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Letter to the Editor by Larry Zhang and Kyungsook Gartrell to "Exploring the Lived Experience of Male Nurses in the Pursuit of Leadership Roles: A Phenomenological Approach"

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December 11, 2019

Response by Larry Zhang and Kyungsook Gartrell to "Exploring the Lived Experience of Male Nurses in the Pursuit of Leadership Roles: A Phenomenological Approach" by David Keselman (2014)

Dear Editor:

Despite the fact that men make up only 10% of the nursing workforce, there exists a psychological fear that men will take over the field of nursing (American Society of Registered Nurses, 2008). Nursing is one of the few havens of western society that was created for women by Florence Nightingale. Prior to Nightingale’s reform of the nursing field, articles dated before this radical change indicated that men existed alongside females in the healthcare industry, including nursing (O’Lynn, 2004). As there were other higher wage and more prestigious occupations for men during the 19th century, this gave females an opportunity to dominate the field of nursing (Stokowski, 2012).

In 1972, Title IX of the Education Amendments made it so that gender discrimination could not be used to block specific groups from academic programs (Stokowski, 2012). The ratio of men in the nursing workforce increased from 2.7% in 1970 to 6.6% in 2008 (Stokowski, 2012). Despite these advancements, with the history of nursing being continuously reinforced as a women’s profession, and today’s endorsement of hyper-masculinity among men, it is not surprising that the majority of men in the U.S. are not choosing nursing as a viable career option.

Keselman (2014) performed a study to determine why so little effort is being put towards recruiting and retaining male nurses when there is predicted to be an extensive shortage of nurses by 2020. By analyzing the experiences of men who have successfully moved into administrative positions, he believes the information obtained can be applied to bring more men into the profession of nursing (Keselman, 2014). Keselman aimed to analyze their challenges and to look into common themes, such as the glass escalator effect and tokenism. The glass escalator effect is defined as riding up the professional ladder with ease due to being a minority, in this case, being a male in the field of nursing. Results, however, showed that a glass ceiling effect was actually occurring in the context of higher administrative positions. Although male employees did excel through the ranks with ease to managerial type roles, they seemed to meet a concrete ceiling near higher level administrative positions, e.g., director of nursing. Tokenism is when one is elevated to a position of high visibility, but given meaningless responsibilities. A positive effect was found for men because managerial positions are still meaningful and impactful jobs. That being said, women have a valid reason to feel hostility towards men in the field of nursing due to the differential treatment based on gender. For example, Keselman (2014) states that men are given preference for admission into nursing school, hiring, and promotion.

Men who take on nursing roles tend to be less socially accepted compared to female nurses. For example, men in nursing prefer to be referred to as a nurse but face the potential of being called a ‘murse’, which is demasculinizing to these individuals in a culture where men need to be hyper-masculine. Those who do pursue nursing are often stereotyped as gay or failed doctors (Keselman, 2014). Nightingale has even been quoted to say that men are not suited for nursing ( Editors, 2019). Nightingale’s beliefs, however, do not fit into the 21st century’s narrative where gender roles have evolved. Humans are born with some innate traits of caring, but to a larger degree, socialized acts of ‘caring’ are learned through imitation. A man’s perspective of caring may be perceived as less emotional and touch-oriented compared to a female’s, but it is in no way less caring. In fact, the problem is further exacerbated in nursing education, as many men tend to feel alienated due to the lack of other male role-models in the field of nursing (Keselman, 2014).

The recruiting and retention of male nursing students needs to start earlier and be approached with more effort. Our nation depends on there being enough nurses to face the incoming surge of patients. Prioritizing the influx of men in nursing should not take precedence over raw merit in order to provide the best patient-centered care. In addition, hiring due to skill alone will help ensure that individuals will not believe they are being employed or promoted simply to increase the diversity within the field. Through defeminizing the field of nursing, we can revolutionize the healthcare system by incorporating new perspectives offered by men. Most importantly, this new target population will allow us to care for the increase in patients who are living longer lives.

Larry Zhang, BSN student
Towson University, Towson, MD 21252

Kyungsook Gartrell, RN, PhD
Towson University, Towson, MD 21252


American Society of Registered Nurses. (2008). Men in nursing. Retrieved from Editors. (2019). Florence Nightingale biography. Retrieved from

Keselman, D. (2014). Exploring the lived experience of male nurses in the pursuit of leadership roles: A phenomenological approach (Doctoral dissertation). Retrieved from ProQuest LCC. (Accession No. 109828419)

O’Lynn, C. (2004). Gender-based barriers for male students in nursing education programs: Prevalence and perceived importance. Journal of Nursing Education, 43(5), 229-236.

Stokowski, L. A. (2012). Just call us nurses: Men in nursing. Medscape Nurses. Retrieved from