The concept of care in male nurse work: an ontological hermeneutic study in acute hospitals

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.

Capturing the value and core concepts of the Clinical Research Nurse

Background

As nurses, we identify our profession as a caring one, but how does this identity translate from a conceptual definition, to real-world practice for the Clinical Research Nurse?

Aim

To offer a novel, four-point conceptual model that encapsulates the Clinical Research Nurse's intrinsic value, active leadership, and direct contribution to high quality, person-centered, safe care, addressing current misperceptions of research nursing.

Methods

This paper describes the provision of 'care', safely delivered by the Clinical Research Nurse through a four-point conceptual model and case-driven example.

Discussion

Clinical research nursing is conceptualized within the domains of Care and Trust, Role, Impact, and Integration. The case example demonstrates real-world application of these domains and the expertise required to balance the complexities of clinical needs and research demands in a healthcare environment.

Conclusions

This paper offers a mechanism for understanding the importance of the Clinical Research Nurse and their role in maintaining safety and a high-level view of the care arena. These reflections are considered with an international application for the role.

Does the nursing curriculum influence feelings of gender-role conflict in a cohort of nursing degree male students?

It is estimated that more than 9% of the global nursing workforce is male and that this share will gradually rise over the next decade. Although there are some positive aspects of having a male nursing workforce, men in the profession still experience discriminatory behaviours and practices. Fortunately, this does not deter a number of men entering undergraduate degree programmes. The aim of this study was to understand the experiences of 14 male nursing students in their first year of the adult Bachelor of Nursing programme. Using the Inventory of Male Friendliness in Nursing Programs and the Gender Role Conflict Scale, this study found that the male students felt welcomed, supported and included into the nursing programme. In addition, they felt no overall gender-role conflict, although feelings of success and achievement caused some challenges. The results of this study suggest that the male students did not necessarily experience those inequitable behaviours and practices reported in the literature. It has been suggested that perhaps the reality of clinical practice may change the perception of nursing for male students. Therefore, implications for further research could include a longitudinal study to ascertain where the perceptions of the nursing programme change for the male nursing students over time.

Potential for misinterpretation: An everyday problem male nurses encounter in inpatient rehabilitation

AIMS

This study aims to report on the everyday concern of the 'potential for misinterpretation', which was the basic social problem revealed in a grounded theory study exploring male nurse practice in inpatient rehabilitation in Australia.

BACKGROUND

Male nurses account for approximately 10% of nursing workforce across western countries and they practice in a range of clinical areas; however, how they practice in inpatient rehabilitation remains unexplored.

METHODS

Constructivist grounded theory was used in this study and was conducted in two phases: (i) involved semi-structured interviews with 11 male nurses from October 2013 to June 2014 and (ii) observation of practice of 12 male nurses and semi-structured interviews with male nurses and 15 patients from February to April 2015.

RESULTS

Nurse participants encountered the intersection of two pervasive patient ideologies about male nurses. Patients perceived nursing to be women's work and that male nurses are sexual threats. These two intersecting ideologies created a concern for male nurses working in inpatient rehabilitation and that concern was labelled 'potential for misinterpretation'.

CONCLUSION

Gender stereotypes impacted on the ability of male nurses to practise nursing in inpatient rehabilitation. Male nurses were mindful on a daily basis that misinterpretation could, and did, happen in inpatient rehabilitation.

Women's experiences of male nursing and midwifery care: An inductive content analysis of blog posts from an open-access parenting site

BACKGROUND

There still remains a gender divide between men and women when it comes to the provision of nursing care. To date, there is a plethora of literature that describes the barriers men face in the profession. However, there is very little with regard to the patients' qualitative experience of male nursing/midwife care.

AIM

The aim of this study was to describe the experiences of women being cared for by a male nurse/midwife.

METHOD

Inductive content analysis was undertaken on blog posts from an online parenting site as they related to the care provided by male nurses and midwives.

RESULTS

A total of 128 blog posts were identified. There were two themes identified-feeling comfortable and feeling cared for. There was a polarized view to the care provided by male nurses and male midwives with respondents either flatly refusing, or wanting a preference as to which gender provided care, to others expressing it was the best care they ever experienced. The provision of care was where the blog posts differed significantly. There were mixed emotions from angered embarrassment at the thought of a male nurse/midwife providing intimate care to being Ok with nonintimate care such as the taking of vital signs.

CONCLUSION

It would appear from the blog posts analyzed that the assimilation of men into clinical areas generally seen as the purview of female nurses is slowly becoming accepted although further research as to the patient perspective of male nursing/midwifery care in these areas is needed.

Nursing is for men: a descriptive phenomenological study

BACKGROUND

The reasons men come into nursing is because of career stability, career progression and financial security.

AIM

The aim of this study was to explore the lived-experience of a group of male nursing students as to the attraction of nursing as a career choice.

METHOD

A descriptive phenomenological approach using Colaizzi's seven step data analysis within the phenomenological empirical framework was used.

FINDINGS

The central theme developed from the transcripts was Nursing is for Men. Seven sub-themes were identified from the significant statements which included: Nursing is for me; wanting a new career; the jobs in the bag; striving to succeed; Men together; Family approval and Mate-ship realigned.

CONCLUSION

The men in this study found the decision to become a nurse and undertake their nursing education challenging. Moreover, it was reconciling with family, friends and work colleagues that many felt was the biggest obstacle.

Attitudes Toward Spirituality and Spiritual Care among Iranian Nurses and Nursing Students: A Cross-Sectional Study

Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.

Difficulties Encountered by Final-Year Male Nursing Students in Their Internship Programmes

BACKGROUND

The cultural norms of the Kingdom of Saudi Arabia do not encourage men to choose nursing as a career. Understanding male nursing students' experiences of their clinical exposure to the nursing profession throughout their internship might increase their retention. This study explored the experiences of final-year male nursing students as they transitioned to the role of registered nurse.

METHODS

A qualitative descriptive research design with an inductive content-analysis approach was used. The experiences of 22 final-year male nursing students from three public hospitals in a major city of Saudi Arabia were explored. The data were collected using focus-group interviews and documentary analysis in March 2015 and May 2015.

RESULTS

Content analysis revealed three major themes: the societal and cultural image of male nurses, male students' engagement in nursing practice, and restructuring the internship programmes' policies to suit male students' needs.

CONCLUSION

The findings reveal issues that mainly stem from negative social views of nursing as a male profession. Considering the students' social and cultural needs during their internship programme will facilitate their transition into the role of registered nurse and their retention in the nursing profession.

Lived Experiences of Novice Male Nurses in Taiwan

PURPOSE

Nursing remains a female-dominated profession around the world. The masculinity and male identity of men who choose nursing careers is questioned by the general public in many countries. Few studies report the situation of novice male nurses at their first year. The purpose of this study was to explore the lived experience of novice male nurses when they first enter the workplace.

DESIGN AND METHOD

A qualitative descriptive study was conducted using purposive and snowball sampling for recruitment. Fourteen participants, 21 to 25 years old, were recruited, all of whom had at least 5 months of work experience. On average, in-depth, face-to-face interviews lasted 1 hour, with more than one follow-up telephone interview per participant.

FINDINGS

The following six themes emerged from the transcribed verbatim data based on content analysis: choosing appropriate work departments based on personality and needs, facing the pressure and frustration of independent work, getting help, obtaining acceptance among female cliques, reflecting on the relationship between gender and profession, and concerns about dependents and financial needs.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

This study addresses masculinity issues and gender stereotyping. In addition, male nurses were very concerned about their career options and development and the likelihood of promotion. This research not only has implications for better understanding of novice male nurses' needs and the challenges in their social life but also makes suggestions for nursing practice to attract and keep more male nurses in the nursing profession. The results illustrate how culturally congruent nursing care can be achieved when we more concern male nurses' role pressure and address traditional gender sensitivity to promote male nurses' career development.

Nurses' Perceptions of Spirituality and Spiritual Care Giving: A Comparison Study Among All Health Care Sectors in Jordan

AIMS

This study aimed to describe nurses' perceptions of spirituality and spiritual care in Jordan, and to investigate the relationship between their perceptions and their demographic variables.

METHODS

The study used a cross-sectional descriptive design and recruited a convenience sample of 408 Jordanian registered nurses to complete the spiritual care giving scale.

RESULTS

The findings of the study demonstrated that most of the participating nurses had a high level of spirituality and spiritual care perception. Significant differences were found between male and female nurses' perceptions of spirituality and spiritual care (P < 0.05); previous attendance of courses on spiritual care also made a significant difference to perceptions (P < 0.05).

CONCLUSIONS

The research findings suggest that, Jordanian nurses' gender made a difference in their perceptions of spirituality and spiritual care. They had satisfactory levels of perception of spirituality and spiritual care. Moreover, spiritual care courses appeared to have a positive impact on their perception of spirituality and spiritual care. Enhancing nursing care by integrating standardized spiritual care into the current nursing care, training, and education should also be emphasized.

Factors Influencing Men Entering the Nursing Profession, and Understanding the Challenges Faced by Them: Iranian and Developed Countries’ Perspectives

Context:

Men entering the nursing profession have been investigated from several different perspectives. Due to male gender characteristics and existing public image, nursing is often not considered as a career choice by men. Whether nursing would benefit from increased number of men is a key question in the literature. The purpose of this integrative review of the literature was to identify factors influencing men to enter the nursing profession. In addition, it sought to understand the challenges they are confronted within this profession.

Evidence Acquisition:

A systematic search of the existing literature was performed using an Internet search with broad keywords to access related articles in both Persian and English databases. Finally, 34 studies (written between 2000 and early 2013) were selected and surveyed.

Results:

Most of the studies were conducted in developed counties. The review identified reasons why males choose nursing, and other challenges facing men entering and working in nursing. Themes that emerged from the literature include educational and societal barriers experienced by men in nursing, recruitment, career choice, and role strain.

Conclusions:

Regarding men’s influences on professional development, and also the importance of gender-based caring, policies for recruitment and retention of men in nursing must be followed hastily. However, there is a need for further research regarding the challenges faced by men entering nursing, in both Iran and other developing countries.

Self-Image of Male Nursing Students in Hong Kong

The image of male nurses is closely related to the development of a female-driven nursing occupation. As a minority group in the nursing industry, male nursing students may have a negative self-image in their learning and clinical practicum. This may affect their psychological health and mental status. This study explored the positive and negative self-image of male nursing students. Eighteen participants were recruited from a local nurse-training institute. The participants were undergraduate bachelor’s and master’s students of nursing. The experience and opinions of the participants were collected by multiple methods. The participants’ drawings and audio diaries representing their self-image as nurses were collected in advance of a discussion of ideas raised in the focus group interview. The findings were categorized into three themes: (a) self-roles, functions, and identities; (b) awareness of gender differences; and (c) the future of professional development. The findings of this study provide information on the nurse role, identity, gender differences, and professional development of male nursing students, which will drive the direction of the development of a positive image for male nurses in the future.

The Relationship Between Surgical Patients and Nurses Characteristics With Their Perceptions of Caring Behaviors

The purpose of this European survey was to examine the relationship of surgical patients’ and nurses’ personal characteristics with their perceptions of caring behaviors. Caring Behaviors Inventory (CBI) was completed by convenience samples of 1,659 patients and 1,195 nurses from six countries of Europe. The results showed that the older the patients, the more positive were their evaluations of CBI. Those with planned admission and good/very good health conditions gave higher ratings compared to those with an emergency and poor health conditions. Type of admission, age, and health conditions explained 5.2% of CBI variance. Nurses with more work experience and experience in the unit gave significantly higher ratings compared to nurses with less experience. Nurses’ total experience and gender explained 2.3% of the variance of perceived care. Therefore, in a multinational surgical environment, caring behaviors may be influenced by other variables, better captured by using different research methods.

A man could never do what women can do: Mental health care and the significance of gender

OBJECTIVE

The basic aim of this paper is to examine how women and men in mental health care understand their own strengths and weaknesses and those of the other gender.

METHOD

This is a qualitative study based on individual and focus group interviews with 49 participants. Content analysis was performed.

RESULTS

Our findings indicate a gender imbalance in strengths and weaknesses on several levels. The female workers describe mothering as a female identity, and think women have a greater natural quality for caring than men. They orientate towards relationships and are inclined to take on too much responsibility. Men, on the other hand, use their gender power as a mobilizing attitude. However, they have a tendency to consider themselves too objective and too emotionally reserved. Female workers consider men's professional distance in caring as a strength. Although the latter's lack of handling emotions is considered a weakness. Male workers emphasize the women's willingness to offer care as a strength, although women taking on too much responsibility is described as a weakness.

CONCLUSION

The imbalance between genders in mental health care may have some consequences for decision-making in relation to patients and care planning. Thus there is a need for work organizations to focus on the influence of gender not only for the working milieu, but also to better use the competence that exists to the benefit of the patients.

Discourse Analysis of Nurse-Patient Communication in a Hospital Setting

This ethnographic study examined the symmetry (active listening)/asymmetry (dominance) of nurse-patient communication. A convenience sample of 20 gendered nurse-patient pairs from two community hospitals participated. Eleven discourse modes emerged from taped conversations between nurses and patients. In many nurse-patient interactions, nurses demonstrated symmetry; however, symmetry and asymmetry changed throughout the conversation. Nurses often missed cues that patients needed someone to listen to their concerns. Staff development implications include teaching strategies that increase symmetrical nurse-patient communication.

Caring for female patients: the experiences of male nurses

This article presents the results of two small qualitative studies, which examined the experiences of six male registered psychiatric nurses (RPN) and five male registered general nurses (RGN) when caring for patients of the opposite sex. Semi-structured interviews were used to collect the data. The focus of the interviews was an attempt to describe the male nurses' experiences of caring for women with a particular emphasis on interventions that involved physical touch. Themes were generated from both studies and the common themes are presented here. Male nurses in this study were often apprehensive about using physical touch and they used coping strategies in response to their fears of being accused of using touch inappropriately. Several factors also influenced the male nurses when using physical touch as an intervention. These findings suggest that learning about caring for female patients needs to be included in the undergraduate curriculum and that further research on the experience of men as nurses is required.

Male nurses' experiences of providing intimate care for women clients

AIM

This paper reports a study of male nurses' experiences of providing intimate care for women clients.

BACKGROUND

The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded.

METHOD

Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004.

FINDINGS

Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery.

CONCLUSIONS

Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

Gender-Based Barriers for Male Students in Nursing Education Programs: Prevalence and Perceived Importance

To meet the recent call to increase the number of nurses by recruiting men, nursing education programs will need to reduce gender-based barriers. No study found has adequately quantified the prevalence and perceived importance of barriers to men in nursing education programs. These barriers create an academic environment that is unfriendly to men. As such, I defined a new construct, "male friendliness," as a function of the presence and importance of these barriers. The aims of this study were to describe the prevalence and perceived importance of barriers and to develop a tool to measure male friendliness in nursing programs. A pilot tool addressing 33 barriers, which were obtained from the literature, my experience, and a panel of nurse educators, was mailed to 200 male nurses. The findings revealed that seven barriers were importantly different in prevalence between different subsamples of male nurses, and no barrier was rated unimportant by more than 20% of respondents. The similarities in findings between groups of male nurses, diverse in geography, school attendance, and graduation dates, suggest that the barriers men face in nursing school are pervasive, consistent, and have changed little over time. From the findings, the Inventory of Male Friendliness in Nursing Programs (IMFNP) was developed.

Cautious caregivers: gender stereotypes and the sexualization of men nurses' touch

AIM

The aim of this research was to explore the experience of men nurses and the ways in which gender relations structure different work experiences for women and men in the same profession.

BACKGROUND

Men are now entering the nursing profession in record numbers and challenging the notion that men are inappropriate in caregiver roles or incapable of providing compassionate and sensitive care. A limitation of the current state of knowledge regarding caring and men nurses is that it is primarily focused on men nursing students, not practising nurses. Little is known about men nurses' practices of caring and how such practices reflect the gendered nature of nursing and nurses' caring work.

METHODS

The theme of men nurses as cautious caregivers emerged from data that were collected in two rounds of semi-structured interviews with eight men nurses practising in Nova Scotia, Canada. Thematic analysis, informed by feminist theory and masculinity theory, was used as the method for analysing the data.

FINDINGS

For men nurses, the stereotype of men as sexual aggressors is compounded by the stereotype that men nurses are gay. These stereotypes sexualize men nurses' touch and create complex and contradictory situations of acceptance, rejection and suspicion of men as nurturers and caregivers. They also situate men nurses in highly stigmatized roles in which they are subject to accusations of inappropriate behaviour. For men nurses, this situation is lived as a heightened sense of vulnerability and the continual need to be cautious while touching and caring for patients. Ultimately, this situation impacts on the ability of men nurses to do the caring work they came into nursing to do.