Issues of Diversity in Nursing: Gender Discrimination

Introduction

This briefing aims to examine stereotypes and the existing issue of nepotism in relation to men in nursing. It aims to discuss gender discrimination; issues relating to discriminatory behaviour and explores methods to promote gender equity.

The purpose of this briefing is to focus on the fact that although women face more discrimination than men, it does not mean that men cannot be the targets of gender bias. Most psychological theories state that the consequence of gender discrimination is not gender specific. Men make up 10% of the nursing workforce in the UK and 6.6% in the United States of America. This shows evidence for nursing being predominantly a female dominated industry and male nurses often reported stereotyping and face prejudice faced while on the job. The result of unrecognized, unaddressed gender bias in nursing profession, could have clear detrimental outcomes to the profession as well as our hospital. It would also limit our ability to recruit and retain robust workforce. As one of the oldest and the most reputable government hospitals in Melbourne, it is important for us to focus on issues relating to gender discrimination.

Issues

In the recent coverage of the nursing shortage, media highlighted reports that demonstrate men are more likely to leave nursing than women. In 2000 National Sample Survey of registered nurses showed that men leave nursing at a higher rate in the first 4 years of practice (Spratley et al. 2000). The question that is this higher rate of retention related to bias that men experience in their nursing profession? If so, what are the ways in which we can recognize discriminatory behavior and the ways we could strategically implement promote gender equity?

Literature review

Studies have shown that often men decide to be nurses for one of the two reasons, self-actualisation or if they do not get into medical school (Zyberg & Berry 2005). Many a times men entering the nursing profession encounter barriers in choosing their specialty due to the risk of being labelled and stereotyped. One of the reasons for this is that the expression of feelings and empathy are considered to be female qualities. This has been passed on through the nursing education system is mainly focused on educating women (Sherrod 2003). In a survey conducted by The Association of Women’s Health, Obstetric and Neonatal Nurse (2007), as professionals, 75% male nurses reported bias from the nursing staff and 8% from the female physician. Furthermore, in 2005, the American Assembly for Men in Nursing, several other nursing groups surveyed 498 male nurses. The results showed that 73% of men referred to negative stereotypes and 42% reported having a lack of male models and mentors (Cude &Winfrey 2007). This supports the theoretical perspectives of the mainstream definition of prejudice, which specifies that the negative treatment of members of a group which is unfair or unjustified. Thus, examining whether and under which circumstances men are discriminated against on the basis of their gender has important implication for both our organisation as well as the nursing profession.

Issues that need to be addressed in our hospital

We are known as a world-renowned institution that provides outstanding care and treatment. We strive to improve the outcomes through clinical trials and a comprehensive medical program for future health professionals. We have over 2,800 full-time equivalent nurses as of 2018. Our values statement emphasis on caring (treating everyone with kindness and compassion), excellence (committing to learning and innovation), integrity (being open, honest and fair), respect (treat everyone with respect) and unity (work together for a common goal). Our organisational values have been strongly upheld for over a century.

Keeping in mind our reputation and values, it is important for us to intervene in the related to discrimination against male nurses. It has come to our notice that male nurses have been stereotyped in their capabilities of providing care. Based on assumptions such as men are not naturally caring and nursing, therefore men in nursing could not be ‘real men’ and definitely not ‘real nurses’ (Anthony 2006). Moreover, there has been an existing case of nepotism in the department, where the nursing managers department, ran by two women, favoured promotion of more women. Due to this, there is a lack of male nurses in our hospital. there has been a higher rate of retention, more and more men are leaving our hospital. More so, we are not getting enough male nurses applying for nursing role vacancy. The absence of men in our hospital is not just a matter of needing more bodies in the roles to keep up with demand but also means that some of the best talents remains untapped.

In 2018, Yahoo, one of the biggest tech companies was accused of reverse sexism where two of their women managers were accused of laying off only male employees and favoring female employees. This has affected Yahoo’s reputation and has had a lawsuit filed against them (Reader 2016). To avoid such an extreme consequence, the HR department of our hospital need to be aware and informed about the existing problem related to discrimination against men in nursing.

Solution

One of the useful tools to shed some light on these prejudices is managers and employees recognising their own bias. To understand their own preconceptions using Harvard University’s Implicit Association test should be mandatory. The Implicit Association Test (IAT) measures attitudes and beliefs that people may hold but be unaware or unwilling to report. It shows people an implicit attitude that they were not known about. For example; one may believe that women and men should be equally associated to careers such as science but have an automatic association that could show that he/she may associate men with science over women with science. Although IAT could be a useful tool, it is recommended that it is not used for recruitment and promotion purposes, the sole aim of IAT is to educate individuals and develop an awareness of implicit preferences and stereotypes. Using this tool could help nursing managers and female nurses have a better understanding of their unconscious biases which would further help in organisational change.

Another solution to changing the existing issue of discrimination is incorporating organisational responsibility (Kalev et al. 2006). According to the U.S Department of Labor (2005), organisations should assign responsibility to the staff and give them the authority, resources, support of and access to top management. This way our hospital can assign accountability and responsibility for ensuring gender equity. Kalev et al. (2006) reported organisational responsibility to be the most effective practice to practice diversity and inclusiveness.

Furthermore, the absence of men in nursing education would have further alienated many men from nursing, therefore, having more support and mentorship for male nurses would be beneficial. Academy of Medical-Surgical Nurses (2012) states that “mentoring is a collaborative learning relationship between two or more individuals with shared accountability for the success of the relationship”. Embedding mentorship in our nursing department can guide male nurses in their professional and interpersonal growth.

A long-term solution for this would be promoting campaigns publicising the changing image of nursing as a woman’s profession. A few examples of such campaigns are Discover nursing, designed by Johnson & Johnson (2018), although this campaign is not specifically directed towards promoting men in nursing, its social media and digital presence does include numerous profiles of men who are successful nurses and a more controversial campaign launched by the Oregon Center for Nursing (2002), that depicts nine different ethnicity and rugged men captioned “are you man enough to be a nurse?”. Although promoting controversial campaigns may not be ideal for a renowned health care facility like ours, it is advised that we have subtle campaigns such as posters of a men nurse-midwifery instead of a female nurse. This may help break down societal prejudices and stereotypes.

Conclusion

There is a need to revise nursing culture in our hospital, at least those seen to be gender-biased in order to develop an environment of acceptance and equal opportunities. Thus, empowering male nurses by providing mentorship, guidance, and support to take stand up against discrimination would be the first step to change. Secondly, recognising the unconscious bias that managers may hold and having a no-tolerance policy for favoritism in the department through a fair and rigorous promotion and recruitment process. Thirdly, having short term and long-term goals to change the perception of nursing being a feminine profession by reinforcing organisational responsibility and advocating awareness that nursing as a career is not gender specific. Considering these solutions, the nursing department of our hospital should develop a strategic plan which addresses the eradication of discrimination and racism in and by the nursing profession. This plan must be implemented, adequately funded and evaluated yearly and revised as necessary.

Recommendations

The following recommendations are made based on the conclusions of this study:

• Nursing department of our hospital should encourage and promote gender diversity in nursing through the implementation of IAT for nursing managers
• Nursing as a career for both males and females and this should be reinforced by implementing organisation responsibility to the staff and providing adequate resources and staff to do so.
• Providing mentorship and support to male nurses
• We should take measures to promote campaigns that promote portrayal of nursing as a gender-neutral profession
• We should target recruitment and retention of more male as professions however also making sure that the recruitment process is fair and the best candidate is selected