Just Call Us Nurses: Men in Nursing

Laura A. Stokowski, RN, MS

Disclosures

August 16, 2012

In This Article

Teaching Caring and Touch

It's easy to dismiss the superficial mistaken perceptions about men in nursing -- that they are gay, or doctor wannabes -- but other beliefs go deeper and are more worthy of reflection. One pertains to what has been called the "heart and soul of nursing"[10]: caring. Will having more men in the nursing profession alter the fundamental nature of nursing as a caring profession? Can men really care?

The other touchy issue is, well, touch. In today's society, can male nurses touch female patients without reticence or unfounded accusations of inappropriate physical contact?

Caring. O'Lynn devotes an entire chapter of his book to whether men can demonstrate the caring behaviors that go hand-in-hand with nursing. If caring actions communicate caring feelings, what does it mean if men fail to exhibit the caring actions often associated with nurses? Does it mean that men don't care?[7]

O'Lynn, who has written that "men have as many female attributes as women" and "are just as suited to nursing," believes that men can, and do, care. It's the way in which they show caring that might differ from what we expect, and often see, from women. Despite the familiarity and ubiquitous use of the word, caring is an elusive concept. We all develop our personal thoughts about caring, says O'Lynn, and if what we see doesn't fit the mold, then we don't recognize it as caring.

O'Lynn explains, "Caring is an art, and there are different ways of showing it. Men demonstrate caring differently from women." Where a woman might show caring by touching, leaning close, and speaking in a low, calming voice -- combining physical contact with expressions of emotion -- men might show caring in the way that a man might relate to another man, or to a buddy. Masculine styles of caring are often modeled on friendship behaviors -- joking, teasing, a punch on the shoulder -- rather than the "maternal behaviors" often displayed by women.[7]

It is alarmingly easy to drift into stereotypes and assume that the ability to demonstrate physical caring comes easily to all women and is denied to all men. But even among women, the way in which caring is demonstrated can differ. Some women are comfortable with touch and maternal behaviors. Other women, like many men, either learn these behaviors through imitation or develop their own unique styles of caring. O'Lynn emphasizes that caring is not the domain of women only but instead is a human trait, and that men, too, have the capacity to care.

For the male student or new nurse, however, figuring out how to demonstrate caring can be a daunting task. O'Lynn shares a story from his own experience as a student nurse.

"I was taking care of an elderly, confused man who was trying to leave his room. Everything I said only seemed to agitate him more, and I didn't know what to do to calm him down. Another nurse (a woman) came in the room, and she immediately put her arm around him, led him gently back to the bed, speaking in a maternal voice. After she left, I thought, "I can't do that." As a 24-year-old man, I couldn't see myself putting my arm around someone and speaking in a maternal voice. I have since learned how to make that happen." Many men, he says, resolve the caring conflict by adopting an amalgamation of feminine and masculine approaches to caring.

O'Lynn conducted a survey of 111 practicing male nurses, who attended 90 different schools of nursing, and asked them how they learned caring.[7] Almost one third (31%) reported that their nursing instructors emphasized a feminine style of caring in clinical practice. More than one half of the men claimed that no masculine style of caring was discussed or demonstrated.

Clearly, the lack of inclusion of masculine styles of caring in nursing education is a problem. The problem is exacerbated, explains O'Lynn, by the lack of role models in nursing education to teach men how to demonstrate caring.

Touch. Although a nurse may be able to communicate caring, comfort, and concern without physically touching a patient, touch eventually becomes mandatory in the course of nursing care. Touch becomes even more important as care becomes increasingly high-tech.[11] Humans, regardless of sex, who are truly uncomfortable with touching patients would be advised to seek another career. Learning how to touch patients in a way that makes patients comfortable is integral to a nurse's education, but sadly, this education is rarely explicit, and students are often left to develop these skills by trial and error.

O'Lynn finds that many nursing educators fail to adequately address the issue of touch with students, male or female. The lack of guidance, however, is more serious when it comes to men. Men fear false accusations of sexual inappropriateness while providing care, a fear that could be well founded in our increasingly litigious society. However, possibly even worse than a complete absence of guidance about the appropriate use of touch is inappropriate guidance or excessive focus on the issue of touch, and its potential consequences. Nursing faculty who appear to be overly concerned about the issue might make male students even more self-conscious about touch.[7]

Instead, O'Lynn advocates a systematic approach to teaching touch -- for all students -- that should be followed by clinical instructors or nurse preceptors, and that is based on a set of commonsense principles[7]:

  1. Assume that students are ethical, professional, and pursue nursing because they want to help people.

  2. Make no requirements for automatic chaperones (except in unusual cases).

  3. Touch with confidence. Be gentle, but not weak or hesitant.

  4. Accompany touch with verbal communication -- notify the patient when and where touch will occur, and distract him or her with conversation.

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