A Critical Ethnographic Study of the
A Critical Ethnographic Study of the
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Perceptions of Men in Nursing about Gender
Perceptions of Men in Nursing about Gender
Influences on Their Career Paths: Preliminary
Influences on Their Career Paths: Preliminary
Influences on Their Career Paths: Preliminary
Influences on Their Career Paths: Preliminary
Findings
Findings
Chris Edwards BS, BSN, RN
Chris Edwards BS, BSN, RN
University of Texas Medical Branch at Galveston
University of Texas Medical Branch at Galveston
University of Texas Medical Branch at Galveston
University of Texas Medical Branch at Galveston
Graduate School of Biomedical Sciences
Graduate School of Biomedical Sciences
credward@utmb.edu
credward@utmb.edu
@
@
Nursing shortage affecting patient care
(Beurhaus, 2008; IOM, 2004)
Increase number of men in nursing
(Eveloff, 2003)
Men in nursing represent <6% of the 2.9
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million nurses
(NINR, 2007)M l
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i
Males more likely to leave nursing
(Sochalski, 2002)
Gender specific challenges
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(Bernard Hodes Group, 2005; Evans, 2004; O’Lynn, 2004, 2007)
Explore and describe the perceptions of men
in nursing about gender influences on their
career paths
1.
What influenced the decision of men in nursing
to pursue nursing as a career?
Wh t
th
ti
f
i
i
2.
What are the perceptions of men in nursing
regarding the effects of their gender on their
nursing educational experience?
nursing educational experience?
3.
What are the perceptions of men in nursing
regarding the effects of their gender on their
regarding the effects of their gender on their
professional experiences?
4.
What do men in nursing believe would increase
4.
What do men in nursing believe would increase
Themes
Historical changes affecting the experiences of men in
nursing
nursing
Recruitment and retention of men in nursing
Challenges after deciding to pursue nursing as a career
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Role strain
Gaps
Rationale for career paths of men in nursing
Gender specific challenges affects on men in nursing
S bj ti
d
t
di
f th
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Subjective understanding of the role strain men in nursing
experience
Male Sex Role Identity (MSRI) and Sex Role
Strain (SRS) paradigms
(Pleck, 1981)G
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l
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d b
d
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Gender roles defined by gender role norms and gender role
stereotypes.
▪
Simple
or
unitary bipolar
vs.
androgynous
or
dual-polar
characteristics
(opposite vs. separate)
▪
Gender roles are contradictory and inconsistent causing violations
and gender role strain.
R l
t i
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d
h
i t
d
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▪
Role strain experienced as shame, anxiety, depression, or experience
of social condemnation.
▪
Overcompensate by overexaggerating gender characteristics in order
to adjust
to adjust
Design
: Critical Ethnography
(Thomas, 1993)
Explores non-quantifiable features of social life and social
inequalities in order to influence positive social change
(Thomas, 1993; Carspecken, 1996)
Asks what could be for a group
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p
(Thomas, 1993)( , )
Opens people’s minds by challenging perceptions and
offering different viewpoints
(Carspecken, 1996)
Studies exploring cultural schema in various situations can
focus on interviews.
(Carspecken, 1996)
Sampling Procedures
Inclusion criteria
Convenience, snowball, & purposive sampling
▪
Allows for maximum variability in age, ethnicity,
education, years in practice, and practice settings
Setting
g
Medical centers in the Southern Texas
Data collection
Demographic questionnaire
Semi-structured, face-to-face interviews
▪ “Tell me about how people responded when you told them you wanted to be ” d “T ll h t it h b lik b i i i ”
a nurse” and “Tell me what it has been like being a man in nursing”
Follow-up interviews
J
l
i
d
d fi ld j
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Journals – primary record and field journal
Data saturation or informational redundancy
(Burns & Grove, 2005; Spradley, 1979)
Data analysis
Thematic analysis using Carpsecken’s 6 steps for critical
ethnography
(1996)▪ Read transcripts
▪ Develop preliminary codesp p y
▪ Develop subcodes for similar phenomena
▪ Review data for recurring codes and subcodes
▪ Move from low-level concrete codes to higher-level abstract codesMove from low level, concrete codes to higher level, abstract codes
Trustworthiness
Credibility - data saturation, member checks, & peer
debriefers
Fittingness -
sampling
methods
to
ensure
maximum
variability
of
respondents
and
experiences
follow up
variability
of
respondents
and
experiences;
follow
‐
up
interviews
Auditability -
Auditability
decision
decision
or
or
audit
audit
trail
trail
through
through
preliminary
preliminary
and
field
journals
Sample
Sample
N = 9 male nurses
Age: 25-52
Age: 25 52
Experience: 3-29 years
Ethnicity: Caucasian (6), Hispanic, African
American, Asian
Education: Assoc. (3), Baccalaureate (6)
N
i
fi t
(4)
(5)
Nursing as first career: yes (4), no (5)
Employment areas: ER, ICU, Intermediate Care,
Med-Surg & dialysis
Med Surg, & dialysis
1. Pros of pursuing a nursing career
Nursing as a calling
▪ “I don’t know of any particular person or event or anything, that I can recallI don t know of any particular person or event or anything, that I can recall that was actually something that led to this other than I always felt like this was a calling, that this was something I was supposed to do.” (P5)
B i
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Being of Service
▪ “I liked the idea that I might be able to help out. And the fact that, you’re in a hospital and it might be my third day there and my fifth year as a nurse but, it might be your first day your first time in a hospital or you know the first might be your first day, your first time in a hospital or, you know, the first time that you’ve ever been this sick. And you’re tired and you wanna go home. They’re still stuck there, so I try and give ‘em a little sense of, I don’t know, a little piece of home, a little normal sense, a little sense of humor, a little something to brighten up their day….” (P7)
1. Pros of pursuing a nursing career cont.
Exposure to healthcare providers or illness
▪ “Actually [wanting to be a nurse] started when I was about eleven years old. I had a uh uncle that was sick, uh he had diabetes real bad and um, he had just become debilitated, and so, we didn’t want to put him in any nursing
h thi lik th t j t t k hi h d t k f
home or something like that, so we just took him home and we took care of him. And uh, both of my parents were older, so basically, they showed me how to do it.”(p7)
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Job opportunities
▪ “the job market looked really good and it, it always has for nurses.” (P8)
▪ “the money part of it was good”(p2)
▪ the money part of it was good (p2)
2. Cons of pursuing nursing
Negative responses from people
▪ “[friends] call you a murse or uh, you know, make several jokes” (P1)[friends] call you a murse or uh, you know, make several jokes (P1)
Encountering stereotypes
▪ “wearing the little white hats, and the dress and whatever.” (P2)
▪ “you’re going to be doing a lot of wiping butt” (P2)
▪ “you wanted to go to med school one day” (P4)
▪ “if you was a guy going into nursing you was gay” (P3)
▪ “I’m already gay and they will find out I’m gay.” (P9)
Lack of exposure to male nurses
Lack of exposure to male nurses
▪ “when I was growing up, I never heard of males being nurses.” (P4)
Media influences
▪ “Of course we got a lot [of jokes] about the uh you know about the Meet the
▪ Of course we got a lot [of jokes] about the uh, you know about the Meet the Fockers kind of thing” (P3)
1 P
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1. Pros of nursing school
Nursing as a calling
▪ “[My rotations in a nursing home] really nailed down that I picked the right
▪ [My rotations in a nursing home] really nailed down that I picked the right field because I was just as upset on my last that I was on my first day…. These people go back to the same position I just got ‘em in, you know a few weeks before hand, so it almost crushed me as much as the first day as it was the last day because then I realized, you know, it’s still affecting me.” (P4)
Positive responses from people
▪ I could remember faculty sayin’ something to the effect that, you know, that, y y g , y , , you’re gonna do good, you’re gonna go up. The guys, there’s such a need for guys in nursing.” (P7)
The challenge
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▪ “[In nursing school] there’s so much information to learn, to know, and so challenging.” (P9)
2. Cons of nursing school
Negative responses from people
hi k h h h i h f l lik l i i
▪ “I think uh, that there were some instructors who felt like, males coming into nursing was a threat to them, and so they treated us a little bit, uh, harsher, especially in clinical.”(p4)
▪ “[Instructors] would ignore all the guys in the class and just say well you
▪ [Instructors] would ignore all the guys in the class and just say well you women know about this.” (P6)
▪ “I was [in L&D] for like two days and nobody said a word to me the whole time” (P7)( )
Encountering stereotypes
▪ “I think [instructors] were trying to tell me something… this is a female dominated business Just wanted to make sure I understood that I know dominated business. Just wanted to make sure I understood that…. I know that's what I got out of the situation.” (P8)
3. Feelings from cons of nursing school
“I’ve experienced more, discrimination in nursing school,
than I did when I became a nurse. ”
(p4)
“Don’t emascualte me”
(P6)
“No men [allowed] here”
(P7)
“Disappointed”
(P5)
“I was in uh, some trouble as far as the male female thing”
(P8)1. Pros of being a nurse
Being of service
▪ “It’s very rewarding, um, just to know, that you’re taking care of people andIt s very rewarding, um, just to know, that you re taking care of people and um, enhancing their life in some way and actually making a difference.” (P7)
The challenge
▪ “there’s a lot of toys and things and um, you know, devices, that require a lot more skill to operate. I think that’s why men area attracted to critical care.” (P4)
“Respect”
“I f l i d b l h ’ i
▪ “I feel nurse is good because people trust you more that you’re not going to abuse or take, take uh, you’re going to give the best, compassionate care.” (P9)
▪ “people have said that the males nurses was the best nurses they ever had.” p p y (P5)
2. Cons of being a nurse
Different expectations
▪ “Viewed as muscles” (P3)Viewed as muscles (P3)
▪ “Expected to go into leadership positions” (P2)
▪ “[taking care of both gendered patients] is okay for girls, female nurses and men, but the reverse of that, it's not always etched in stone so to speak.” (P9)