500 word blog

Throughout this course you will read scholarly work on questions of diversity, exclusion and inclusion. You will write a weekly blog reflecting upon those issues, but rather than offering an unsubstantiated opinion on these matters, you’ll be expected to offer a unique but informed opinion supported by scholarly research and empirical evidence. 

1. Minimum 500 words.
2. 1 citation from academic source materials read that week in class. This must be cited with a page number and author. Sources may not be reused week-to-week.
3. 1 citation of an academic source (a relevant peer-reviewed article) from outside of class.  Sources may not be reused week-to-week.
4. 1 citation of a news media article relevant to the topic.
5. At least 1 audio or visual element that adds substantial content to support your argument. This could be a link to a video, pictures, etc.

This week reading.  Men in nursing: issues of gender segregation and hidden advantage Joan Evans RN MN Doctoral Student, Dalhousie University, Halifax, Nova Scotia, Canada 

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Career choice in nursing students: Gendered
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Journal of Advanced Nursing, 1997, 26, 226–231

Men in nursing: issues of gender segregation and
hidden advantage

Joan Evans RN MN
Doctoral Student, Dalhousie University, Halifax, Nova Scotia, Canada

Accepted for publication 17 July 1996

EVANS J. (1997) Journal of Advanced Nursing 26, 226–231
Men in nursing: issues of gender segregation and hidden advantage
The small but growing number of men in the nursing profession does not herald
a progressive integration of masculine and feminine sex roles. The evidence
presented in this paper suggests that even in female-dominated occupations
such as nursing, patriarchal gender relations which reflect a high valuation of
all that is male and masculine, play a significant role in situating a
disproportionate number of men in administrative and elite specialty positions.
At the heart of this gender dynamic is the need to separate the masculine from
the lesser valued feminine. Male nurses do this by employing strategies that
allow them to distance themselves from female colleagues and the
quintessential feminine image of nursing itself, as a prerequisite to elevating
their own prestige and power. They are aided in this task by patriarchal cultural
institutions that create and perpetuate male advantage, as well as by women
nurses themselves who, consciously or unconsciously, nurture the careers of
men colleagues.

Keywords: male nurses, masculinity, advantages

feminine sex roles. On the contrary, the literature suggests
INTRODUCTION

that the small number of men currently in the profession
occupy a privileged position in relation to their womenThe devalued status of women and women’s work in the

context of patriarchal society is reflected in the female- colleagues. This position is established and maintained by
patriarchal cultural institutions and the use of strategiesdominated occupation of nursing. Here stereotypical femi-

nine traits of nurturing, caring, dependence and sub- by male nurses to separate themselves and their masculine
sex role identity from their female colleagues and themission exist in stark contrast to masculine characteristics

such as strength, aggression, dominance, self-control and feminine image of nursing itself. These strategies and the
patriarchal structures that support them will be dis-objectivity. The incompatibility of masculine and femi-

nine sex role identities, coupled with the fact that increas- cussed in relation to their advantages for male nurses and
disadvantages for women.ing numbers of men are now entering the nursing

profession, prompts questions as to how men adapt to
nursing’s quintessential feminine sex role, and how the

TOKENISM AND MALE ADVANTAGE
influx of men in a female-dominated occupation impacts
on women nurses themselves. Statistics indicate that men in nursing remain a small min-

ority. In Canada and the United States, 3·1% of nurses areThis paper explores these questions and asserts that the
entrance of men into nursing does not necessarily herald male (Ryan & Porter 1993 p. 265). In the United Kingdom

(UK) the figure is 8·77% (Ryan & Porter 1993 p. 265). Inor signify a progressive integration of masculine and
contrast to the non-supportive and sometimes hostile treat-
ment that small numbers of women experience in male-Correspondence: Joan Evans, Department of Nursing, St Francis Xavier

University, PO Box 5000, Antigonish, Nova Scotia, Canada B2G 2WS. dominated occupations, Williams (1989) and Villeneuve

226 © 1997 Blackwell Science Ltd

Men in nursing

(1994) refer to Kanter’s concept of tokenism, and suggest the result that their perceptions of themselves are sub-
merged in the oppressor’s reality; the characteristics of thethat scarcity is not necessarily synonymous with disadvan-

tage in the case of male tokens. powerful group are perceived as being the best that can be
achieved, thus oppressed groups admire oppressor behav-Defined as solo or minority group members (up to 15%),

Kanter (1977) suggests that tokens are people who di�er iours and strive to be like them; horizontal (nurse to nurse)
violence and divisiveness, as a consequence of low self-from majority group members in ascribed characteristics

such as sex or race, which carry with them a set of assump- esteem and self-hate, plague the relationships of the
oppressed; and oppression is most complete when it is nottions about culture, status and behaviour. In the context

of patriarchal culture, men’s greater status and power in even recognized (Freire 1993).
Given these attitudes and behaviours, then, it comes asrelation to women a�ords them situational dominance,

with the result that small numbers of men in the female- little or no surprise that women nurses consciously or
unconsciously nurture the careers of men colleagues, oftendominated nursing profession are given a special and

privileged minority status (Ryan & Porter 1993, Villeneuve to the detriment of their own, which they may perceive to
be of lesser value.1994). Of additional significance is the observation that

with this high status comes power. In the nursing pro- The acknowledgement that men constitute a privileged
group in patriarchal society appears to be a major rationalefession, power and prestige are becoming increasingly

associated with small numbers of men by virtue of their for encouraging the entry of men into nursing, as it is
anticipated that a large influx of men will raise the pro-occupying a disproportionate number of elite specialty and

administrative positions (Ryan & Porter 1993, Gilloran fession’s status and prestige ( Johnson 1994, Cummings
1995). There is a flaw in such reasoning, however, as the1995).

The privilege accorded male tokens in female- issue of whether men will actually improve the image and
status of nursing, and the lot of nurses in general, is debat-dominated occupations such as nursing is in keeping with

Dorothy Smith’s (1987) view that it is men, not women, able. The lack of consensus or investigation regarding the
impact of men in and on the profession is reflected inwho have title of routine entry into the circle of those who

count for one another. She adds that for men there is some- diverse views expressed in the nursing literature.
Some authors suggest that men are not needed to elevatething like a plus factor that adds force and persuasiveness

to what men say and do. For women, however, there is a nursing’s status and that women, without the assistance
of men, have made significant gains in this area during theminus factor that depreciates and weakens (Smith 1987

p. 30). Consequently, how men and women tokens are last quarter century (Ryan & Porter 1993). Others, particu-
larly men authors, contend that women in nursing shouldtreated in occupations dominated by the opposite sex is

significant and indicative of the high value associated with not expect men to protect women from other men or to
function as saviours of the profession (Wheeler 1991). Stillall things male and masculine in patriarchal culture.

In the specific context of the nursing profession, the others point to the disproportionate numbers of men in
elite specialties and leadership positions as an indicationentry of small numbers of men, and their disproportionate

attainment of status and power, may also be facilitated by that, rather than elevating the status of all nurses, the entry
of men into the profession elevates the status of men onlynursing’s caring ideology — an ideology that reflects pro-

fessional, as well as feminine, values of nurturing and sup- (Watson 1983, Gilloran 1995).
For women nurses, then, the presence of men in theporting others (Villeneuve 1994). When such an ideology

is coupled with the notion that men are valuable, special profession does not necessarily signify an improvement in
professional or individual status. Indeed, for women, theor unique, the occupational climate that results is charac-

terized by women nurses who consciously or uncon- inter-occupational subordination which they experience
in the context of a patriarchal, physician-dominated,sciously support and nurture the careers of men colleagues

(Kauppinen-Toropainen & Lammi 1993, Villeneuve 1994). health care system may well be exacerbated by the
addition of a second and intra-occupational site of subordi-Women nurses’ complicity in nurturing and furthering

the careers of men colleagues can also be understood nation to men colleagues. Such a situation is captured by
Porter (1992) who contends that nursing will increasinglywithin the context of oppressed group behaviour. Nurses

Roberts (1983) & Hedin (1986) draw on the work of Paulo become an occupation divided between men managers and
women ward workers.Freire and propose that nurses as women are an oppressed

group by virtue of their subordinate status in patriarchal At the heart of such a situation is the maintenance of
patriarchal gender relations predicated on the separationsociety, as well as the male, physician-dominated health

care system. They further elaborate by suggesting that of male and female characteristics and the subsequent
valuing of the male over the female. For men nurses, awomen nurses display attitudes and behaviours which

typify those identified by Freire (1993) as characteristic of masculine sex role identity is therefore based on the suc-
cessful separation of the ‘masculine’ and the male fromall oppressed people. These include: oppressed groups

internalize the norms and values of their oppressors with the ‘feminine’ and the very image of nursing itself — an

227© 1997 Blackwell Science Ltd, Journal of Advanced Nursing, 26, 226–231

J. Evans

image which is the embodiment of feminine values and them as ‘deviant’ and isolate them from other men
(Greenberg & Levine 1971, Egeland & Brown 1988).the feminine sex role in patriarchal culture. The nursing

literature describes various strategies used by male nurses Secondary benefits of specialization also include increased
pay and enhanced prestige (Williams 1995). Specialtiesto do just this.
chosen by men for their compatibility with male character
traits include: psychiatry, because of its association with

SPECIALIZATION
physical strength; anaesthesiology, because of its associ-
ation with technical prowess and autonomy; and, inten-Despite a rich and documented history of men nurses

throughout ancient times, the middle ages, and the 19th sive and emergency care, because of their association with
technical prowess and cool-headedness.and 20th centuries (Okrainec 1990), men in the nursing

profession continue to be stereotyped as anomalies, Not only do these specialties reflect stereotypical mascu-
line behaviours, but male identity within these fields ise�eminate or homosexual (Haywood 1994, Williams

1995). This stereotype, rather than based on any objective further reinforced by their lack of association with femi-
nine nursing traits — specifically the need to touch, andassessment of men’s sexual life styles, is, as pointed out

by Williams (1995), based on beliefs about masculinity. the delivery of intimate care at the bedside (Greenberg &
Levine 1971). As a consequence of choosing fields of nurs-She elaborates by stating that, because nursing is assumed

to require female attributes such as a capacity to nurture, ing with a low feminine and high masculine sex role
identification, men are credited with seeking out and cre-empathize and serve others, men who nurse must be

feminine. ating for themselves ‘islands of masculinity’ within the
profession (Egeland & Brown 1988).Nurse Gary Okrainec (1990) suggests that a lack of appli-

cation of the long history of men in nursing is one factor It is not men alone, however, who create such islands,
as a significant role is played by women nurses whothat has perpetuated the feminine image of nursing. Also

of great significance is the role played by Florence reinforce stereotypical gender relations. In support of this
claim, Williams (1995) argues that men nurses are alsoNightingale in the 19th century in firmly establishing nurs-

ing as a female occupation. To Florence Nightingale, every tracked into prestigious specialties by women nurses, edu-
cators and administrators who, like their men colleagues,woman was a nurse, and women who entered nurses’

training were doing only what came naturally to them as perceive them to be more compatible with the masculine
sex role. This observation is supported by Squires (1995).women (Nightingale 1969). The apprenticeship style of

education she subsequently initiated for nurses was based In a survey of workplaces of men nurses in 50 Connecticut
hospitals, he found that men nurses tended to be employedon these beliefs, for it was deemed that women did not

require education prior to working in hospitals. Instead, in ‘fast-paced, high tech areas’ such as the ICU, ER or OR,
whereas no men were employed in obstetric or gynae-they would learn on the job under the tutelage of men

physicians. cology specialties. Reasons for these employment trends
were not explored; however, the fact that California’s FairThe belief that nursing was an extension of women’s

domestic roles was consequently instrumental in estab- Employment and Housing Commission recently upheld a
San Bernadino hospital’s ban on men nurses working inlishing nursing as not only a woman’s occupation, but as

one that was unskilled and of low value in comparison to obstetric and gynaecology specialties (Letizia 1994, cited
in Squires 1995) provides irrefutable evidence that the pro-male occupations, particularly medicine (Palmer 1983).

This devalued or lesser status assigned to women and fession supports the view that men are better suited to
practice in some areas of nursing than others.women’s work provides us with what Porter (1992) calls

a reflection of the ‘patriarchal feminine’. Such a term, he What ultimately serves as the basis for these judgements
is patriarchal notions of what constitutes appropriate femi-points out, is not simply descriptive, but one that involves

judgement about the value of various human activities. nine and masculine sex roles. In response to such judge-
ments, nurse Mike Haywood (1994) argues the case ofThose activities categorized as a man’s domain were

valued more highly than those judged appropriate for reverse discrimination and suggests that it is of paramount
importance that nursing takes a look at itself and ensureswomen.

Given the feminization of nursing work itself, the label- that it is not guilty of gender discrimination while fighting
for equality on women’s issues.ling of men nurses as odd or homosexual can also be inter-

preted as a social control mechanism which re-defines
nursing as women’s work, since such stigmatizing labels

NURSING TASKS AND IMAGE
imply that men who do nursing are di�erent from other
men (Mangan 1994). The appeal then of nursing specialties In addition to men choosing and being tracked into nursing

specialties that support a masculine identity, research withwhich appear to be more congruent with the masculine
sex role is significant, since men nurses are able to reduce men and women nurses in Sweden, Norway and Finland

suggests that men also shape their work role to be moreor eliminate sex role conflict and dispel labels that identify

228 © 1997 Blackwell Science Ltd, Journal of Advanced Nursing, 26, 226–231

Men in nursing

masculine by emphasizing their task-oriented, as opposed the reverse. Reasons cited by men nurses included the
perception that men and women just did not talk the sameto people-oriented behaviours. In so doing, researchers

Kauppinen-Toropainen & Lammi (1993) found that men language, and that the topics discussed by women, i.e.,
‘babies’ and ‘periods’, and the shortcomings of men, arenurses were able to distance themselves from their women

colleagues and the feminine working strategy which not of interest to them (Williams 1989 p. 118). Instead,
men nurses reported that they were more interested instresses a care-oriented rationality. Williams (1989, 1995)

supports this finding in the American context and adds talking about sports and vehicles, and they subsequently
shared these interests with other men, particularly menthat, even for those men nurses working at the bedside in

more feminine caregiver roles, masculine identity is main- physicians. This practice, in addition to fulfilling men
nurse’s socialization needs, also provides significanttained by emphasizing di�erent caring styles, and the

‘specialness’ of masculine-oriented skills such as heavy advantages for men’s career advancement prospects.
In support of this statement, Williams (1989) suggestslifting and male catheterization.

Consistent with research findings which suggest that that men nurses receive special treatment from physicians
who view them as being more competent. This attitude,men nurses experience only minimal or no role strain,

Villeneuve (1994) identifies nursing’s job title and associ- which is then reflected in physician evaluations, plays an
indirect but significant role in determining nurses’ pos-ated images, and not the practice of nursing itself, as sig-

nificant barriers to the recruitment of men into the itions in hospitals. Conversely, special attention paid to
men nurses by physicians may also be potentially damag-profession. Similarly, Williams (1989) found that men

nurses in the US Army Corps felt that changing the pro- ing if, as Williams (1995) suggests, men nurses come to
identify too closely with physicians and become disen-fession’s name to escape its feminine breastfeeding conno-

tation was of primary importance if the profession was to chanted with nursing because of its low status and pay.
Men nurses’ strategy of socially distancing themselvesattract men recruits.

An additional nursing image identified as compromising from women colleagues is also, as suggested by Egeland &
Brown (1988), often characterized by a devaluing ofmasculinity is the traditional nursing uniform (Greenberg

& Levine 1971). Perhaps not surprisingly, Greenberg & women’s small talk. They elaborate by pointing out that
men tend to describe women’s small talk as ‘gossiping andLevine (1971) noted that many of the specialty areas

chosen by men nurses required non-traditional nursing bitching’. Such labelling, they add, constitutes a subtle
form of discrimination which promotes the idea thatdress which consequently enabled them to escape explicit

identification as nurses. Psychiatric nurses wore street women are not suited to positions of authority.
As a consequence, then, of men nurses distancing them-clothes, and nurse anaesthesiologists, operating room

greens. Of particular significance is the observation that, selves from women colleagues and allying themselves with
men physicians, patriarchal gender relations that valuewhile wearing greens in the operating room, nurse anaes-

thesiologists blended with men physicians and were thus masculine character and leadership traits are perpetuated
and maintained. This is accomplished by devaluing thepromoted by their dress.
feminine, and consequently poses a significant barrier to
women’s attainment of leadership positions.

SOCIAL DISTANCING

The nursing profession, like all professions, is structured
PATRIARCHAL INSTITUTIONS AND MALE

in ways that benefit men (Smith 1987, Williams 1995). Top
ADVANTAGE

jobs in nursing emphasize leadership skills, technical com-
petence, and an unconditional dedication to work — qual- The hiring and promotion advantages a�orded men due

to the high value attached to male character/leadershipities typically associated with the male sex role (Williams
1995). Qualities associated with the feminine nursing role, traits, assumes even greater significance when it is com-

pounded by advantages hidden in patriarchal institutions.such as attention to detail and emotionalism, are viewed
as inappropriate leadership skills, and they consequently Demographic data regarding men and women nurses’

marital status and education highlight this observation.act as barriers to women’s achievement of higher status
positions in the profession. For men nurses who aspire to Data with regard to nurses’ marital status indicate that,

for men nurses, marriage is a significant career advantage.leadership positions, separating the masculine from the
feminine and its associated anti-leadership traits presents For women, it works to their disadvantage. Because the

patriarchal family frees men from the heavy burden of chil-as an important task in maintaining gender-based prestige.
This task is accomplished by strategies such as socializing drearing and housekeeping responsibilities, men benefit

by having more time and attention to devote to activitieswith physicians and distancing themselves socially from
women colleagues. outside the home. Okrainec’s (1994 p. 102) research sup-

ports this conclusion and indicates that only 63·9% ofWilliams (1989) reports that men nurses tend to exclude
themselves from socializing with women colleagues, not women, as compared to 89·6% of men, nursing students

229© 1997 Blackwell Science Ltd, Journal of Advanced Nursing, 26, 226–231

J. Evans

in Alberta schools of nursing expect to be working full- preferred men as supervisors. Cummings (1995) suggests
that this attitude reflects two stereotypes that blocktime in nursing 10 years after graduation. Anticipated

family responsibilities were suggested as a major reason women’s access to power in organizations. The first is that
no one wants to work for women, the second that they arefor this disparity.

The stereotype that married men are also family bread- too bossy and controlling. Together, these stereotypes
block the e�ective use of power and women’s leadershipwinners provides an additional advantage to men, as it

implies that married men are more permanent employees potential.
Conversely, Williams (1995) points out that, for men,and more dedicated to their careers (Williams 1995). Given

that marriage appears to benefit men and disadvantage subtle processes may actually pressure them to move
into the best possible positions — often despite the inten-women in career advancement, it is not surprising that

women nurses who occupy positions of status and prestige tions of the men involved. She elaborates by referring to
the gay stereotype of men nurses and acknowledges that,tend to be single and childless (Hutt 1985, cited in

Gilloran 1995). although it is not advantageous to men, neither is it
deleterious to their career prospects. In some cases, sheA second example of demographic data which reveals

hidden institutionalized advantages for men is that of edu- suggests that it may even inspire men to pursue adminis-
tration careers to avoid patients with stereotypical atti-cation. The literature indicates that, in general, men nurses

tend to have more university degrees than their women tudes, and thus concludes that negative stereotypes can
pressure men to move up in the profession (Williamscolleagues (Greenberg & Levine 1971, Okrainec 1994).

Okrainec (1994, p. 99) reported that 18·2% of men nursing 1995 p. 70). Ultimately then, gendered attitudes shared by
women and men are reinforced and perpetuated by patriar-students, as compared to 6·7% of women, had university

degrees. Given that education is one of the best predictors chal societal institutions and processes. The ultimate
result is the positioning of women nurses in inferior ‘femi-of career success (Williams 1989), women nurses are dis-

advantaged when competing in hiring and promotion situ- nine’ roles, and men nurses in roles that reflect masculine
identity and values of male supremacy.ations with men who have better credentials. Williams

(1989) reports that married women nurses are significantly
less likely than single women to pursue advanced degrees.

CONCLUSION
Again, heavy domestic duties are suggested as a possible
reason. Additionally, Pyke (1991) points to the fact that The entrance of men into the nursing profession does not

signal a progressive integration of masculine and femininewomen are less likely to pursue higher degrees, and attri-
butes this situation to the masculine quality of education sex roles. Indeed, the evidence presented in this paper

suggests that, even within female-dominated occupationswhich she contends creates a ‘chilly climate’ for women
students due to sex-based inequalities and discriminatory such as nursing, patriarchal gender relations play a sig-

nificant role in situating a small number of men in pos-practices. She elaborates by describing ‘chilly climate’ fac-
tors as: calling upon women students less frequently; the itions of status and power. At the heart of this dynamic is

the need to separate the masculine from all that is femininetendency to trivialize and devalue women’s work and con-
tributions; and, the maintenance of an argumentative, com- and of lesser value within the context of patriarchal cul-

ture. Williams (1989) supports this observation and con-petitive, impersonal, interactive style that is not conducive
to women’s ways of knowing and being in the world. tends that, as long as men feel a psychological need to

separate themselves from women and as long as their ownUltimately, then, in the context of patriarchal culture, edu-
cational institutions and the institution of marriage itself adult gender identity is premised upon denying and denig-

rating whatever they conceive to be feminine, men willprovide men with hidden but powerful advantages that
assist them in achieving high status leadership positions continue to desire that certain activities remain ‘for men

only’ (Williams 1989 p. 142). The hope for change, then,over women.
Given the way in which institutions construct and lies in challenging and transforming hegemonic notions of

masculinity and femininity.reinforce patriarchal notions of masculine superiority in
relation to leadership capability, it is not surprising that
more men than women nurses aspire to leadership pos-
itions (Okrainec 1994), and that more men than women

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