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Abstract

Introduction

Despite advances in health care and education, males continue to be considered a minority in nursing programs. Little is known about the decision of Jordanian male nursing students to become nurses.

Objective

The purpose of this research was to explore the factors that encourage or discourage Jordanian male nursing students from pursuing a career in nursing.

Methods

A qualitative narrative approach was used for this study. Data were collected using semi-structured individual interviews. Purposive sampling was used in the research. In this study, interviews were conducted with a sample of 28 male college students.

Results

The current study discovered that the following six themes exemplified the male nursing students’ lives: “helping and caring,” “job security and economic stability,” “parents and peer influence,” “level of autonomy,” “social stigma,” and “long working hours.”

Conclusion

The study's findings highlighted the importance of researching male nursing students’ motivating and inhibiting factors.

Keywords

male nurses nursing students qualitative research choosing nursing Jordan

Background

Today's health care facilities are becoming even more complex, requiring a high level of technological skills as well as skilled personnel in the face of the COVID-19 pandemic. It is estimated that there will be a shortage of nine million nurses worldwide by 2030 (World Health Organization [WHO], 2016). Furthermore, the growing shortage of nurses is a global issue, with nursing recruitment and retention identified as the primary concern worldwide (Haryanto, 2019; Kearns & Mahon, 2021). Although males have provided care in early societies, military health care, and the religious sector (Smallheer et al., 2020), nursing as a profession has been dominated by females. It is estimated that approximately 90% of the world's nurses are females (Buchan & Catton, 2020). The shortage of men in nursing is a long-standing issue that can be attributed to the feminization of nursing as a profession, which has resulted in stereotypes and gender biases that have harmed males (Ross, 2017). For example, while approximately 12% of registered nurses in the United States are males (U.S. Bureau of Labor, 2019), males account for less than 1% of the total population of nurses in China (Rajacich et al., 2013). Even though nursing is still primarily a female-dominated profession in Jordan, the tide is turning (Jordanian Nursing and Midwifery Council [JNC], 2016).

Due to alterations in the public perception of nursing and the rapid growth of health care facilities, the number of male nurses joining the nursing workforce has increased internationally (Yi & Keogh, 2016). Scholars argue that attracting males to the nursing profession could help alleviate labor shortages at the local, national, and international levels (Twomey & Meadus, 2016). As a result, understanding male participation in nursing programs is understandable (Gavine et al., 2020).

Review of Literature

According to the available literature, males and females are drawn to the nursing profession for the same reasons. Due to financial constraints, males were significantly more likely than females to choose nursing (Ashkenazi et al., 2017). In addition to their career mobility needs, many males who enter nursing have a family member who is a nurse or have had contact with a male nurse as a patient or caregiver (Gavine et al., 2020). A study conducted by Powers et al. (2018) highlighted that the educational experiences of male nurses influenced the future career decisions of other males.

Much of what is written about males in nursing, however, comes from developed countries where culture, education, and social stereotypes may differ from those in developing countries. Although some studies are valuable, they are now more than a decade old (Grainger & Bolan, 2006; Meadus & Twomey, 2011); thus, the available evidence must be updated with a different student sample and cultural context. As a result, the study sought to identify the factors that encourage or discourage Jordanian male nursing students from pursuing a career in nursing.

Methodology

Design

Qualitative narrative research methods were used to collect data from nursing students at Faculty of Nursing at government university. The current study employed the purposive sampling technique to recruit the study sample.

Sample

In this study, the qualitative research was concentrated on male students who were nurses at a government university in Jordan. A total of 28 male students were chosen for interviews in this study. The study reached to saturated interview (28 participants). The researcher gave each participant an assurance of confidentiality and anonymity, in order to respect their right to privacy and confidentiality.

Inclusion/Exclusion Criteria

The identity of participants who were interviewed had been kept confidential. Participants were abbreviated as, among other things, “Participant S1,” “Participant S28.”

Ethical Consideration

The research was authorized by the nursing school's research ethics committee. No academic contact was made between the researchers and selected students in order to minimize the influence of bias as faculty members.

The participants were informed of the purpose and nature of the study and that they were free to withdraw at any time without incurring any penalties. Participants were also urged to consider the focus group confidential and refrain from discussing it after the meeting. During group meetings, group and participant identification numbers were used to ensure confidentiality. All participants provided their informed, written consent.

Participant data were collected through semi-structured individual interviews for this study. Among the participants in these studies were male nursing students. With these inquiries, we hoped to get a better feel for what attracts male nursing students in Jordan. The research has been approved by university ethics boards in Jordan. Participants who expressed interest in the study were provided with consent forms and information about the research.

As previously stated, this investigation required approval from the Jordanian University's Ethics Committees. Participants were given a consent form and an information sheet.

All interviewees gave their informed consent to having their voices recorded before the actual interviews took place. Before beginning to collect data, the researchers went over not only the study's goals and significance, but also its purpose. The typical interview lasted 35 min, though their duration ranged from 30 to 40 min. Each interview lasted around 35 min on average.

Twenty-eight male nursing students’ data were analyzed with NVivo. The data were not processed without first reviewing the transcripts of the interviews. The concept mapping data were imported from NVivo. Finding common themes within the study's data were one of the aims of the analysis. This study's data were analyzed by (1) reading each transcription line by line to identify key words, meanings, or concepts relevant to the study objectives, (2) rereading the transcripts to identify the most pertinent words, (3) refining the coding by assembling similar codes and grouping codes together. A criteria was developed in 1985 to assure the dependability of the data (Lincoln & Guba, 1985). To increase the trustworthiness of the data, the final results were provided to all participants, however only nine responded to the validation request. Participants, setting, and data collection method were documented and provided within the context of the data, hence boosting transferability. To ensure the study's reliability, the original author used retrospective journals (Klenke, 2016). Researchers kept interview notes and memos to encourage conformity. This study adhered to COREQ's qualitative research reporting principles (Tong et al., 2007).

Results

Sample Characteristics

All the interviewees were older than 18–22 years of age. They were first-, second-, third-, and fourth-year students. The vast majority of participants are between 21 and 22 years old. The sample comprised of 28 male students.

Themes

Prevailing themes from the interviews revealed the factors that encourage or dissuade Jordanian male nursing students from pursuing a career in nursing by examining the following primary topics, as described by the participants in the interviews. The male nursing students lived experience was exemplified by the following six themes: “helping and caring,” “job security and economic stability,” “parents and peer influence,” “level of autonomy,” “social stigma,” and “long working hours.”

All participants (n = 28) were asked to highlight why they selected to study nursing. All male nursing students decided on nursing as a career choice, and the additional steps taken to obtain information that encouraged their decision to apply to nursing were for helping and caring for others in need of assistance, as well as receiving gratitude and thanks. All of the participants pointed out that they believe males do not become nurses because they are in the position of servant and do not have autonomy to do their job. This quote is from one of the participants responses:

…. I love to help others, mainly people who suffer from health problems…I feel excited when patients tell me that I am doing well… I am getting better… thanks. (S1)

Most male nursing students felt that they had a real desire to care and to be involved with helping others. For most of them, this crave emerged from some personal background while caring for someone.

I make my decision to study nursing because of the caring aspect of making people more comfortable and making them feel better…I enjoy doing that…. (S2)

Another factor highlighted by participants was related to job security and economic stability. It is apparent from their responses that job security was another factor that influenced their choice of career. It is one of the major factors that encourage them to pursue nursing as a career.

…as you know, job availability now is limited and the unemployed rates are high…I think nursing jobs are available whether in Jordan or in Gulf countries… (S4)

Other participants indicated that economy plays a significant role nowadays, he adds:

… by studying nursing, I can earn good money… I can help myself and my family as well…I think this career is better than others… (S1)

Additionally, when the students graduated from university, not like other university graduates, it was easy for them to get a job, and this plays significant role in their desire to select nursing as a career.

….my colleagues from other faculties graduated from their colleges and they take a while to find a job but that is not the case in nursing you are assured a job right away after graduation as a result of shortage of nurses in our country…. (S4)

…I have no issue to apply for a job right away after graduation. There are many vacancies for nurses in both government and private hospitals or even outside the country. This is an important benefit for nursing. (S5)

Other factors that influenced male nursing students to select nursing as a profession were associated with opinions and recommendations through family members, friends, or even peers who already have an idea about nursing. Some of the participants conveyed the importance of parents and peer advise. It was evident that participants took this issue as of high importance. A participant commented:

… after getting my high school grades…my mum, dad and brother encouraged me to study nursing… they feel it be appropriate for me… (S13)

For all male nursing students, low level of autonomy is highlighted as a theme that might play a significant role in not choosing nursing as a career. As one narrative affirmed:

…. working with other medical teams like pharmacy makes me feel that I just follow doctor's orders…this is my job as I feel… (S15)

Some of the participants view themselves as non-decision makers. In this context, one participant commented:

…. The power and decision making in our hospital is for doctors…we don’t have any right to make any decision…our patients believe that they are the only ones who can give the patient right answers… (S21)

The fourth theme is the social stigma. Although all participants view nursing as a profession of humanity, they still feel this is not a suitable job for males, taking into consideration our Arabic and Islamic culture. Gender stereotypes, mainly in our societies is still related with nursing, specifically that Arab and Muslim countries, they still view nursing profession as a female one thus affects the male nursing students desire to remain in nursing. This theme was obvious through the student's narratives. One participant pointed out:

…I don’t think it fits with my society … most people are still not fully convinced that nursing is suitable for males…they called me nurse… (S26)

In addition, male nursing students stay away from situations where their career was discussed due to humiliation about doing a job that was perceived as female job.

…. When some one asked me what you study….I told them nursing, I feel shame about that since most people in our societies believe it is female job…. (S20)

In talking about their experiences, several nursing students identified long working hours as a major factor. It is well recognized that the nature of nursing duty is 24 h divided into three shifts, approximately 8 h each. Nursing students mentioned this theme and highlighted it, as one stated:

…working with patients and their families for 8 continuous hours is very hard…you get very exhausted…. compared to the work of other health team members like doctors and pharmacy…(S28)

Another participant mentioned that working with different shifts for long hours prevents them from participating in social activities within the community, mainly in weekends. One participant said:

…most of our occasions are during weekends…I think it might hinder me from choosing nursing…. you can’t fix your schedule for morning shifts…(S10)

Discussion

The recent study sought to offer insight on the experience of being a male nurse: exploring the enhancing factors and barriers of Jordanian nursing students. The data discovered six themes: “caring of and helping others,” “job security and economic stability,” “parents’ and peer's influence,” “Level of autonomy,” “social stigma,” and “long working hours.”

According to the study findings, the main factor that encouraged nursing students to join nursing was the desire to help and provide care to others and it was explicitly evident in their narrative comments. As a matter of fact, the essence of nursing profession is directed toward providing care for others and it is congruent with the Arabic and Islamic culture. The current study's findings are consistent with previous research that found the desire to help and care for others to be the most important factor among nursing students (Başkale & Serçekuş, 2015; Usher et al., 2013).

The second theme is that nursing students recognized the job security and economic stability as a motivating factor that attracted them to join nursing. According to their narratives, the most common reasons reported for selecting nursing were job security and economic stability. These findings are consistent with other researchers that investigated why males select nursing as a career (Başkale & Serçekuş, 2015; Glerean et al., 2017; Liaw et al., 2016; Rashid et al., 2013; Saleh et al., 2020). Furthermore, Glerean et al. (2019) supported the concept of job security; nursing was considered as secure job.

The third theme is parents and peer influence. It was evident by participants’ narratives that the influence of family and peer are apparent. Within the Arabic and Islamic culture there is strong family connection and most of our students after getting their high school grades discuss with their family and peer their future path of education. This contradicts with Neilson & McNally (2013) who highlighted that there is negative influence of parents and significant others on high academic achievement students choosing nursing as a career.

All the respondents mentioned that lack of autonomy is the major hindering factor. In our Jordanian culture as part of Arabic and Islamic culture, the stereotype of power and decision making among health care providers are doctors. The historical subordination of nursing to the medical model limits the decision-making power of nurses (Baykara & Şahinoğlu, 2014; Galbany-Estragués & Comas-d’Argemir, 2017).

All participants mentioned that nursing in general for males has some social influence in terms of social stigma. As mentioned earlier, Jordan is an Arabic and Islamic culture that still believes that nursing is a shame for males. Despite men having a significant contribution to the profession of nursing since the Middle Ages and Florence Nightingale's time until now, nursing has been primarily a female dominated job. Although nursing is one of the professions in the field of medical sciences, female individuals make up a large proportion of the nursing profession population (Dos Santos, 2020). Moreover, Rowlinson (2013) mentioned that gender of a nurse influences the lived experience when compared and contrasted. However, Mao et al. (2021) stressed that there was no clear line between the gender-related advantages and disadvantages as factors influencing professional development can be turned by the males from barriers to facilitators.

The final theme the participants highlighted was long working hours as a hindering factor. It is well known that nurses provide direct patient care for 24 h divided into three shifts. From the participants’ perspectives, they feel working for almost 8–10 h per shift is quite long time and makes them feel fatigued. Moreover, the changing between shifts decreases their involvement in social activities. This finding is consistent with other studies that nursing and midwifery are demanding professions, carrying high levels of public and professional performance expectations, and often involve long and irregular hours of work (Başkale & Serçekuş, 2015).

Strengths and Limitations

It is of importance to acknowledge the limitations affecting the findings, the methodology, and the issues of comparison of the results of the current study taking into consideration that the current study was conducted in a developing country in sense of culture, historical, and gender issues.

Other limitations of the current study include the small population sample size causing findings to be only relevant within the area it was taken from, therefore, may not be representative and cannot be generalized outside of this study. Qualitative research is not completely precise and complete objectivity and neutrality are impossible to achieve, thus this may limit the accuracy of the study findings. Therefore, future studies in other social and culture communities using different data collection methods are essential. Moreover, further studies may help in comparing between male and female motivation and hindering factors that help them in choosing nursing as a future career.

Implications for Practice

It is critical to understand why males choose nursing as a career and their experiences in the nursing education program. This understanding may aid nurse educators and key personnel at nursing colleges in their efforts to change male students’ cultural stereotypes and promote effective strategies (Messineo et al., 2019), thereby encouraging more males to enter the nursing profession.

Conclusion

The current study's findings highlighted the importance of researching the primary motivating and inhibiting factors influencing male nursing students to pursue a career in nursing. Although the male–female ratio in Jordan is not problematic, females outnumber males. The challenge for nursing colleges (administration and educators) is to continue to encourage more male students to enter the profession and to broaden the profession's diversity. Because this study identified some pushing and pulling factors, it is critical to develop effective strategies for fostering and supporting students, ongoing recruitment strategies, as well as strategies to make nursing more male-friendly. Understanding why males enter the nursing profession and learning about their educational experiences is beneficial. This study, we believe, will inspire future researchers to devise a strategy to recruit more male nursing students and to reconsider the impact of nursing students’ reasons for becoming nurses. Comparing to international statistics, Jordan's male–female ratio is convergent, but females outnumber males.

Footnotes

Acknowledgments

Researchers would like to thank everyone who contributed to the study.

Author Contributions

Each of the credited authors has made a significant contribution and approved the final manuscript.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Abdullah Algunmeeyn

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The Experience of Being Male Nurse: Exploring the Enhancing Factors and Barriers of Jordanian Nursing Students

Abstract

Introduction

Objective

Methods

Results

Conclusion

Keywords

Background

Review of Literature

Methodology

Design

Sample

Inclusion/Exclusion Criteria

Ethical Consideration

Results

Sample Characteristics

Themes

Discussion

Strengths and Limitations

Implications for Practice

Conclusion

Footnotes

Acknowledgments

Author Contributions

Declaration of Conflicting Interests

Funding

ORCID iD

References