History matters. It provides a necessary context to the present. Each person represents an example of living history that many can trace back in time through their family name. This legacy provides direction, stability, and strength for future challenges that every one of us will ultimately face.
In my own life, this living history is represented by my grandmother. Her family were Mennonites who immigrated from the Ukraine as a child because of the Communist Bolshevik revolution that started in 1917. She could trace her Mennonite/Anabaptist heritage all the way back to the Protestant Reformation in the 1500’s when this movement began!
When Martin Luther began the Protestant Reformation in the early 1500’s in Germany, the Anabaptist’s were considered the radical wing of the Reformation who emphasized the need and desire to follow the example of Christ in everyday life in order to demonstrate the authenticity of ones faith.
They were persecuted, many even killed for their beliefs, but stayed faithful in ongoing adversity. This rich legacy and stories from my Grandmother were a highlight of our many trips to visit her in Winnepeg, Manitoba and strongly influenced my own spiritual journey. Knowing this as my historical legacy has directly influenced the man I am today.
Another example of the power of knowing your name and legacy is demonstrated in the movie “Gladiator” (see the YouTube link!). Maximus, a former Roman general who is now a slave is confronted by the villain Commodus in the Coliseum. He demands the “slave” to tell him his name. Maximus responds:
My name is Maximus Decimus Meridius, commander of the Armies of the North, General of the Felix Legions and loyal servant to the TRUE emperor, Marcus Aurelius. Father to a murdered son, husband to a murdered wife. And I will have my vengeance, in this life or the next.
If Maximus has no identity in who he is or was, his ability to fight to the death as a gladiator who knew his legacy would be futile, and he would not have the strength or resolve to persevere in adversity.
What does this have to do with men in nursing?
If men have no knowledge of their historical name, legacy, and identity as caregivers, they will continue to see no need to consider or even enter the nursing profession and persevere in nursing education. Do men have a name and legacy as historical caregivers? If this identity is not known, does it influence the success of men in nursing education? Let’s take a brief look at what the literature would communicate to address these important questions!
Historical Legacy as Caregivers
The earliest nurses in recorded history were male caregivers. In Hippocratic writings in ancient Greece, public nursing care was provided by men (1). In India around 275 BC, public hospitals were developed where men were the primary caregivers. In ancient Rome, the best possible care was provided to soldiers in military hospitals.
Male nurses called “nosocomi” were the primary caregivers, but unfortunately, they did not likely do their job well because this is also the root word for hospital or “nosocomial” acquired infection (2)!
One of the most well known stories that Jesus taught was the parable of the Good Samaritan, who despite the ethnic division between Jews and Samaritans, was moved with compassion to sacrificially serve and care for his “neighbor” who was critically wounded and lying in the ditch. This famous unknown caregiver was also male, likely situating the historical context of men as caregivers such as the nosocomi in Rome. The image of this post represents this parable in art.
The early Christian church had male deacons as well as female deaconesses who were responsible for ministering and caring for those who were ill (3).
In the third century, orders of monks known as Parabolani provided care for the ill (3). Because the black plague was endemic at this time, men willingly and sacrificially served as caregivers and many lost their lives as a result. Monastary orders including St. Benedict were present throughout the Middle Ages. Military orders of knights were founded in the eleventh century, and some orders defended Jerusalem during the Crusades.
The order of the Camellians, founded by a Franciscan monk, St. Camillus de Lellis, who served in the fifteenth century, gathered men who desired to serve and care for others who were dying because of their love for humanity. They had a symbol for his order, the red cross, that remains the primary symbol of healthcare today (4). Men also participated in nonmilitary orders during this time up until the sixteenth century when monastery orders were dissolved (5).
Nightingale Not a “Fan”
This legacy of men as caregivers changed when Nightingale instituted the modern era of nursing. Though she remains a hero to me as a radical transformer, she also chose to firmly establish nursing as a woman’s profession. To her, “every woman was a nurse,” and a woman who entered nurse training was doing only what came naturally (6).
Nightingale believed that men have no place in nursing “except where physical strength was needed” (6). Where was this strength needed in the 1800’s before antipsychotics? You guessed it, it was the insane asylums! In England during the late 1800s, men who remained in nursing were excluded from general nursing practice as well as Nightingale’s schools of nursing.
This is the primary reason why the current male participation rate in nursing remains as low as it is (9.6%). In the 1960’s it was even lower at only 1%!
Educational Barriers Today
Nursing textbooks have limited or excluded historical male contributions to nursing while emphasizing those of women. This revision of nursing history perpetuates the myth that nursing has always been a female dominated profession (3). If this historical legacy was clearly presented in textbooks, and widely known by nurse educators, this barrier could be eliminated immediately!
The lack of inclusion of the history of men as caregivers is a barrier to men in nursing education today that influences their success. Because of this and other barriers/stereotypes that men experience, the end result for many men is AMBIVALENCE. They question their choice of nursing and are much more likely to quit. The failure to complete nursing education rate for men has been 3-4x higher when compared to women (7).
If a simple search of the literature in nursing provides the references that I have provided for this blog, the essence of this also belongs in the history of nursing that is found in most fundamentals of nursing textbooks.
Examples of Current Bias in Fundamentals Texts
I have been impressed with the accuracy and extensive inclusion of men in nursing history found in Kozier & Erb’s Fundamentals of Nursing. Unfortunately this is the exception. The following are examples of bias and even revision of nursing history in others:
- In a former but recent edition, the “Milestones in Nursing History” table begins with this entry: “400 AD, entry of women into nursing” (off by almost 1000 years & wrong gender!)
- Beginning nursing history with Florence Nightingale, ignoring over 2000 years of caregiving (this was found in more than one text)
- Primary Contributions of Selected Early Nurse Leaders begins with Sojourner Truth in 1827 and ends with Mildred Montag in 1952. All leaders in this table were female, even though some male nursing leaders were present in this time context including Luther Christman
Be the Change!
This blog and these resources will empower any nurse educator to be a change agent! The following is a list of action items I hope you will consider and implement:
- Include a full presentation of both the BCE and AD eras in your nursing history lecture as well as examples of men as caregivers. I highly recommend Chad O’Lynn’s recent book “A Mans Guide to a Nursing Career” because he has a strong history of men in nursing that includes rich and relevant examples of male caregivers that men can use to recapture this lost legacy!
- Let your male students be aware of the resources (books/website) to provide needed support
- Check out the fundamentals of nursing textbook that your program uses. If the history of men in nursing is inaccurate, minimal, or nonexistent, contact your book rep and express your concern! If an error is found in a textbook, it is immediately addressed and corrected for the next edition. In the same way, any inaccurate or lack of information of men as caregivers should also be addressed and included in the next edition!
What is your men in nursing IQ? Was the information in this blog known to you? If not, what do you plan to do differently to make it known?
Respond in the comment section below and let the conversation begin!
Resources for Men in Nursing
- Website: American Assembly for Men in Nursing: http://aamn.org/
- Book: A Man’s Guide to a Nursing Career by Chad O’Lynn
- KeithRN-Men in Nursing webpage
- Brown, B. (2000). Men in nursing: Ambivalence in care, gender and masculinity, International History of Nursing Journal, 5, 4-13.
- O’Lynn, C.E., & Tranbarger, R.E. (2007). Men in nursing: History, challenges, and opportunities, New York, NY: Springer Publishing Company.
- Anthony, A.S. (2004). Gender bias and discrimination in nursing education: Can we change it?, Nurse Educator, 29, 121-125.
- Men in Nursing: A Historical Timeline. Retrieved from http://allnurses.com/men-in-nursing/men-nursing-historical-96326.html
- Evans, J. (2004). Men nurses: A historical and feminist perspective, Journal of Advanced Nursing, 47, 321-328.
- Villeneuve, M.J. (1994). Recruiting and retaining men in nursing: A review of the literature, Journal of Professional Nursing, 10, 217-228.
- McLaughlin, K., Muldoon, O., & Moutray, M. (2010). Gender, gender roles and completion of nursing education: A longitudinal study, Nurse Education Today, 30, 303-307.