Int’l Nurses Day: Men in nursing open up on employment challenges and stigma

Coming from a family where a number of his cousins were nurses, Vivian Selvan was inspired by the profession being both ‘high tech' and ‘high touch' - a combination of stable income and an opportunity to contribute to society. After facing a few disappointments at some hospitals in Mumbai, where only female nurses were hired, he has now worked as Operation Theatre nurse at Wockhardt Hospitals in Mumbai's Mira Road for three years. "For male nurses, opportunities are fewer and we sometimes still struggle for public acceptance." Nursing, Selvan points out, is one of the rare professions in India that is dominated by women. Joice P Thomas, who is working in the orthopedic department at Fortis Kolkata, says the perception is slowly changing. He was inspired by his sister, who is also a nurse, and was drawn towards the idea of social service and caregiving to fellow human beings. "People used to think that men are rude and not capable of being as empathetic as females, but they realised they were wrong after seeing us work. With the intervention from female nurses, we have learnt a lot and eventually, things have become smoother," he adds.

Selvan and Thomas are among many such male nurses, referred to as ‘brothers' in the hospitals, who have chosen to take up nursing as their profession amid fewer employment opportunities in government and private hospitals. They defy the popular belief that nursing is a job meant only for women.

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According to Jibin T C, president of United Nurses Association (UNA), Maharashtra, "Under the pretext that male nurses are incapable of providing care and patients are uncomfortable with them, hospital management have generally stopped recruiting male nurses despite a rise in the number of men taking up nursing courses."

On International Nurses Day, which is observed to commemorate the birth anniversary of Florence Nightingale, a social reformer and pioneer of modern nursing, Mid-Day Online reached out to a few men in nursing. They shared their experiences of interacting with patients and the challenges in navigating employment opportunities after completing a nursing course.

Hints of exploitation and inherent gender-bias

According to the data provided by the Ministry of Health and Family Welfare in the Lok Sabha, as per the Indian Nursing Council (INC) and National Medical Commission, the nurse-to-population and nurse-to-doctor ratios in the country are 1:510 and 2.1:1 as against the WHO norm of 1:300 and 1.7:1 respectively. Jubin points out that there is a coordinated effort to restrict the number of nurses in the hospitals by private managements in order to restrict the costs and maintain profits, thereby compromising the care given to the patients.

This has resulted in non-recruitment of male nurses, who have in recent years, organised and created a movement across the country to raise issues of exploitation of nurses in both government and private hospitals. In 2020, the All India Institute of Medical Sciences (AIIMS) reserved 80 percent of nursing jobs for women and 20 percent for men stating that more female nurses were required for patient comfort and care in several wards and departments. In February 2021, Maharashtra introduced a similar move of a gender-based quota of 90:10 in nursing staff recruitment. In response to an RTI filed by Jubin, the AIIMS recruitment cell and INC provide no substantiate reasoning or cite any kind of survey/study on the basis of which the decision of gender-based reservation was brought in.

"In the last few years, some of the unions headed by male nurses have organised to raise the wage and hiring issue, which is considered as troublesome by the hospital management. They want to kill this threat and the easy way out is to not hire male nurses," says Jubin. This, he states, has further added to the exploitation of female nurses, who are working with low wages and are sometimes left with no option but to continue with the job for a stable income, fewer job opportunities elsewhere and family concerns.

According to the WHO data, the proportion of male nurses in India increased from 6 percent in 2004 to 20.11 percent in 2009 and then dropped to 12 percent in 2018. This is despite an increase in the number of males enrolling for nursing courses. In 2019-2020, as per the All India Survey on Higher Education report, out of 3.07 lakh enrolments, approximately 85.4 percent were female students and 14.6 percent were male students. In 2018, total enrolment in nursing courses stood at 2.81 lakh out of which approximately 86.1 percent were female students and 14 percent were male students.

Anuraj R.U, nursing supervisor at Fortis Mulund, states in departments such as the Operation Theatre, Casualty and Intensive Care Units, male nurses are often given priority over female nurses. "These departments require lifting the patients, heavy equipment and carrying the stretchers across the building, sometimes without lift, which is why more male nurses are recruited for these departments." Additionally, there are situations when male patients demand that they be handled only by brothers, sometimes due to inherent gender and religious stigma, and in some other situations when they feel uncomfortable speaking freely to the female nurse.

‘We can be caring too'

According to WHO's National Health Workforce Accounts 2020 report, 88 percent of the total nursing professionals in India are females and 12 percent are males. Widely perceived to be a profession suitable for females, nursing is a rare occupation where men say they are often at the receiving end of stigma and gender-bias from the public and the hospital management. From disbelief and misunderstandings to trust issues among administration members of the hospital, a number of challenges often hinder their daily duties.

While some patients find it hard to accept that men are into nursing too, others refuse to be attended by them and call for a female nurse. This also becomes a concern when a female patient needs care. To avoid any misunderstandings and discomfort, as Thomas points out, male nurses always have to accompany a female nurse, mainly in departments such as gynaecology and obstetrics.

"In the beginning, there were serious problems. Patients would ask ‘where is the sister?' and then I had to explain that there's a course for male nurses too. To make them believe that I am also a caregiver was the biggest challenge," Thomas, who also had to face language barriers during his work at Kolkata.

"After Covid-19 their perception is changing. People now know our work and that empathy comes from inside. We are also learning from senior female nurses, because they have been here for so many nurses. It's only in the last four to five years, 30-40 percent male nurses have joined the band," adds Anuraj.

Though the stigma continues, the nurses also observe that there is a gradual change in the mindset of the people, especially after the Covid-19 pandemic. With a rise in the number of men taking interest in the nursing profession, there is a growing acceptance of male caregivers among the patients and their families. Brothers at the hospitals affirm that even "male nurses can be empathetic, caring and comforting".

Meanwhile, Jibin states there is no major gender-based discrimination or bias anymore, especially after the year 2000 and that male nurses are also trained in how to make the patient comfortable, irrespective of the gender. "The number of men in nursing is increasing and we need a gender-balanced profession, rather than a discrimination-based one. The awareness among the public has also increased and we are getting their acceptance. It's a good sign for us," he adds.

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