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RN Men: The XY Viewpoint

Small Talk Can be a Big Deal
October 7, 2016 3:18 PM by Nicholas Nicholson
There are so many instances where small talk is practiced regularly in the various nursing units. Small talk is unescapable: in the elevator, in the lobby, in the café... everywhere. The real benefit to small talk isn't what's said; it's when relationships are built over time.

If your shift starts at 0700, then chances are you are going to see the same people day in and day out. Why not take the opportunity to chat about the weather or the traffic, or any other inconsequential topic? A great opener might be, "Have you had any time to watch TV lately?" This gives you a sense of the person's interests as opposed to presuming things about the person. After all, that's what small talk is: conversation about nothing important, right?

Maybe not.

Building relationships with the community you are a part of is invaluable to your health (physical and mental), and frankly, it passes the time as you are ascending to the upper floor of the facility. But, does the small talk have to end there? Often it is continued with various degrees on the floor with colleaguesand patients as well.

If there is an educational offering, often staff members have an opportunity to socialize prior to the beginning. Depending on the specific area in nursing (and the source), the percentage of men involved can be around 9%. So for an educational offering with 10 staff members, that means you may notice the one male colleague. As the small talk begins or as it really begins to gain momentum, keep in mind that male colleagues may have very different interests. They might not, but having been subject to what seems like endless small talk, waiting for the educational offering to begin, I can attest to a total mental disengagement of the conversation going on. Instead of small talk having value for connecting humans and improving engagementwhich it truly cana socially isolating situation can be created inadvertently.

Communication and connection with each other in the working environment can literally mean the difference between solid patient care and not-so-great patient care. Creating staff connections and a welcome, engaging environment starts with small talk. If we feel connected to our workplace, we are more likely to effectively communicate and share our concerns and help each other out. Doing that ultimately helps our patients.

As we do when working with patients from different cultures, the best thing to do may be to admit our ignorance of the culture and ask genuine questions about the person. In this case, instead of presuming those male colleagues are interested in the same stereotypical small talk issue, try asking if they had a chance to watch TV lately.

To Hug or Not to Hug
September 9, 2016 9:57 AM by Nicholas Nicholson

In nursing, I will venture a guess you have found yourself in a patient room hugging someone (patient or family member), because they needed that support.

If you are a male-I'm going to venture another guess that in that SAME situation mentioned above, BEFORE you extended your arms, you found yourself wondering, "Should I hug this person or not?" Perhaps you ended up doing a "high five" or something along those lines instead. Nurses are compassionate and caring, and some nurses show this support through physical contact. For example, a hug.

Hugs occur during the best of news and the worst of news. A patient's family I was working with in the medical intensive care unit was confronted with horrible news about their family member. Despite our best efforts, we could not figure out a way to increase the ejection fraction of the heart. We all knew what that meant, and it wasn't good. The patient's wife, who happened to be an older adult, began to cry and to sway in a way that signaled she was going down. She was comforted as anyone should in that situation with a warm supportive embrace. That made all the difference in the world in that moment. I believe that the power of compassionate touch is an important tool in the multi-situational toolbox all nurses have and need.

However, this situation has made me ponder a number of questions. Would it matter if that wife was younger, much younger than me even? What if that patient had a partner instead of a wife or was from a different culture-would that alter the way I helped the family member cope with the situation in some fundamental way? Would the family have reacted differently if I weren't a male? Would my supportive hug be perceived differently? Should I be doing a high-five or a head nod instead? Should it matter than I am a male and who my patient is?

My response is: no. It should not matter, but in reality, I think that it does. Or at least, it could matter. Any of those potential situations could result in a supportive hug being perceived as a number of things not conducive to the best interests of the patient and/or their family. I work hard in my classroom and in my practice to empathize with those who I work with and to understand how the actions I take impact the patient and family prior to taking them.

I hope we can get to a place where every nurse can hug when necessary regardless of gender or any other factor-not that physical embrace is warranted in every situation (actually, it rarely is). But, for now, when hugs are necessary, us males may still wonder... to hug or not to hug?

Growing in Numbers
August 29, 2016 8:29 AM by Michael Madrid
Can anyone remember all the way back in nursing school how many males were in your class? I can remember, back in 1993; I was the only male in my CNA/ROP class. There were three males in my LVN program and five in my RN program. I think we can recall to the past generations that many gentlemen who entered into nursing school were faced with some serious barriers such as a some gender discrimination from female instructors and fellow nursing students as well as imbalanced access to clinical training in areas like obstetrics and gynecology (I was relieved from my clinical assignment in my LVN program). Not to mention the lack of support from family and friends who strongly believed that nursing was strictly a "women's profession."

Needless to say the numbers are increasing in the nursing programs, as well as in the workforce, in a profession that has been known for a predominantly female-dominated presence. Data from the US Department of Health and Human Services in 2008 indicated that approximately 6.6% of nurses in the US are men. It could very well be safe to say that more and more men are entering into the profession, and it is reassuring to see that in current nursing textbooks and literature both men and women are portrayed as working together as nurses.

In various care environments, patients are becoming more comfortable to having both male and female nurses, so we can say as a profession "Change is here!" Commonly, men in nursing tend to be in critical care and the emergency department, however men in this profession are spreading throughout the care spectrum and are usually well received and very much appreciated. 

It can be said that the nursing profession is becoming more diverse in ethnicity, race and gender. Many cultures are receptive and accepting to the idea of male nurses. Having a healthcare workforce comprised of many different people from different religious beliefs, ethnicities and genders provides for a very global view in the ability to provide the best care for the patient. 
Use of Human Subjects in Research
August 18, 2016 9:05 AM by Jasper Tolarba
In response to controversial medical researches involving human subjects resulting in death or devastating effects among participants, several policies and guidelines were undertaken to ensure that human subjects who join in these kinds of research or experiments are protected. The scientific community and the modern society in general do not want to witness another research nightmarelike the Nazi medical experiments, the Tuskegee syphilis study, or the Jewish Chronic Disease study, to name a few.

In spite of concerted efforts to end unethical use of human subjects in research, the realization continues to be a challenge up to this day. Unfortunately, existing safeguards to protect people from the dangers of research procedures prove ineffective as some medical and pharmaceutical companies employ unscrupulous researchers who know how to make a run around the established rules. Termed as "professional human guinea pigs," some individuals are willing to give consents to become study subjects exposed to unknown side effects of trial drugs or clinical procedures for which they are willing to endure for the sake of money.

The Nuremberg Code written in 1948 is the first international document to discuss the requisites of involving human subjects in research. Although this code has no force of law, it was vital in the research community, because it emphasized the need for informed consent and voluntary participation.

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research issued the Belmont Report in 1979, tackling the boundaries between practice and research; ethical principles of respect for persons, beneficence, and justice; and its applications, such as informed consent, risk and benefits, and the selection of subjects.

Similarly, the World Medical Association (WMA) has implemented the Declaration of Helsinki which serves as a guide to medical doctors who are pursuing medical research. It requires that research for humans must have undergone laboratory and animal testing prior to administration to humans.

When everyone thought that the problem was solved with the implementation of the aforementioned guidelines, addressing ethical principles involving biosamples and tissue handling became obsolete. Apparently, in the case of the Havasupai tribe in Arizona, faculty researchers from Arizona State University (ASU) collected 400 blood specimens from members of the tribe originally intended for diabetic research. However, members of this native group claimed that the researchers used the collected specimens to do research other than diabetes including schizophrenia, inbreeding, and other secondary uses that were not originally consented.

This case was eventually settled out of court whereby ASU paid 41 of the Havasupai tribe members the amount of $700,000, as well as returned the contested blood specimens.

Institutions charged to protect human subjects must come up with updated guidelines and rules to address issues involving research volunteers who are willing human "guinea pigs." It's unlawful for people to engage in research activities that have risky and unpredictable outcomes, even if an informed consent has been provided.

Laws pertaining to biosamples should be instated so that not just human subjects but also human parts containing genetic materials are regulated and protected.  Debates and discussions on this subject matter will act as the springboard to finding policies and statutes to change and guide the practice. Otherwise, everything will continue to be empty words and medical researchers fall into the decadent times we feared seeing.
When the Personal and Professional Realms Collide
August 12, 2016 8:31 AM by Nicholas Nicholson
There is an interesting perspective a nurse (or a nurse's loved one) who is a patient has. First off, it's not easy to be a patient-it's especially not easy to be one when you are a nurse. It's even more difficult when you teach nurses how to take care of others as there are certain expectations of care that should be provided. So, naturally, when my daughter was born in July, I noticed quite a few things about my experience.

Here are a few observations as they relate to the postpartum area: There was a true lack of any male perspective in the area. The only men on the floor were a few nervous new dads, obstetrics physicians, and some ancillary staff. (If you are wondering, I was in that first category-nervous new dad.)

Noticeably missing were men in the nursing role.

I remember being a student on the postpartum floor and taking excellent care of all of my families. So I began wondering if it was me who missed something during my stay on this floor or if it was the institution.

One thing I didn't miss was the general feeling that the dads and support partners were around (in the room even), but were NOT patients. This brings me to my point: As nurses, let's help the dads and support partners be more of an integral part of the process. After all, aren't nurses holistic and aren't we treating the entire family? It would be great if we could begin staffing these units with more men, but at the very least, can we all make a concerted effort to include all those involved in the creation and care of the newest patient?

I know what some of you might be thinking, men would not be a good fit as they can never have the actual experience of giving birth. True, but how many of us have had all of the diseases, afflictions, and experiences that ALL of our patients bring in with them? Does that mean that, as nurses, we are any less effective with our empathy? The fold out couch is okay, allowing the partner in the birthing suite is okay, but can't nursing do better?

In nursing, we've come a long way from how things used to be in postpartum but maybe not as far as we think. Can we start by calling them co-patients? It's simple but empowering for an important part of that new family. Can we provide them with hospital supplied food? Primarily, so they can complain about how bad it is but also to feel like a co-patient.
If Only It Had Been an “April Fool’s” Prank
July 13, 2016 5:09 PM by Nicholas Nicholson

As a college professor and registered nurse, I have come to expect the unexpected when it comes to walking into a patient's room (or a classroom). However, nothing could have prepared me for the fact that one day, someone would decide to put up a billboard on I-84 East in Waterbury, CT, near exit 25, portraying a shirtless man with a stethoscope around his neck. "Who's caring for your mom?" asked the question printed next to him. I thought, "It's too far away from April Fool's Day for this to be a prank."

Although I hoped it actually was some type of prank, deep down I knew it wasn't. I knew what it was, because I've seen it before-we all have. It wasn't a joke at all; it was much worse. It was an attempt to advertise for an all-female care unit in a long- term care setting.  It used the same stereotypes of nurses that we've seen time after time on TV, magazines, everywhere. 

What is the message? The message is that women are nurses and care for people, not men.  It implies that being born a man means that you can't care for people in a compassionate, respectful, competent and comfortable manner. After I processed all of the overt messages (and a few where reading between the lines was necessary), I really wished it were a prank.

I felt sadness, and also disappointment with a pinch of anger.  In this day and age, how could someone think I could not (or would not) provide the best possible care? As a male nursing instructor, I wondered, "Would all of my students now be ineligible from taking care of patients on this all-female unit, because a man provided them with nursing knowledge from (gasp) a male perspective

Where does it end? Where do we draw the line as to what is an acceptable hiring practice, and what is a discriminatory, downright immoral and possibly illegal hiring practice? This billboard was a thinly veiled attack on the quality and type of nursing care a male would provide. 

Perhaps the worst part is that the people who put it up almost certainly don't realize what they did. The great thing about being a professor is I can spot someone in need of an education a mile away, so I'll do the same thing here that I do with my students: I challenge the facility that put the billboard up to put real nurses on that billboard instead, not stock photos of male models. 

The premise that gender is a key factor in determining one's ability to perform the job functions of a nurse is outdated and stale. Instead of focusing on what the person who is taking care of you looks like, let's focus on patient outcomes, such as the ones found in the National Database of Nursing Quality Indicators (NDNQI). Plenty of outcomes are impacted directly by the levels of care provided by nurses. If you want care for my mom in your facility, try citing your fall rate, or your pressure ulcer rate! 

  • To see the insulting billboard that sparked this blog post, click here.
Male Nurses: We Care for Our Patients Because We Care for Our Patients
July 13, 2016 4:16 PM by Jasper Tolarba

I chose nursing as my profession because I truly believe it is one of the few callings that transcend gender, race, socio-economic status and religion. It is ignited by one's motivation to care for other people-a desire that is consummated every time a patient's health and well-being is restored. Sure, there are times a patient's outcome may not be what everyone hoped for; but part of the sanctity of this vocation includes possessing the ability to provide courage and hope to patients when the future seems difficult and uncertain.

I could have chosen to become an architect, a lawyer, or perhaps join the military-to join a profession that most other guys typically choose. And yet, I ended up choosing a profession where more than 90% of the workforce is comprised of women. It's okay as long as I care for my patients and make them feel better on a day-to-day basis. At the end of the day, if I can say I made another's person's health struggle more manageable (if not easier), then I leave work a happy and fulfilled person.

I don't mind "taking one for the team" by being the default nurse assigned to either the highly assaultive and confused patient on the floor, or the morbidly obese patient who needs to be turned every hour. Nor do I take the slightest offense to being the person designated to buy coffee for everyone in the unit at 3 a.m., since as a male nurse, I am perceived to be in less danger walking alone on a deserted street.  I love my fellow nurses; I am married to a nurse; and who knows-maybe my children will one day also become nurses. I have no regrets that I chose this noble profession.

So imagine how dismayed I was to drive by the billboard on I-84 East in Waterbury, CT, portraying me and the rest of my fellow male nurses as individuals who would sexualize and prey upon our elderly female patients (insinuated by the half-naked guy with the stethoscope around his neck). What a disrespect to all male nurses! It's a vicious attack on our integrity as professionals. Who allowed this billboard to go up? Unequivocally, this bit of advertising is a reflection of somebody's poor sense of insight and civility.

Anyone who has worked in healthcare can vouch that male nurses are much-needed employees. Most healthcare facilities throughout the country are doing their best to be inclusive and diversified in their hiring practices, because evidence has shown this produces the best results and outcomes for patients. Yet, Cheshire Regional Rehabilitation Center is doing just the opposite, in the guise of a marketing strategy, hoping to ultimately increase their bottom line.

To everybody out there: male nurses are not the kind of person depicted in this billboard! Just like our female counterparts, male nurses care for our patients because we care for our patients. Anything short of that is not nursing. We are professionals who care for our patients because that's our calling and our commitment. Someday, we hope that society will begin to depict us that way.

  • To see the insulting billboard that sparked this blog post, click here.
Will We Ever Get Past the Term “Male Nurse?”
July 13, 2016 3:53 PM by Michael Madrid

Unbelievable! As far as the healthcare industry has come, as far as the nursing profession has come, and as far as we as human beings have come-and still, here I was, in shock and disbelief as I drove by   Cheshire Regional Rehabilitation Center's latest billboard, which is located near Exit 25 on I-84 East in Waterbury, CT.  It poses the question, "Who's Caring for Your Mom?"

This organization's marketing approach is questionable, archaic, and offensive, not only to male nurses, but to the nursing profession as a whole. This advertisement negatively portrays male nurses as being predatory, incompetent, and having no place in this organization's portrayal of good care.

The billboard can be added to our culture's growing list of negative depictions of men who are nurses. Another example can be found in the 2001 romantic comedy, "Meet the Parents." In the film, Chicago nurse Greg Focker faces off with prospective father-in-law-from-hell Jack Byrnes in an old-fashioned attempt to win his blessing for a marriage proposal to his daughter Pam. Throughout the film, Greg is continually insulted and bullied by the father, who takes potshots at his career choice by making condescending challenges to his intellect and manhood.  Thank you, Hollywood, for yet another negative image of male nurses!

I thought as a society we were past all this. In the rest of the United States, men are being welcomed with open arms, encouraged and supported to join the profession to help remedy a troubled American economy (as well as the much-publicized shortage of nurses).

Men enter the nursing profession for the same reasons as women: they want to care for people who need help; they like the complexity of the occupation; they appreciate the job security the nursing profession offers; and they are drawn to the possibility of earning a good income.

Men have become a staple in every nursing area, department and specialty. But then I drove by that billboard. Just think: I almost thought we were past the days of calling someone a "male nurse." Is there anyone still using the term "female doctor" anymore?

  • To see the insulting billboard that sparked this blog post, click here.