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Gender Disparity in Nursing Part I

gender disparity in nursing Why do men in nursing earn more ?

Gender Disparity in Nursing

The other day I listened to Sean Dent’s podcast titled “Men in Nursing: Disparities” as Sean and his guests discussed the question “Do Men Earn More than Women in Nursing?”

One of the great things about Sean’s podcast is that it’s a unique chance to listen to four nurses all offering a male point of view. The four guys are:

  • Sean, the host, successful podcaster of A Change in Shift, and an ICU NP
  • Keith, author, advocate of equality in the workplace, and holistic career coach at nursekeith.com
  • Craig, a podcaster and blogger at KeepitRealRN.com, aka Mr. Passionate, an outspoken long time critical care nurse
  • Robert, twitter handle @RobertBSNRN and moderator of Twitter page @MeninNursing.
Gender Disparity in Nursing

Men make more $$ than women

The podcast provides insight into gender disparities in nursing by the minority guys themselves.

It’s a great listen, and a much-needed conversation. Bonus– Want to hear men describe the difference between how men and women fight on the job? Tune in.

You can also access the podcast at iTunes:https://itunes.apple.com/us/podcast/the-change-of-shift-podcast/id1050668824


Gender Disparity in Nursing?

Is there gender disparity in nursing? It seems there is. Healthcare is characterized by paternalism and patriarchal structures that reflect society’s gender power differences.

Men in nursing have a hidden advantage that affords them higher pay, hiring and promotion considerations, and higher representation in prestigious specialities.

As an example of prestigious specialities, 41% of all nurse anesthetists, the highest paid and arguably one of the most prestigious clinical specialities, are males, while only 10% of all nurses are males.

For men in nursing, minority status in nursing has translated to career promotions.

Gender Disparity in Nursing: Feminine Profession and Social Stigma

For over a hundred years, nursing has been seen as “women’s work”. Florence Nightingale herself firmly established nursing as a  female profession. Men have avoided this female profession in droves. Men risk public stigma and loss of prestige when choosing a woman’s career.

A man announcing to his friends and family “I’m going to be a nurse!” is not necessarily high-fived for his prestigious career choice.

A man entering nursing is an example of a high status social group member entering a lower status profession, and faces negative stereotypes.

Gender Disparity in Nursing: Discrimination from Within

When females attempt to enter a male dominated occupation, they can experience a poisoned work environment including sabotage and sexual harassment. (4) There are well documented examples of hostility and even violence towards females entering the military and other male occupations such as fireman, and policeman.

Males typically do not experience the same discrimination and prejudice that women do. By contrast, men are often well-integrated into their nursing unit.

Men in nursing may experience occasional awkwardness and social isolation, such as not being invited to an outside baby showers (or worse, being invited).

They may report that they are automatically assigned to be The Lifter, or The Fixer of Computers, but such stereotyping doesn’t rise to the level of hostility and even violence that women encounter when crossing over into a male-dominated profession.

Gender Disparity in Nursing: Female Tokenism versus Male Tokenism

By definition of being less than 15% of the work force, men are tokens in nursing.

Gender disparity in nursing

Good Old Boys Club

Tokenism is a very different experience for men than women. While token status for females is a disadvantage, token status for males is a distinct advantage. A male’s inherent social status is higher than his job status.

Sexism trumps tokenism in nursing

Men do not check their gender privilege in at the door when entering nursing.  Men in nursing are tokens with gender privilege.

While women try to downplay their gender in a non-traditional role, men don’t, as their gender difference is a positive.

A hiring bias exists towards men- employers will hire a male over a female.

Men enjoy hiring and promotion favors, as well as relationship advantages with male physicians and males of higher status in the organization.

Gender Disparity in Nursing: Disparity in Pay

Imagine if a study in an influential journal revealed that female coal miners earn more than their male counterparts.

The facts are out. Females vastly outnumber males in nursing, but males earn more than females. In a female dominated profession and the largest healthcare occupation, women have not been able to hold their own. Women earn about ninety cents to the dollar than men in nursing (Muench, 2015).

note: The men on the podcast debated some limitations to the JAMA study and all agree more research is needed.

Gender Disparity in Nursing: Disparity in Advancement

gender disparity in nursing

Males advance faster in their nursing careers

During the podcast, Beth Boynton of Confident Voices hit the nail on the head when she tweeted that the issue is also one of advancement. She says “….no specifics (but I’ve observed ) subtle experiences of (women) being dismissed or overlooked- which makes it more pervasive”

Minority status for women is a career liability. Minority status for men is a career mobilizer. While women crowd into the glass ceilinged elevator, men glide upwards on the glass escalator. It goes further. Faster.

Male nurses represent a fraction of the  nursing workforce yet hold a disproportionate amount of higher paid positions. Men are “kicked upwards” (Williams, 1992)  and receive preferential treatment when it comes to advancement. They enjoy advantage in both hiring and promotion.

Mike has been a  nurse for one and a half years, and has already been promoted to Charge Nurse by his male manager. Marilyn, a coworker with 14 years of nursing experience, who is in a Master’s program, is overlooked for the role. Marilyn responds with disbelief. She asks “How can Mike possibly be a clinical resource to me?”

Many men receive preferential treatment simply because they are men, and not on the basis of competence or aptitude.

Gender Disparity in Nursing: Old Boys Club

According to Sean Dent, there is an inside circle that can only be entered by invitation. It is not a circle that can be found on any org chart, but unless you’ve been invited in, you are going nowhere (or maybe going in circles).

The powerful Boys Club ensures advancement and opportunity for its members. Patriarchal gender relationships place men in sought after, elite positions. Recruits are placed on a fast track and groomed for elite positions.

Once in administration, men can distance themselves from the feminine image.

Anecdotally, in the podcast, Rob says that as a new nurse, he and other men have been approached to seek out managerial positions. Nurse Keith concurs and says “Men rise more quickly in the profession” and as a nursing administrator, offers himself as an example.

Gender Disparity in Nursing: Are Females Complicit?

But are females themselves complicit in  gender disparity in nursing? Read  Gender Disparity in Nursing Part II for thoughts on how women perpetuate the problem.

Summary

Higher pay is just one quantifiable indicator of something we already know- men have a higher social status than women. It’s a reflection of our culture, of our broader social beliefs. Along with the higher status comes opportunity and advancement in the workplace, and nursing is not exempt to this truism.

Unfortunately more men entering nursing is not going to redeem the situation of the low status image of nursing. Men are not going to “rescue” the profession of nursing and enhance its image; they are going to carve out male career tracks and dense pockets of males in speciality areas within nursing.

The gender inequity solution in nursing is not simple, but Muench, et al.,  (2015) has provided data to further the conversation.

Until next time friend,

Nurse Beth

 

Come visit me at Ask Nurse Beth career column at allnurses.com for all kinds of  entertaining and informative career questions and answers, and to submit your own question 🙂

References
  1. Muench, U., Sindelar, J., Busch, S. H., & Buerhaus, P. I. (2015). Salary Differences Between Male and Female Registered Nurses in the United States. JAMA, 313(12), 1265-1267.
  2. King, E. B., Hebl, M. R., George, J. M., & Matusik, S. F. (2009). Understanding tokenism: Antecedents and consequences of a psychological climate of gender inequity. Journal of Management.
  3. US Census Bureau. Men in nursing occupations. American Community Survey highlight report. February 2013.https://www.census.gov/people/io/files/Men_in_Nursing_Occupations.pdf Retrieved December, 2015.
  4. Williams, Christine L. 1992. “The Glass Escalator: Hidden Advantages for Men in the “Female” Professions.” Social Problems 39(3)

 

About Beth Hawkes (126 Articles)
Nice to meet you! I'm a Nursing Professional Development Specialist in acute care, a writer, speaker and career columnist.
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  • This is a very astute post about the topic, Beth and I commend you for making the hidden advantages that men have in nursing more visible. I also commend Sean, Keith, Craig, and Robert for discussing this ‘touchy’ issue in an open and professional manner. Sometimes, in all honesty, I am simply worn out. Tired of trying to prove what I know is my experience. I’m not at all ‘anti’ men in nursing, please note, yet whether measured in pay rates, positional power, status, or social value….it has been my experience that this is true in many facilities and on many units. It is a microcosm of our society at large and speaks to the value we place on women. Thankfully it is changing….slowly in some places. 🙂

    In fact, I often reflect on the value that women place on relationship vs. men place on task and wonder how the value on relationships has been marginalized in healthcare and how focused we are on tasks. We can bill for the latter. Sitting and holding someone’s hand when they’re anxious is not nearly as glamorous or profitable as inserting the airway. Is this simply a matter of nursing culture or healthcare culture? I think the value judgment is more deeply planted in our society.

    Like with any culture change, organizationally or socially, the people who have power are in a position to help lead change with more clout than those not in power and it calls upon them to share power in ways that may mean deferring to others. Not taking a position when one knows that someone else is more qualified is an example and helps to illustrate how hard this might be. Keith Carlson offers another example: during Sean’s podcast where he was a guest and I was a viewer, (which made him visible and me not), he made a point to refer to my comments/tweets that I was making during the session. As I do my work to become more assertive, nurse leaders like Keith help by listening and ensuring others listen. I think this is very important and thank him publicly for being a role model.

    The issue of status is fascinating to me and involves human behaviors and cultures. It is going on all around us and the more you study it the more evident it is. Another way to get at the underlying issues of this complex topic is to have discussions about status and Medical Improv is a great way to open the door to discussions. It can create opportunities for experiential learning about both high and low status and being conscious about using status in positive ways. This blog post delves deeper into what status looks and feels like and links to a podcast that goes even deeper. http://bit.ly/1LpNG45

    I’d also like to share this youtube called, “My Voice Lost and Found” where I share some incidents in my life (in nursing and other areas) where being a woman has made it more challenging. https://www.youtube.com/watch?v=o48WD_XYqp8

    Finally, I want to acknowledge that the passive aggressive and even passive behaviors that men in nursing experience from female nurses at times is not okay and suggest that this kind of behavior is an attempt to have a voice in a culture where respectful voices are discriminated against and sometimes very subtly. Understanding this can be helpful in building assertiveness b/c it is absolutely crucial to have cultures where respectful listening is the norm.

  • disqus_Nj9jXLoavw

    I’m afraid your assertions outstrip the data available. Would you like to perpetuate the sexism in nursing started by Nightingale? I don’t hold that against her, she faced a lot of sexism herself as a scientist, and I believe it was a reaction to her social environment. Instead we should take her example, as a scientist, and seek to understand why things really are happening. It’s a testament to women’s changed status in the workforce and academia that articles like this can be taken seriously without overwhelming data to support them. Nightingale certainly would not be remembered as she is today if she did not have solid data to convince a social group that was set against her.

    • Beth Hawkes

      For my views on perpetuating sexism, read Gender Disparity: Part II

    • No, I would not like to perpetuate sexism. Read Gender Disparity: Part II for my views on perpetuating sexism.

      • disqus_Nj9jXLoavw

        1.”Healthcare is characterized by paternalism and patriarchal structures that reflect society’s gender power differences.”

        2.”Men in nursing have a hidden advantage that affords them higher pay, hiring and promotion considerations, and higher representation in prestigious specialities.”

        3.”For men in nursing, minority status in nursing has translated to career promotions.”

        4.”A hiring bias exists towards men- employers will hire a male over a female.”

        5.”Men enjoy hiring and promotion favors, as well as relationship advantages with male physicians and males of higher status in the organization.”

        6,”Many men receive preferential treatment simply because they are men, and not on the basis of competence or aptitude.”

        7.”The powerful Boys Club ensures advancement and opportunity for its members. Patriarchal gender relationships place men in sought after, elite positions. Recruits are placed on a fast track and groomed for elite positions.”

        8.”Once in administration, men can distance themselves from the feminine image.”

        9.”Higher pay is just one quantifiable indicator of something we already know- men have a higher social status than women.”

        You have an awful lot of claims for 4 references. In order to confirm these claims there needs to be not only research showing a correlation(which is easy enough to find), but research demonstrating that reasonable alternative explanations are not responsible for the disparity. You have claimed simple sexism for circumstances that are probably caused by a variety of factors interacting. Where is the attempt to really understand what is going on? Sexism is the easy answer, the answer that gets clicks or political attention, but that doesn’t mean it is the right answer(or more accurately the only answer). I won’t go into detail about what other factors could contribute to the disparity, it’s easy enough to find out if you are interested. I will however leave you with this thought:

        You claim that men have greater social power. I disagree. In some situations that is true, but women have always had more social power in certain situations(those are of course different today than in the past). Let’s take your example of Mike getting promoted over Marilyn. In this case there is a blog post about it. It’s not uncommon to see articles or public discussions about the same thing, a man getting promoted over a woman, and claims that it is only because of gender. Let’s say that Mike and Marilyn are construction workers instead and Marilyn is promoted over Mike. The same thing is said, Marilyn only got the promotion because she is a woman. The only difference is, in this situation women enjoy greater social power. While the inverse might have had an article written about it, in this case Mike only mutters about how unfair it is at the water cooler. If Mike’s opinion were to be known publicly it would likely greatly damage his career and promotion prospects if it didn’t result in his immediate dismissal. Is Mike sexist? Maybe, but he likely would have made a similar complaint if Joe had been promoted ahead of him. Joe is a suck-up, or Joe is a good ‘ol boy and only got the promotion through nepotism. We should consider that the average person thinks that they are distinctly above average and this effect may be the result of a wider bias. To simply call it sexism or to allow it to be thought to be the result of only gender bias is an afront to the men and women who have earned their promotion legitimately. So yes, I do consider it to be perpetuating sexism to say that Mike/Marilyn got their promotion because of their gender, without evidence, whether that is at the water cooler or on a public forum.

        • Craig

          Wow, this was a lot to chew on. You made some great points especially in the last half. I agree that with the construction worker analogy and if the reverse were true. Mike would have to keep his opinion to himself about the injustice or face thew wrath.

        • Your points are well taken and thanks for the feedback. For my blog post I did a lot of research and most all points are directly from the literature, peer- reviewed journals, including social theory and organizational theory. I’m currently reading Kanter’s (1977) classic and landmark work on tokenism.

          I think going back to the facts around gender pay disparity in our country and in nursing (JAMA study) the picture is clear. Overall, women earn approximately 78 cents to the dollar that men do.

          Recent research shows that men out earn women at every step of the career ladder, with the gap increasing at the top of the ladder.

          Re: advancement. There are undeniable gender-based barriers to females in senior management. Just a fact.

  • Craig

    In you example of Mike being promoted to charge nurse after only a year and a half by his “male” manager, would it have the same teeth if the manager were female? But just because the manager is male, the guilty as charged? And even though Marilyn has 14 years of experience and is in a Masters program does not mean that she is necessarily a good leader or respected by her peers. Years of experience and a masters program does not a leader make. Maybe Mike has had a prior career such as the military which polished his leadership skills before becoming a nurse . Maybe Mike is more respected by his peers because despite having a lot less experience Mike is a team player and generally does a good job and is nurturing to to those around him. In order to say that Mike has been the beneficiary of cronyism proof needs to be shown that Mike is incompetent in his charge nurse duties and received the job as a result of a personal favor from the manager.

    • Actually, Mike is probably competent, although inexperienced. What would you say about a nursing management team that is made up of 6 men and 2 women in a facility where 8% of the nurses are male?

      • disqus_Nj9jXLoavw

        What would you say to a country in which the population is 50% male and only 3.5% of stay at home parents are male?

        • I would say that if the per cent of stay at home dads inched up to 7%, that country would be called America

      • Craig

        I would have to know:
        1. Were these men promoted from within?
        2. What was the total number of applicants?
        3. What was the ratoo of men/women applicants?
        4. What was the ratio of men/women actually interviewed?
        5. What is the ratio of men/women in leadership positions in the whole facility?

        To make the leap that males nurses are favored for management positions because the overall percentage of males in the nursing work force is 8% and in your example the percentage of males in your leadership team 75% is not compareing apples to apples. In fact I would go as far as to say that it isn’t even comparing apples to fruit.

        • What ratios would you have to see in # 3,4,and 5 to confirm disparity in the example given?

          • Craig

            3. 1:4
            4. 1:2
            5: 1:1

      • Craig

        One other question I have regarding charge nurses. Is it more important for the charge nurse to be an expert clinician or a great leader? The reason I ask is because when I was a unit coordinator I was in charge of several ICU’s (my expertise being CVICU) that included medical and neuro. In those areas I was competent but far from an expert. However when I was needed in those areas I knew who the experts were and where to find support and expertise if needed. Could I help the neuro surgeon put in an ICP if I had to? Sure, but when it came to complex situations I utilized others who knew more than me. Did the nurses in those units think less of me because I was not an expert medical or neuro clinician? No because I could rally support where it was needed by being an effective leader. A good charge nurse does not need to know the answer to everything but should know where to find it.

        • I have seen charge nurses too young to recognize the early signs of a patient starting to go downhill, or early signs of sepsis. Because they didn’t know what they don’t know, they were ineffective at advocating for more resources for the unit, such as extra help, delay or hold on admitting ED admits, etc. Meanwhile the nurse with an unstable patient was on her own without backup as the new charge nurse was at the desk, approving new admits to the floor.

          • Craig

            I can’t disagree that a charge nurse needs a certain amount of clinical comptence, but is that clinical competence necesarily measured by years of service. People are individuals and someone at a year and a half may have a high level of common sense and have had a wide variety of experiences from which to draw from. The nurse in your example with 14 years of experience may not be any better if her experience is repeating the same year 14 times. I have known and had nurses who were clinical experts and great bedside nurses but they simply sucked at leading or running a unit.

            I will be the first to say that there is a HUGE difference between a nurse who is 23 years old with a year and a half of exeperience and a nurse who is 35 or older who has had a previous career and is new to nursing with only a year and a half of experience. A huge difference.

          • Craig

            In your example if it is a real world example, how did Mike do as a charge nurse? Did he do a good job? Maybe he was an exception. Do I think most nurses are ready for that role at a year and a half? Of course not, but it is not completely out of the question once all the variables are considered. What I’m saying here is that the rush to conclude that he was chosen because he was part of the old boy network is quite a leap but easy to say without the reader having the benefit of knowing all of the details of the unit, the staff, the culture, and the deal.

          • I understand what you are saying. Consider it for what it is; an anecdote. Then look at the facts.

  • Craig

    I’m not seeing a pay difference espcially on the front lines where nurses are paid by the hour. A new grad gets hired in a a certain predertimend hourly rate that is not adjusted for experience (because the new hire has none) nor is it adjusted for gender. So in my experience all new nurses start at the same pay rate. At my faciility pay raises come at annual intervals and are based on longevity. In other words nurses who are at the same milestone are at the same pay rate. Again this is my personal experience.

    As far as the CRNA stats I would think that the percentage of male CRNA’s would reflect the percentage of males vs females who apply to get into school. Where I am CRNA classes tend to about 30% male. I would be interested what percentage of the applicants are male. If the percentage of CRNA students who are male is significantly larger than the percentage applicants who are male then you may very well be correct that there is a gender bias. If the percentage of applicants and the percentage of accepted students are similar than I would likely disagree.

    • I agree. I suspect that males gravitate more towards CRNA, so therefore there are more male applicants, and more male CRNAs. My experience with bedside nurse, esp new grad pay, is the same as yours. The data showed that there is more pay disparity in ambulatory, not acute care.

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