As a boom operator at Fairchild Air Force Base, Staff Sgt. Thomas Wright flew 200 missions over Iraq and Afghanistan, maneuvering refueling booms into waiting fighter planes high above the earth.
Now he’s traded his flight suit for scrubs, preparing to graduate in May with a bachelor’s degree in nursing, his education covered by the GI Bill.
As a man, Wright, 32, will be in the minority among colleagues. But it’s a growing minority: A recent report from the U.S. Census Bureau showed that the proportion of men in the field has more than tripled in the past few decades, to 9.6 percent in 2011 from 2.7 percent in 1970 for registered nurses.
And in Wright’s class at Washington State University’s College of Nursing, it’s a bigger minority: Men have comprised 15 percent to 18 percent of WSU nursing graduates over the past five years.
Area hospitals also report higher-than-average male representation in their nursing staffs – 16 percent at Kootenai Health, 12 percent at Valley Hospital and 10.5 percent at Deaconess Hospital. At Providence Holy Family Hospital, about 10 percent of the nurses are men. Just over 12.5 percent are male at Providence Sacred Heart Medical Center & Children’s Hospital.
The aging U.S. population has fueled growing demand for long-term and end-of-life care, the report said. In the meantime, skilled nursing care has expanded in schools, retail clinics and mental health services.
Predicted nurse shortages led to increased recruiting and training efforts, the report said, including recruiting men into the field. In previous decades, barriers keeping some men from the field included refusal by some nursing schools to admit male students. The U.S. Supreme Court deemed that practice unconstitutional in 1981.
Jan Moseley, nursing director at Kootenai Health, said a combination of factors have led more men to nursing. She credited declining employment in other industries in the region, such as timber and mining, along with a desire for secure, good-paying jobs amid tough economic times.
The field also offers more opportunities for advancement than it used to, Moseley said. Nurses with graduate-level education can take relatively lucrative jobs in health care leadership and as nurse practitioners or nurse anesthetists.
Other options for nurses, male or female, are varied and growing, too, including work in acute care, patients’ homes, hospice centers or in temporary positions through travel-nursing programs.
“It is a viable career track,” said Ryan Townsend, 39, a psychiatric nurse practitioner with a private practice in Spokane who’s also on the faculty at WSU. “They’re certainly forecasting for increased need, so that provides a sense of security. And the salaries are commensurate with the training. I think it’s a good investment in terms of college education.”
Tina Bayne, assistant dean for undergraduate programs at WSU’s nursing school, said the nurse shortages experienced in other parts of the country don’t apply in the Inland Northwest. It’s been difficult in the past five years for new graduates – men or women – to secure a nursing job right away.
But she sees their prospects improving now, in part, she predicted, because experienced nurses who kept their jobs during the recession as their spouses endured layoffs will finally retire, “just because they’re too weary to continue.”
Unequal ranks, unequal pay
Despite the increase in males in the ranks, the ranks are still lopsided. Women remain the overwhelming majority among nurses. More surprisingly, perhaps, the pay is lopsided, too: Male nurses outearn female nurses, according to the Census Bureau.
On average, men earned $60,700 a year, while women earned $51,100.
Part of the difference can be attributed to the fact that men work in greater percentages in higher-paying nursing occupations. Forty-one percent of nurse anesthetists were men, earning an average of $162,900 a year, more than twice the average for all nursing occupations.
But men also outearned women working in the same jobs, according to the Census Bureau report, based on data from the 2011 American Community Survey, which has an annual sample size of about 3.3 million homes in the U.S. and Puerto Rico.
Female nurse anesthetists made an average of $131,675 a year.
Among registered nurses, men made an average of $61,898 a year, compared with $55,159 for women. Among licensed practical and licensed vocational nurses, men earned $40,216 while women earned $34,935.
Bayne said while the disparity on the national level was distressing, she doubted it applied in the Spokane area, where contracts between large health care organizations and unions would prevent it.
‘There all the time’
Nursing had significant male representation until the 1800s because of the early association between nursing and the military and religious orders, the report said.
But men’s representation in the field declined in the 1900s as “reformed” nursing – founded by Florence Nightingale – spread quickly.
“The inherent assumption underpinning this new nursing was that it was ‘natural’ for nursing to be performed by females,” researcher Carolyn Mackintosh wrote in a historical study of men in nursing published in the Journal of Advanced Nursing. For Wright, and other men in the field, it seems natural to want to help people.
Wright said his military experience helped guide his career choice, as he saw fellow airmen struggle to return to family life and the military as a whole struggle with post-traumatic stress disorder and suicides among veterans. He wants to be a psychiatric nurse.
While a doctor may focus on a patient’s illness and how to cure it, a nurse is more likely to also consider the patient’s family or other support system, spiritual life, socioeconomic status, diet, housing situation – the whole person, Wright said. The chance to help sick people get their lives back appeals to him.
“I see on the floors that a doctor can come in and spend 15 minutes with patients,” Wright said. “They seem focused on efficiency. The nurses are there all the time. I really want to get to know the people.”
Townsend said a neighbor and childhood mentor was a male nurse who was empathetic and caring, qualities that resonated with him.
“I knew a lot of male nurses growing up. I must have known all six of them in Spokane,” he joked. “There wasn’t a reason I wouldn’t want to become a male nurse. I had role models.”
He was surprised that he was one of only about four men to graduate with their cadre of 50 from WSU’s nursing school in 1999. Still, he said: “It felt like I was going to nursing school, not female school.”
A growing body of research has found that patients believe receiving primary care and having a usual source of care is more important than who provides it, according to a policy brief published in October in the journal Health Affairs.
But in some cases, Townsend said, people feel more comfortable discussing sensitive health issues with someone who’s the same gender – a good reason, he said, for the profession to try to boost male participation.
“If you have prostate cancer and you’re being treated for that,” Townsend said, “there might be a tendency to feel more comfortable talking about the symptoms of treatment with a male nurse than they would be with a female nurse.”
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