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Why are there so few men in nursing?

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The number of men entering the nursing profession still remains low. Emma Vere-Jones explores the possible reasons for this gender discrepancy.

In these times of gender equality, you might think that a profession as high profile as nursing would have a fairly balanced number of men and women. Especially when you consider that male nurses are marginally better paid and proportionally more likely to be in senior posts than their female colleagues. But despite this, the number of men entering the profession has hardly grown in recent years.

According to the most recent NMC figures, only one in ten nurses on the register last year were male, a figure that has remained static for the past four years. Although there has been a rise in men entering the profession in the last few decades, it has been a small, slow one.

While perceptions are beginning to change, some nurses believe that the profession is still seen as a feminine one. Ian Hulatt, an RCN policy adviser and mental health nurse, says: ‘I think public perception is still that it is a female occupation, which sometimes makes it hard for blokes to say: “I’m going into nursing.” In some ways I think the public is still unsure what it wants from nurses – half still think of a nurse as the subject of an erotic fantasy and the other half want to see someone with a stethoscope around their neck.’

Furthermore, there are significant differences between how certain practice areas within the nursing profession are viewed and this is reflected by big differences in the proportion of men working in different sectors.

According to workforce figures from the NHS Information Centre, mental health – which has long been regarded as an ‘acceptable’ job for men – is more than a third male. Other areas that attract a lot of men include intensive care, theatre and A&E, which are seen as more ‘macho’ than other areas of the profession.

‘I did the typical male nurse thing and initially gravitated towards critical care and surgery. It was just seen as much more acceptable,’ says Steve Robertson, a post-doctoral research fellow at the University of Central Lancashire, who worked as a general nurse before moving into health visiting and then education. ‘When I’m in the pub and tell people I’m a nurse, they are sceptical but when I tell them I work in intensive care, they think of me slightly differently.’

However, in areas such as health visiting or midwifery, where men make up 1.5% and 0.8% of the respective workforces, men’s career choices may still be questioned – not just by members of the public but also by some members of the profession.

Mr Robertson explains: ‘There does sometimes seem to be an undercurrent among female colleagues as to what is and isn’t appropriate. I suspect most of my health-visiting colleagues were unsure about whether blokes ought to be doing the job. It never came out overtly but covertly I think it was there.’

Even those men going into a supposedly ‘more masculine’ area of the profession admit that their career choice has sometimes raised eyebrows and this can
be a barrier that prevents men from entering the profession.

Brian Owens, who is a staff nurse in a day surgery unit at Royal Wolverhampton Hospitals NHS Trust, left a career in the male-dominated world of banking to train as a nurse. He says:

‘People did express some doubts, despite my going into the slightly more manly area of surgery. Nursing is still seen, to some degree, as the Florence Nightingale profession and it is still very female-dominated.’

He believes this springs partly from the public’s lack of knowledge about what nurses actually do, which could deter younger men who have little experience of being in hospital.

‘The public perception is that a nurse is a runaround and that all you do is wash people. Of course, that is part of the job, but it’s not the only part. Nurses have a good deal of respect and responsibility. Unless they’ve been into hospital and been cared for by a nurse, I don’t think people realise how we actually spend our day.’

Another barrier that may deter some men from entering the profession is the issue of pay. While obviously both men and women face the same low-level starting salary, for men it may be more of a disincentive because, on average, they earn more than women.

Figures from the Office of National Statistics reveal that in April 2007 the median earnings of full-time male employees in the UK was £498 per week compared with £394 for women. The average full-time nurse salary was £436 a week.

Dave Munday, Unite/CPHVA professional officer and a health visitor, says: ‘I think it’s the case that women who go into nursing see themselves earning a better wage than they can in other jobs but men going into nursing would see it as a lower wage. I think pay probably is still an issue to some degree.’

However, male nurses do in fact earn slightly more than their female colleagues and that gap has widened in the last four years, figures from Income Data Services reveal. Men are also more likely to take on senior positions and are disproportionately represented at higher levels. For example, despite making up a tenth of the workforce, 17% of nurse consultants and 18% of nurse managers are male.

However, being male is not always an advantage in a profession and, like any minority group, there are times when they face discrimination. Mr Hulatt, who trained in the 1970s, says: ‘My generation of male nurses were exposed to blatant discrimination. For example, you weren’t allowed to do the maternity or health-visiting placements and if you pressed for
it, there would have been a question over your motive. Today there’s less overt discrimination. There’s equity of opportunity to do midwifery, for example, but there’s
still a covert cultural message that puts a question mark over why males may want to do those things.’

But do we really need more men in nursing? Mr Robertson says not. ‘From the research I don’t think it’s too much of an issue,’ he adds.

Mr Hulatt disagrees. ‘I think it seems appropriate to me that services should reflect the community they serve. We feel that about ethnicity – that we should be able to walk into a hospital and see a reflection of the community’s ethnic mix. Why shouldn’t that apply to gender?’

However, until the barriers that prevent men from entering the profession cease to exist, it seems unlikely that the gender imbalance is likely to be reversed any
time soon.

‘My family were a bit unsure about what I was doing but now they can see how well it’s suited me’

When Roland Kirkby (pictured) changed profession 14 years ago to become a healthcare support worker, he was more than happy to bid the world of retail goodbye. He left what he describes as a ‘thankless profession’ to join one with ‘great opportunities and dynamism’.

‘I was attracted to the caring side of nursing,’ he says. ‘I saw it as a positive role with a good job image.’

After five years of support work and subsequent nurse training, he became a staff nurse in surgical urology, before moving into sexual health. He currently practises as a charge nurse at the Royal London Hospital, east London.

During the time he has worked in nursing, Roland says that he has never experienced any prejudice against him for being a man.

He says: ‘It’s a great place for blokes to be. The area I work in tends to be female-dominated but I’ve found that’s been to my advantage because I stand out more.

‘My family were a bit unsure about what I was doing but now that they can see how well it’s suited me, and that there’s the opportunity for good career progression, they are happy with it.’

Roland says his career has moved in the direction of sexual health nursing because it gives him the opportunity to build up patient relationships with long-term care. ‘I’ve never been attracted to the fast-moving stuff,’ he says. ‘My focus has always been on holistic, humanistic care.’

Regarding the issue of pay, he says that with no dependants and no mortgage, he was able to convert to a career that other men may have struggled to reconcile financially. That said, for Roland, the most important thing is job satisfaction.

He adds: ‘It’s a very flexible profession, with lots of avenues you can take in your career. I’ve always looked at nursing as a job worth doing and never time wasted. The money is a bonus really.’

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