Barriers and facilitators to recruiting and retaining men on pre-registration nursing programmes in Western countries: A systemised rapid review

Addressing Shortages in Nursing with Male Representation: A Literature Review

The nursing shortage in the US and all over the world continues to skyrocket. An untapped channel of recruitment that some are considering is men in the nursing profession. Currently a large disparity exists in the representation of men in nursing causing issues with quality of care, diversity, and staffing. Research suggests that nursing recruitment should occur before licensure in order to better address gender stereotypes and prejudice. Early exposure is revealed as a defining factor in enticing men into the profession. Further research reveals that issues related to nurse educator staffing must first be considered to include more men into the profession. Without nurse educators, schools are unable to increase class sizes and admit more men into programs.

Qualitative systematic review: The lived experiences of males in the nursing profession on gender discrimination encounters

AIMS

This review aims to synthesise the best available evidence exploring the lived experiences of males in the nursing profession on gender discrimination encounters.

BACKGROUND

The underrepresentation of males within the nursing profession could potentially cause discrimination and stereotypes against them, causing barriers to entry into, and retention within, the profession. With a shortage in manpower, the deterrence of males to nursing might exacerbate the existing manpower shortage. This review consolidates and highlights the lived experiences of males in the profession.

METHODS

The review was synthesised according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Employing the meta-synthesis approach, two independent reviewers conducted critical appraisal and data extraction of included studies, using the standard Joanna Briggs Institute (JBI) Critical Appraisal Instrument for Qualitative Research and a standardised data extraction form, respectively.

RESULTS

Twenty-three studies were included. Extracted findings were aggregated into 14 categories and synthesised into three themes: stereotypes, discrimination and challenges faced by males.

DISCUSSION

The synthesised findings showed that male nurses faced gender discrimination in multiple facets. These caused them to have difficulty in carrying out their nursing duties, missing out of clinical opportunities and causing them multiple social and mental stressors.

CONCLUSION

This review informed the discriminatory experiences faced by males within the nursing profession. With males already underrepresented within this profession, it is imperative for interventions, policies and research to be made to address this issue to improve experiences of male nurses, thereby limiting the deterrence of males into the profession.

IMPLICATIONS

Findings of this study showed that males are being stereotyped and discriminated, resulting in challenges faced solely because of their gender. Effective interventions and policies could be implemented to alleviate the negative experiences.

Building Career Pathways for Cancer Nurses: Ensuring Cancer Nursing's Future

OBJECTIVES

It is well established that cancer nurses and advanced practice nurses (APN) are critical to the delivery of high-quality, accessible, safe, and affordable cancer care globally. Specialized cancer nurses and APNs with a strong foundation in the pillars of nursing practice (clinical, leadership, education, and research) are essential to optimize patient outcomes, create increased cost-efficiencies through innovative models of care delivery, and can further leverage interprofessional collaboration in cancer care. To address the existing shortcomings in cancer control, Australian cancer nurses, including APNs, and cancer nurses and APNs globally, need an evidence-informed consensus drive framework to harmonize clinical, educational and career pathways leading to specialization, advanced practice, promotion, and equitable and accessible education.

METHODS

Critical perspective.

RESULTS

Scoping work has begun to build on the 2009 seminal Australian EdCaN framework, with ambitions to develop a contemporary practice and career framework for all cancer nurses which details clear pathways to specialized and APN roles inclusive of navigating to and through direct clinical care, research, academia, education, and management or executive leadership.

CONCLUSIONS

A revised framework that is cognizant of the changing landscape of contemporary cancer care, and the growing diversity of nursing roles is needed to address the imminent nursing workforce crisis.

IMPLICATIONS FOR NURSING PRACTICE

The revised framework may support the implementation of the newly released Australian Cancer Plan and provide a career pathway model that may be adopted internationally, including in low- and middle-income countries.

Strategies to attract school-leavers to nurse education programmes: an integrative literature review

The shortfall of nurses in the UK has led to concerns that there are insufficient staff to ensure safe and high-quality care. To address this shortfall, one group to focus on for recruiting nursing students is school-leavers. This article reports on an integrative literature review that was conducted to explore the educational strategies used to attract school-leavers to undergraduate nurse education programmes. The review identified that a variety of educational strategies were used, and all of the included studies reported positive effects on school pupils' intention to undertake nursing studies. These strategies often included interactions with nursing staff and/or nursing students, as well as observing and practising clinical skills, for example via simulation. However, most participants likely had a pre-existing interest in healthcare or nursing, the interventions were delivered predominantly to young women, and the included studies lacked longer-term follow-up. This highlights a need to conduct further research to assess the longitudinal impact of recruitment strategies aimed at broader audiences.

Reliability and validity evaluation of the Chinese version of the gender misconceptions of men in nursing (GEMINI) scale among nursing students

BACKGROUND

Misconceptions about male nurses not only exacerbate the gender imbalance in the nursing profession but also negatively impact male nurses embarking on their careers. Currently, no tool exists to measure the gender biases toward males in nursing among nursing students in China. Consequently, the primary objective of this study is to assess the validity and reliability of the Chinese translation of the Gender Misconceptions of Men in Nursing (GEMINI) scale among nursing students.

METHODS

This cross-sectional study involved 1,102 nursing students from China who participated online. We utilized the Brislin translation technique with a forward-backward approach. To determine the factor structure within the Men in Nursing Gender Misconceptions Scale's Chinese version, both exploratory (EFA) and confirmatory factor analysis (CFA) were applied. The scale's internal consistency was measured through the Cronbach's alpha coefficient, corrected item-total correlation, and a retest reliability assessment.

RESULTS

The scale showed a content validity index of 0.938 and a retest reliability of 0.844. EFA indicated a two-factor structure for the translated instrument. CFA revealed a chi-square/degree of freedom of 3.837, an incremental fit index (IFI) of 0.952, a goodness-of-fit index (GFI) of 0.910, a comparative fit index (CFI) of 0.952, and an RMSEA of 0.073, all of which were within acceptable limits. The scale's Cronbach's α was 0.953, and the corrected item-total correlations ranged between 0.539 and 0.838. Gender-based misconceptions about men in nursing among students appeared to be influenced by their gender and whether they considered a nursing program as their first choice when applying for a major. Misconceptions about male nurses are greater among men and those who do not consider nursing programs as their first choice when applying for a major.

CONCLUSIONS

The Chinese adaptation of the GEMINI scale showcased high reliability and validity. It stands as a potential instrument to gauge gender misconceptions concerning male nurses among Chinese nursing students.

Are men treated differently in clinical placements during nursing studies? A cross-sectional study

AIM AND OBJECTIVE

To explore the perceptions of nursing students regarding the treatment of men in nursing during their clinical placement.

BACKGROUND

Negative placement experiences of men who are nursing students is a risk factor for student attrition. Hence, exploring gender disparity in treatment during placement from both men and women studying nursing will contribute to improving student experience and reducing attrition.

DESIGN

Survey capturing both quantitative and qualitative data.

METHODS

Nursing students were surveyed between July and September 2021 across 16 Schools of Nursing in Australia. In addition to the Clinical Learning Environment Inventory (CLEI-19), an open-ended question explored if men received different treatment during clinical placement.

RESULTS

Those who expressed difference in treatment of men were less satisfied with their clinical learning experience (p < .001). Of the 486 (39.6%) who responded to the open-ended question, 152 (31%) indicated a difference in the treatment of men, reporting that men received: (a) better (39%); (b) different, not exclusively better or worse (19%); and (c) worse (42%) treatment from either the clinical facilitator or ward staff. While both men and women perceived gender differences in the treatment of men during placement, men were more likely to report worse treatment.

CONCLUSION

Despite the advances achieved in recruiting men in nursing, negative experiences during clinical placement are characterised by stereotypes, prejudice and discrimination, adversely impact retention.

RELEVANCE TO CLINICAL PRACTICE

Nurse educators need to recognise specific support students require during placement regardless of gender. Our findings reinforce the adverse impacts of inequitable treatment on both men and women nursing students on learning, clinical performance, morale and ultimately on retention in the nursing workforce. Addressing gender stereotyping and discrimination in the undergraduate nursing program is an important step in promoting diversity and inclusivity in the nursing workforce.

Male nurse practice in inpatient rehabilitation. Finding a safe way: a grounded theory

BACKGROUND

Research interest in nursing's contribution to inpatient rehabilitation is growing. Nurses contribute to rehabilitation specifically by teaching patients how to care for themselves. This contribution is largely reported from a female or genderneutral perspective. Despite the work of male nurses being examined in a range of other specialities, their work within inpatient rehabilitation remains underexplored.

OBJECTIVE

To report on a grounded theory study to identify and make visible male nurse practice in inpatient rehabilitation in Australia.

DESIGN

Constructivist grounded theory informed by symbolic interactionism.

SETTING(S)

Stage 1 data were collected in locations of participants choosing throughout Australia. Stage 2 data collection centred on seven data collection sites across two specialist rehabilitation hospitals in two states of Australia.

PARTICIPANTS

Twenty-three male nurses and 15 patients participated in the study.

METHODS

Stage 1 (October 2013 to June 2014) consisted of semi-structured interviews with 11 male nurses. Stage 2 (February to April 2015) consisted of semi-structured interviews and 63.5 h of non-participant observation with 12 male nurses. Fifteen interviews with patients as recipients of male nurse care were also conducted. Data analysis included initial coding, focused coding, and theoretical coding using constant comparative methods, memo writing and diagramming.

RESULTS

Nurse participants were aware of patient perceptions about nursing being an occupation for women and male nurses being perceived as sexual threats, which led to an everyday concern of potential for misinterpretation. To address this concern, male nurses engaged in a three-phase process known as assessing and managing risk in order to minimise risk and to keep themselves safe in practice. However, two contextual conditions, type of care and urgency of care, influenced engagement in assessing and managing risk. The core category and substantive grounded theory to explain these results is finding a safe way.

CONCLUSIONS

Gender stereotypes affected the daily working lives of male nurses in inpatient rehabilitation. To counter the risk of misinterpretation male nurses used a range of strategies to address the barriers encountered daily in their working lives. However, male nurse efforts were often influenced by conditions outside of their control. In inpatient rehabilitation, male nurses practised cautiously to keep themselves safe in order to practise nursing.

Barriers and facilitators to enrolling in nursing programs as perceived by male students: a qualitative study in the United Arab Emirates

OBJECTIVES

Despite the cultural challenges and stigma associated with nursing in the United Arab Emirates, there has been an increase in male nursing students. It is therefore important to understand barriers and facilitators that influence their decision to choose nursing education.

METHODS

This qualitative study used purposive sampling to recruit 30 male undergraduate students. Semi-structured interviews were conducted and data were analyzed with thematic analysis.

RESULTS

Ten themes were identified that described barriers and facilitators to choosing nursing programs as perceived by male students. Four themes reflected barriers and six themes were identified that encompassed facilitators to choosing nursing programs.

CONCLUSIONS

For international audiences, our findings could be helpful in enhancing both the recruitment and educational opportunities for male nursing students. Male students may be inspired to pursue the nursing profession by the presence of men in the profession and favorable male role models. Effort is needed to recruit male role models in nursing schools.

The Experience of Being Male Nurse: Exploring the Enhancing Factors and Barriers of Jordanian Nursing Students

Introduction

Despite advances in health care and education, males continue to be considered a minority in nursing programs. Little is known about the decision of Jordanian male nursing students to become nurses.

Objective

The purpose of this research was to explore the factors that encourage or discourage Jordanian male nursing students from pursuing a career in nursing.

Methods

A qualitative narrative approach was used for this study. Data were collected using semi-structured individual interviews. Purposive sampling was used in the research. In this study, interviews were conducted with a sample of 28 male college students.

Results

The current study discovered that the following six themes exemplified the male nursing students' lives: "helping and caring," "job security and economic stability," "parents and peer influence," "level of autonomy," "social stigma," and "long working hours."

Conclusion

The study's findings highlighted the importance of researching male nursing students' motivating and inhibiting factors.

Men in the service of humanity: Sociocultural perceptions of the nursing profession in South Africa

Background. The classification of nursing as a female-gendered profession, along with patriarchally determined cultural gender roles, makes it difficult for men to select nursing as a career and to excel in their caring capacity as nurses.Objective. To gain in-depth insights into and an understanding of male nursing students’ perceptions of the nursing profession.Methods. A generic qualitative approach, which was explorative, descriptive and contextual, was used to conduct the study. Sixteen male nursing students at two nursing education institutions in KwaZulu-Natal Province, South Africa, were purposively sampled to participate in the study. Data were collected using semi-structured interviews and unstructured observation. Thereafter, thematic analysis was used to analyse the data. Results. Three main themes were developed from the interview data. The participants perceived nursing as the extension of women’s work, with low social status ‒ nursing is not considered to be a profession for men. During the provision of nursing care, feelings of discomfort and embarrassment were experienced. They feared misinterpretation of their care, especially when caring for the naked body when alone with a patient. They resorted to the use of cautious caring, where they do not provide physical care alone, but seek support, especially from female nurses. Conclusion. Male nursing students require role models to support them in their academic journey towards becoming competent practitioners. A male-friendly environment should be created to enable them to provide quality nursing care to all patients. The society needs to be empowered in understanding that men choose the nursing profession to provide care, and that they are capable of caring for the sick.

Listening to the minority: A qualitative study exploring male students' perceptions of the nursing profession and reasons for choosing nursing as a career

INTRODUCTION

Nursing is a rapidly growing profession that has traditionally been dominated by women. Research has highlighted various challenges associated with increasing the number of male nurses, such as cultural challenges and stigma related to nursing. The United Arab Emirates (UAE) has experienced an increase in male students enrolling in nursing programs. To ensure this is sustainable, it is important to understand how male students perceive nursing and clarify factors that influence their decision to choose nursing as a career.

OBJECTIVES

To explore male nursing students' perspectives of the nursing profession and understand why they chose nursing as a career.

METHODS

Participants in this qualitative analysis were 30 male students that were selected using purposive sampling. Semi-structured interviews were used to collect data about participants' experiences. We used a qualitative content analysis to guide the data analysis.

RESULTS

Three main themes were identified that described male students' perspectives of and reasons for choosing nursing: (1) perceptions of nurses and nursing profession; (2) individuals as facilitators or role models in choosing the nursing profession; and (3) barriers to choosing the nursing profession.

DISCUSSION AND CONCLUSION

Our results regarding barriers and facilitators for male students in choosing to study nursing may be useful to help improve the recruitment of and learning opportunities for male nursing students. Highlighting the male presence in the nursing profession and positive male role models may encourage males to enter the profession. Therefore, understanding the experiences of male nursing students in choosing nursing as a career has important implications for nursing practice and education.

Factors Influencing Male Nursing Students' Adaptation to College Life in Korea

BACKGROUND

Male nursing students face challenges in the nursing profession because of its female-centered nature. In particular, most male students in South Korea must complete military service while in college. Although these kinds of situations may make it difficult for them to adapt to college life, the number of male nursing students is gradually increasing. Therefore, it is important to identify the influencing factors to promote male nursing students' successful adaptation to college life.

PURPOSE

This study was developed to investigate the relationship between self-efficacy, social support, stress coping, and adaptation to college life among male nursing students in Korea. Factors that influence their adaptation to college life were also analyzed.

METHODS

A cross-sectional study was conducted on 217 male nursing students from seven colleges in Korea. Participants completed a questionnaire that was designed to measure self-efficacy, social support, stress coping, and adaptation to college life. Data were analyzed using descriptive statistics, independent t test, one-way analysis of variance, Scheffé test, Pearson's correlation coefficient, and multiple regression.

RESULTS

Male nursing students' self-efficacy, social support, stress coping, and adaptation to college life were shown to all positively correlate with each other. The main factors influencing adaptation to college life were social support, self-efficacy, satisfaction with major, and problem-solving-centered stress coping.

CONCLUSIONS

Strategies to enhance social support, self-efficacy, satisfaction with major, and problem-solving-centered stress coping should be developed to improve male nursing students' adaptation to college life.

The Influence of Messaging on Perceptions of Careers in Veterinary Medicine: Do Gender Stereotypes Matter?

The veterinary medical workforce is increasingly female; occupational feminization often transfers stereotypes associated with the predominant gender onto the profession. It is unknown whether within veterinary medicine a feminized public image is a possible contributor to the reduction in male applicants to training programs. The influence of stereotypically gendered messaging on how male and female undergraduate students perceive veterinary medicine was investigated in 482 undergraduate students enrolled in five introductory or second-level biology courses. Two short videos introducing the field of veterinary medicine were developed with imagery and language selected to emphasize either stereotypic feminine (communal) or masculine (agentic) aspects of the field. Participant groups were randomly assigned one of the two videos (feminine/communal or masculine/agentic) or no video (no exposure). An outcome survey elicited impressions of the field of veterinary medicine and gathered demographic data. There was a significant linear trend of condition on perception of the profession as feminine or masculine and on perception of the activities of a veterinarian as feminine/communal or masculine/agentic. Female participants were significantly more likely to agree that someone of their gender would be valued in the profession. Male participants reported significantly higher self-efficacy scores for performing the tasks of a veterinarian when they viewed the feminine stereotype video. These results demonstrate that gendered perceptions of the field can be manipulated. Intentional gendered messaging should be further explored as one strategy to broaden the talent pool in the workforce by attracting men back to the field.

Isolation and Marginalization: Exploring Attrition of Men in Preregistration Nursing Programs

BACKGROUND

In Scotland, similar to other countries, male nursing students have a high attrition rate. This study examined the reasons for and ways to decrease the attrition rate.

METHOD

This four-phase collaborative study included four Scottish universities. Phase 1 involved three telephone interviews with men who had left a nursing program. Phases 2 through 4 used focus groups and interviews with 18 nursing students (13 men and 5 women) and 12 nurse lecturers. Thematic analysis followed a four-stage process.

RESULTS

Male nursing students in this study felt isolated and marginalized, were stereotyped regarding their masculinity and physical attributes, had difficulty communicating, and were reluctant to seek help. Financial pressures and access to learning opportunities also disproportionately affected male students. Resilience and maturity are required to cope with these challenges.

CONCLUSION

Proactive measures and visible role models in academic and clinical environments are needed to support male students in completing their nursing education. [J Nurs Educ. 2022;61(4):179-186.].

Family-supportive supervisor behaviour positively affects work behaviour and nonwork well-being among men in long-term care

AIMS

This study examined whether family-supportive supervisor behavior is associated with work behavior (safety compliance and organizational citizenship behavior) and nonwork well#x2010;being (family time adequacy, time in bed and sleep quality) among men working in long-term care. Men's nonwork care roles for children (double-duty-child caregivers), adult relatives (double-duty-adult caregivers), or children and adult relatives (triple-duty caregivers) were assessed as moderators.

BACKGROUND

Family-supportive supervisor behaviour is a modifiable workplace practice that may help recruit and retain men in nursing amid their increasing nonwork demands.

METHOD

Multiple linear regression analysis was performed on cross-sectional, secondary survey data from 122 men working in U.S.-based nursing homes.

RESULTS

Family-supportive supervisor behaviour was directly and positively related to safety compliance, organisational citizenship behaviour and family time adequacy. It was also positively associated with time in bed and sleep quality for double-duty caregivers.

CONCLUSION

Family-supportive supervisor behaviour plays an important role in the work behaviour and nonwork well-being of men with and without nonwork care roles in the long-term care workforce, a finding with favourable implications at the employee and organisational level.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers need to recognize that family-supportive supervisor behavior can benefit men, as many have nonwork caregiving responsibilities. Training may facilitate nurse managers' engagement in family-supportive supervisor behaviour and, in turn, improve employees' work and nonwork outcomes (link to training resources provided).