at hand.
Discussion
According to O’Lynn (2004), men are considered a minority in the nursing practice and poorly understood. In the United States, men represent just about six percent of nurses and just an average of 7.5% in Missouri (Missouri Board of Nursing, 2004). While it was noted that there is considerable effort to recruit more males in the profession, male nurses abandon the nursing profession twice as much as females do at 7.5 % to that of 4.1 % females. Indicated of interest in studies include bias, discrimination, and inequalities encountered by male nurses as compared to their female counterparts (Anthony, 2004). While Evangelista and Giddens (2008) noted that there has been the absence of exploration of differences in the discipline of male and female nurses, two studies (Booth and Carruth, 1998, and Green, 1996) observed that male nurses received a disproportionate share of formal discipline in Louisiana and Texas at 18% to 19%. The disparity, however, was not indicated.
Arndt (1994) examined the disciplinary actions against nurses that involve medical errors while another study focused on drug abuse (Sullivan, Bissell, and Leffler, 1990). In Missouri, disciplinary actions are pursuant to Section 335.066.2 RSMo for violations of Chapter 335 of the Nursing Practice Act (Missouri Revised Statues, 2003). Disciplinary action is imposed for the safety of the public against nurses committing substandard or unethical behaviors.
In a study conducted by Evangelista and Giddens (2008), it was noted that in a 4-year period, males received 18.9% of disciplinary actions while females received 81.1%. When taken in terms of the percentage of the total disciplinary actions directed against male nurses, the values range from 17.3 % in 2003 to 21.5 % in 2002. Male nurses represent 7.5% of the total state nurses that translate the findings to the conclusion that male nurses received 2.5 times more discipline than their representation in the profession.
Drug misappropriation accounts for the bigger bulk of disciplinary actions for both genders but male nurses were disciplined at 46.2% or 55 of the 119 total. Females on the other hand were disciplined at 40.2% or 204 of the 508 total. For both genders, the five most common infractions noted were misappropriation of drugs, illegal drug use off the jobs, violation of prior board agreement, working under expired licenses, and care errors (Evangelista and Giddens, 2008). In the study, it was also noted that males exceeded females in some specific categories. Only one infraction which was revealing confidential patient information in the 4-year study was exclusively committed by a male. Other infractions in which male nurses rates 2 times or more times than female rates were an abuse of a patient indicated at 4.2 times greater, sexual contact with the patient at 2.8 times greater, and falsification of skill or license level at 2.4 times greater.
There were also infractions committed more times by female nurses that include working with expired licenses, forgery, and provision of care without physician’s advice. There were also infractions by female nurses which were not committed at all by male nurses during the study period: use of alcohol on the job, advance practice nurse prescribing schedule drugs, leaving post without notification, murdering a patient, passing bad checks, receiving disciplinary actions from other states, other illegal activities and allowing of unauthorized personnel to care for patients (Evangelista and Giddens, 2008). Table A in Appendix indicates the percentage of male and female nurses that were given various discipline levels.
Evangelista and Giddens (2008) noted that male nurses were disciplined disproportionately at 18.9% regardless of the number of infractions or license level. Suspension and revocation of the license were also higher. Already, the study speculated on gender bias as there were no established factors that could have influenced such finding. It was notable in the study that amongst the 10 nurses of which 6 were females and 4 were males who had a sexual liaison with a patient, the females received license censure while the males received license revocation.
Another reason speculated upon by Evangelista and Gidden (2008) is the nursing culture is considered as a historically female dominion (Mendyka, 2000) and that even female authors have openly expressed resistance to men in nursing (Evans, 2002). Men have reported discrimination due to gender (Hawke, 1998) while men were said to report sexual harassment at higher rates than do female nurses (Bronner, Pretz, & Ehrenfeld, 2003).
Black (1976) have already noted that theory of law indicates that marginal persons or those with “different associations” (p 79) are treated differently than the mainstream individual and are more likely to be disciplined, disciplined in a more severe manner, and conduct may be seen more likely as illegal than the mainstream individual. More importantly, the study observed that “very real disparities in discipline do exist,” (p 513).
There had been a noted increase of women in the workplace. Below Positions, previously male-dominated had a proportion of women filling in lower and middle management positions in a steady fashion (Dalton and Keshner, 1993). The prevailing domination of males in higher positions nevertheless has established the “glass ceiling” barrier that keeps females away from higher positions. But in a study conducted by Atwater and Van Fleet (1997) indicated that in a traditionally female job for top and mid-level management position, less-qualified females were selected against the more qualified male regardless of the gender of the raters. Gender was the main reason why the raters selected the female applicant and that the gender type of the job led to the discrimination against males in female jobs. The subjects indicated that the gender of the applicants influenced the selection decision. Diversity and equal employment opportunity in the workplace were posited as being undermined in the process and disconcerting (Atwater and Van Fleet, 1997). There had been significant progress in moving males and females into opposite-sex domains but there is an area that is gender-typed and not equally accessible (Atwater and Van Fleet, 1997). The study concluded that there is a possibility of another “ceiling” in some workplaces that may keep males from entering management positions in female-dominated areas. This bias is so much the same as for females applying for male positions.
As early as 1977, in a study of sex-role and occupational stereotypes, Hesselbart noted that there are few differences in the ratings of the male and female medical students both described as competent and attractive. Male nursing students are rated as unattractive, unrealistic, and un-ambitious suggesting that men entering a predominantly female profession may be seen as more deviant than women entering a predominantly male profession.
Conclusion
It is evident that the issues wherein male nurses or male students of nursing encounter bias in the workplace are considered ethical, legal, economic, social, and political in nature. Ethical and legal in a sense that they are discriminated against, economic in a way that they are hampered from possible employment, social and political in the sense that they are deprived of equality and fair treatment.
This issue is significant at this time because there is a growing need to address health services and professional problems such as the lack of qualified professionals not only in major European and US nations but also the need to address more pressing issues such as the cost of health services.
It is difficult at this time to offer measures to resolve the problem. Health care policy and decision-makers, however, should be concerned with providing sufficient information and understanding on the part of new male nurses, provision of acceptable norms on nursing organizations, exposure of patients to more male nurses in the setting, further incorporation of males in other health professions. To address hospitals and health agencies, taxpayers, and the federal and state governments, it is necessary that advocacy groups be sensitive to the biases against male nurses and males in other female-dominated professions.
Easier said than done, it will take a longer time as well as jolting situations and orientation before certain results are expected. As already established, a lot of other factors need to be considered where biases and discrimination in the workplace are concerned. The tradition established gender roles in professions for certain lengths of time and dismantling it could signal a new era of diversity and equality, more legal, political, and social in nature. This will benefit not only male nurses but more importantly, females and those that are marginalised in a civil society setting.
Referenceы
- Anthony, A.S. (2004). “Gender bias and discrimination in nursing education: Can we change it?” Nurse Educator, 29 (3), 121-125.
- Arndt, M. (1994) “Nurses’ medication errors.” Journal of Advanced Nursing, 19, 519-526.
- Atwater, Leanne E. and David D. Van Fleet (1997). “Another Ceiling? Can Males Compete for Traditionally Female Jobs?” Journal of Management, 1997; vol. 23: pp. 603 – 626.
- Black, D. (1976). The behavior of law. San Diego, CA: Elsevier Press.
- Booth, D. and A.K. Carruth (1998) “Violations of the nurse practice act : Implications for nurse managers.” Nursing Management, 29, 35-39.
- Bronner, G., Pretz, C. & Ehrenfeld, M. (2003). Sexual harassment of nurses and nursing students. Journal of Advanced Nursing, 42, 637-645.
- Evangelista, Anita and Susan Sims-Giddens. (2008). “ Gender Differences in Discipline of Nurses in Missouri.” Western Journal of Nursing Research, 2008; vol. 30: pp. 501 – 514.
- Evans, J. (2004). “Bodies matter. Men, masculinity, and the gendered division of labour in nursing.” Journal of Occupational Science, 11 (1), 14-22.
- Green, A. (1996). “Texas creates a profile of the disciplined professional nurse.” Issues, 17, 8-9.
- Hawke, C. (1998). “Nursing a fine line: patient privacy and sex discrimination. Nursing Management, 29, 56-61.
- Hesselbart, Susan (1077). “ Women Doctors Win and Male Nurses Lose: A Study of Sex Role and Occupational Stereotypes.” Work and Occupations, 1977; vol. 4: pp. 49 – 62
- Mendyka,.E. (2000). “Exploring culture in nursing : A theory-driven practice.” Holistic Nursing practice, 15, 32-41.
- Missouri Board of Nursing (2004). “Missouri Board of Nursing update.” Missouri State Board of Nursing Newsletter 5 (4), 1-3.
- Missouri Revised Statutes (2003).
- O’Lynn, C.E. (2004). Gender-based barriers for male students in nursing education programs: prevalence and perceived importance.” Journal of Nursing Education 43 (5), 229-236.
- Sullivan, E., Bissell, L. and Leffler, D. (1990) “Drug use and disciplinary actions among 300 nurses.” International Journal of the Addictions, 25, 375-391.
- Williams, Christine, L. and E. Joel Heikes (1993). “The Imporatnce of Researcher’s Gender in the in-depth interviews: Evidence from Two Case Studies of Male Nurses.” Gender & Society, 1993; vol. 7: pp. 280 – 291
Appendix
Table A
