In the Preface of Notes on Nursing, Florence Nightingale wrote, “…every woman is a nurse.” That men were—or could be—nurses was not within Nightingale’s Victorian worldview. Men were doctors (husbands) and women were nurses (wives and mothers). A re-read of her book revealed to me one place in which she hints at the fact that men could be useful as nurses. It comes mid-way through her chapter “Noise”:

“A man is now a more handy and far less objectionable being in a sick room than a woman. Compelled by her dress, every woman now either shuffles or waddles—only a man can cross the floor of a sick-room without shaking it!”

She goes on to condemn the wearing of rustling silk and crinoline and the creaking of stays and shoes. Presumably she advocated simple (and quiet) cotton dresses for nurses.

As I wrote in my previous blog post “More than a few more men needed in nursing” (12-15-10), nursing continues to be the least gender balanced of any of the health professions. The traditionally male-dominated medical profession has achieved almost perfect gender balance. The other traditionally female-dominated profession of social work now has at least 20% men, while nursing continues to have a paltry  7% men in the workforce.

Until this week I considered myself an enlightened female nurse on the issue of gender diversity in nursing. But then I started looking at the required readings—especially the ones from nursing textbooks—that I had assigned for my community health course. I realized how un-gender neutral they are. All of the contemporary community/public health nurses who are quoted or included in photographs in the chapters are female. An otherwise well-written chapter on the history of public health nursing in the U.S. only mentions female nurses and uses terms like “our sister nurses” and “our foremothers.” Where are our brother nurses and our forefathers?

Important facts I learned this week from reading up on the topic of men in nursing include:

• Men in nursing have a long and venerable history that is not acknowledged or taught very well in nursing schools. The history includes monastic orders dating back to the fourth and fifth centuries.
• In the U.S. beginning after the Civil War men were actively shut out of nursing. For instance, the U.S. Army Nurse Corps banned men until 1955. When men were allowed to be nurses they were mainly confined to psychiatric nursing, which was considered dangerous and undesirable work for female nurses.
• The commonly held perception (and resentment) among female nurses that men in nursing disproportionately get promoted and hold higher-paying administrative positions over their female counterparts does have merit. Economists call this phenomenon the “glass elevator,” and it applies to men in all female-dominated occupations (pink-collar jobs). However, within nursing this could also be partially explained by the fact that most men enter nursing at an older age and after time in another career versus their female counterparts. (see NYT ” More Men Enter Fields Dominated by Women” by Dewan and Gebeloff/5-20-12 and “More Men Trading Overalls for Nursing Scrubs” by Vigeland/3-21-12).
• The Institute of Medicine’s Future of Nursing report specifically identifies improvement in gender diversity as a necessity for nursing. Running a profession on only half of the population (gender-wise) is unwise and untenable.

My conclusion: Nursing needs the best and the brightest no matter what their chromosomal make-up happens to be. We need more men in nursing. We need better nursing textbooks….