Focus: Men in nursing – tipping the gender balance

In the first of our new series of focus articles, Nursing Times delves into the topic of men in nursing and explores whether the profession needs a more gender-balanced workforce.

“The issue is, we haven’t raised the profile of nursing as a profession for all genders”

Mark Radford

The issue has been highlighted recently by research on a gender “disparity” at senior levels, the introduction of gender-neutral children’s uniforms and campaigners wanting to see more men recruited.

Latest statistics show just 11% of nurses in the UK are male, showing that nursing is still a largely gendered profession.

Little seems to have changed since Nursing Times looked at the issue in 2008, when figures showed only one in 10 nurses on the register were male. Although there has been a rise in men entering the profession in the last few decades, it has been a small, slow one.

But what is it that is keeping men away? Professor Mark Radford, director of nursing (improvement) at NHS Improvement and one of the most senior male nurses in the country, said: “The issue is, we haven’t raised the profile of nursing as a profession for all genders.”

“Perpetuated gender-based images of nursing” played to the idea that nursing was “women’s work”, he told Nursing Times.

“That’s doing a disservice to women who want to join a vibrant and developing career, and also one of the reasons that affects men’s perceptions of nursing and joining the career,” he said.

“If we help people to understand that there are two sides to our story, then it will be more appealing to everybody”

Alison Leary

Professor Radford highlighted that, even his young children have made comments such as “nursing is for girls”, despite growing up in an environment with a dad as a nurse.

Similarly, Rachael McIlroy, senior research lead in employment relations at the Royal College of Nursing, noted that one of the reasons behind there being fewer men in nursing was because young boys were not encouraged into it.

“It’s just not seen as a man’s job and especially for boys growing up, it’s not seen as a career choice,” she said.

However, there are those working to combat children’s perceptions, including the campaign group Men Into Nursing Together (MINT), which was set up at Sheffield Hallam University.

David Gwinnell, student nurse and founder of the group, said it was “worrying” that young children were saying things like “you can’t be a nurse if you are a man”. “How do those children know, where have these thoughts come from?” he said.

“The derivative of the word comes from to nurse a baby, so it’s even in the language”

Craig Davidson

Questions about the origins of the perception that men cannot be nurses was a common theme among those Nursing Times spoke to. Some argued that social media and advertising campaigns had a role to play, while others wondered if the language in nursing posed a barrier for men.

One of Nursing Times’ current student editors, Craig Davidson, said: “Even the word nurse, the derivative of the word, comes from to nurse a baby, so it’s even in the language.”

Nursing Times asked members of the profession whether more should be done to challenge these conceptions and to strive for gender balance.

Professor Radford said that, despite being a man who nurses, he “wouldn’t make a case for saying we must actively recruit more men”. But he acknowledged that having a gender-balanced profession was important to “reflect the society we operate in”.

He also warned that “unless we raise the entire profile of the profession, it’s not going to be seen as an attractive career to either gender”.

“We’re challenging the thought process in children who say, ‘I didn’t know you could be a nurse as a man’”

David Gwinnell

Similarly, Mr Davidson, who is studying adult nursing at Glasgow Caledonian University, argued that “just having more men” was not the solution because those already in the profession were more likely to get senior roles.

“Obviously you’ve got the counter problem where, yes, there’s only 11% of nurses who are men, but when you get to nursing academics and senior management levels in nursing, the gender disparity goes out of whack and you’ve got more men in those positions,” he said.

He called for more to be done to promote gender equality at the top end of the profession and suggested many men were more confident than some women in applying for roles higher up.

“Therefore, we need a real system of empowerment,” he said. “We also need to look at things like flexible hours and job-sharing positions and supported childcare.”

Recent research, published in the International Journal of Nursing Studies, revealed that men have an advantage in terms of faster attainment of higher grades from the point of their registration.

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As one of the study authors himself, Professor Radford said he was “conscious” that the gender issues experienced in nursing may have had “a role to play” in his career in both academia and leadership.

He said he wondered what opportunities were being missed as a result of not creating a better gender equality within the profession.

But Iain Wheatley, nurse consultant in acute and respiratory care, highlighted that he knew many male colleagues who were happy to “not go up the ladder”, because they wanted to be “hands-on nurses”.

“Nursing is nursing, and we all want to do that basic nursing sometimes whatever level we are working at,” he said.

“It’s just not seen as a man’s job and, especially for boys growing up, it’s not seen as a career choice”

Rachael McIlroy

Another consensus among commentators was the need to recruit more men to help benefit patient centred care.

Mr Davidson told Nursing Times that eventually he wanted to become an advanced practitioner in urologic oncology, working specifically with prostate cancer patients. He believed having a male presence in this field of nursing could help men receiving this kind of personal care.

During his three years of training, he said he had not seen any male patient being asked if they minded being treated by a woman yet noted that females receiving personal care were always asked if they mind being treated by a man.

He thought this was because, if a male said yes, it would not always be possible due to the lack of men in nursing.

Meanwhile, when asked if there should be more men in the profession, Mr Davidson said: “I obviously think that more men would be good, from a patient-choice point of view, but it needs to be handled very carefully.”

On another note, former nurse Tom Dunne said he felt it helped having a “mixture of sexes looking after a mixture of sexes”.

He suggested to Nursing Times that having men on the ward could give a “better balance of how the team works”.

“If you have men and women approaching nursing towards male or female patients, they both can bring a different perspective,” he said. “If you have a mix of male and females looking at things in two different ways, you can only improve things.”

At the most basic level, a reason flagged for getting more men into nursing during a panel debate on the topic at the 2018 World Innovation Summit for Health was that the global shortage of nursing simply meant that half of the population could not be ignored as a potential workforce resource.

With these factors in mind, Nursing Times asked how to go about readjusting the gender balance in nursing.

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Professor Alison Leary, who also worked on the recent gender study, said helping society to understand that women do “knowledge intensive occupations” would help nursing to be more valued and, in turn, attract both men and women into the profession.

“One of the things we can start doing is talking about our knowledge and skills and the impact nursing has beyond making people feel better,” she said. “The compassion and the caring are really important, but it isn’t generally compassion that will save somebody’s life.”

Likewise, Professor Leary highlighted that caring was currently seen as the “jurisdiction of women”, though she noted that “men can care too”.

“If we help people understand that there’s two sides to our story, then it will be more appealing as a profession to everybody,” she added.

Similarly, nursing student Mr Davidson reiterated the importance of showcasing that nursing was a “multi-skilled” and challenging occupation.

“We need to look at how we value, as a society, women’s work,” he said. “If we can showcase nursing for what it is and how multi-skilled it is, then I think we will be able to get more men into it.”

But he added that nursing was a “profession that has been championed by women for years” and, therefore, “men should not be seen as knights coming in to save it”.

Highlighting skills and opportunities is something that campaign group MINT has been focusing on to entice more men into the profession. Its stated aim is to encourage all genders to become nurses to help reduce the current 40,000 plus vacancy rate.

Group founder Mr Gwinnell said there were plans to develop an informative poster to be used in public spaces to attract the eyes of men considering a change of job.

He stated that the best way to encourage men into nursing was to “focus attention” at those looking for a career switch.

However, as previously mentioned, MINT has also been carrying out work at a much younger level. Mr Gwinnell and his team have been visiting schools in their uniforms to highlight to pupils that men can be nurses too.

“In that handful of children that say, ‘I didn’t know you could be a nurse as a man’, we’re challenging their thought process,” he said.

In a similar initiative, new chief nursing officer for England, Dr Ruth May, recently launched gender-neutral uniforms for schoolchildren to try on, to relay that nursing is a profession for both genders.

As she said in this month’s Nursing Times big interview: “We want to work with primary school kids so they start considering nursing, it’s not just a female profession.”

Paediatric intensive care nurse, Dann Gooding, has been working alongside the CNO to deliver the uniforms to children in schools to try and “change children’s perceptions” of nursing.

He said the uniform launch was a “great way” to “start dispelling the myths and rumours around nursing”.

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